Whole-body hyperthermia treatment Introduction For over two thousand years, the idea of increasing the body’s temperature has been associated with healing, preventative, and cleansing properties. Fever is the body’s natural defence system that raises its temperature above normal in an attempt to destroy invading organisms and sweat impurities out of the system. For centuries, sauna has been used to create the same effect. Sauna is also used to boost metabolism, as when pulse rates increase, blood vessels become much more flexible, extremities benefit from increased circulation and toxins are excreted through sweat and on the breath. Increasing the body’s temperature helps the body's immune system to fight infection. It is well known that in a number of infectious illnesses the body temperature rises. This is partly because substances called pyrogens, released from the tissues, alter the temperature control mechanisms of the body and set the thermostats at a higher level. This automatic control of body temperature can be overridden by using external heat supplies to increase the body temperature. Whenever the temperature of the body is caused to rise, then metabolism and secretion are accelerated. Breakspear’s IRATHERM® whole-body hyperthermia bed not only raises body surface temperature, as does a sauna, but also raises body core temperature, which can have a major therapeutic effect. Using the hyperthermia infrared-A bed at Breakspear, we have a means by which the whole body can be heated, which can cause the core temperature of the body to be raised by several degrees centigrade. Most other forms of heat therapy raise the core temperature by only tenths of a degree. It is clear that using infrared-A as a source of heat is much more effective than conventional means. The IRATHERM® was developed by the German-based Von Ardenne Institute of Applied Medical Research. For over forty years, Von Ardenne has been undertaking research, development and application of systems for warming up the whole body. Breakspear is the first facility in the United Kingdom to offer this method of treatment. How the IRATHERM®1000 works Using the IRATHERM®1000, the whole body can be heated from a water-filtered infrared-A source. The IRATHERM® reproduces the equivalent part of infrared sun radiation, which is filtered through the water-containing atmosphere. Infrared-A radiation can be called “deep-acting heat”, whereas infrared-B and infrared-C are only surface heat. Water is the obvious choice of filter to eliminate infrared-B and infrared-C radiation, because water, like skin, has a selective transmission of infrared radiation. Water allows infraredA to be transmitted, while infrared-B and infrared-C are almost completely absorbed. With the IRATHERM®, when a water filter is placed in front of the halogen lamps, the result is heat radiation with a spectral distribution nearly equal to the spectral transmission of the skin. Prepared and approved by the medical team © Breakspear Medical Group Ltd, 2011 Breakspear Medical Group Ltd. Registered in England 2035350 Registered office: Hertfordshire House, Wood Lane, Hemel Hempstead, Hertfordshire HP2 4FD UK 1/9 2/9 Using the IRATHERM® means that because the infrared light is filtered through water, the individual will be exposed only to infrared-A frequencies. Once the heat penetrates the skin, to where the blood circulates readily and freely, there is a rapid distribution of warmth to the whole of the body. This causes the core temperature of the body to be raised by several degrees centigrade. Hyperthermia deliberately creates a temporary fever in the patient in order to utilise this natural healing process. Who can be helped by hyperthermia? Mild and moderate whole-body hyperthermia, to which the body has a high tolerance, is able to increase micro-circulation, speeding up the metabolism in a similar way to natural pyrexia (fever). Because heating is encouraged, there is a wide spectrum of treatment indications: • • • • • • • • • • huge increase in metabolic rate fat mobilisation stimulation of the hormone system stimulation of the immune system enhancement of the body’s natural detoxification pathways such as respiratory, renal (kidneys), gastrointestinal and cutaneous (via the skin) reduction of chronic inflammation acceleration of nerve conduction increased perfusion in organs and tissues increased supply of oxygen and nutrients to cells elimination of end-products of metabolism IRATHERM® can help: • • • • • • • • • • • • • • • • • • • • arterial hypertension allergy rheumatic diseases muscle tension multiple chemical sensitivity chronic back pain eczema fibromyalgia syndrome heavy metal intoxication neuralgia migraine effects of ageing chronic rhinitis bronchial asthma excess body weight seasonal affective disorder (a depressive disorder, which can occur in the winter) sports injuries illnesses caused by exposure to pollutants such as pesticides chronic viral illnesses muscle spasm Prepared and approved by the medical team whole-body hyperthermia treatment 141211 Breakspear Medical Group Ltd. Registered in England 2035350 Registered office: Hertfordshire House, Wood Lane, Hemel Hempstead, Hertfordshire HP2 4FD 3/9 10 steps of hyperthermia treatment 1 The patient has an initial consultation and full medical examination. The patient can then book an appointment by contacting Reception. 2 On the day of the treatment, the patient should drink plenty of water and eat only light meals. It is very important to be properly hydrated. 3 Prior to the treatment, a consent form is completed by the patient and the patient’s height and weight will be measured and recorded by staff. The maximum net load is 135kg (298 pounds/21 stone 4 pounds). 4 After the consent form has been completed and the patient details have been taken, an attendant will accompany the patient to the treatment centre. The patient undresses in the private changing room, removing all jewellery including body piercings, and then walks to the IRATHERM® room in a provided robe. 5 The patient’s data, which determine the customised programme, are then entered into the IRATHERM®1000 computer by trained operating personnel. Any scars or tattoos on the back surface of the patient’s body are covered with gauze to protect against overheating. The attendant then switches on the IRATHERM® with low power to warm the bed before the patient lies down. 6 The attendant leaves the room and the individual then lies on the IRATHERM® bed which is made of net, like a hammock, suspended over the source of heat. (The nets are replaced between patients.) The patient then covers him/herself with a towel. The head and heels are supported on a small pillow and/or folded towels. 7 The attendant returns, ensures the patient is comfortable and covers him/her with a clean heat-retaining blanket. The monitoring sensors are put in place and the IRATHERM® is switched on at the recommended power setting. The uncovered head is not exposed to the heat source, therefore the patient’s eyes are not stressed. 8 During treatment the patient is asked to tell the attendant of any discomfort and the heat to any area can be adjusted, if required. Filtered drinking water is available at all times. 9 At the end of the treatment session, the patient cools down and rests on the net for a few minutes, then puts on a robe to sit and cool down for a further 15 – 20 minutes. When the patient is feeling ready and sufficient time has passed, he/she returns to the changing room to have a shower with provided unscented toiletries and towels, and to dress. 10 Supplemental intravenous drips are often recommended after IRATHERM® treatment to replenish essential nutrients. Patients should not exert themselves or drive for 1 hour after treatment. The computer-recorded vitals record is printed out and filed in the patient’s medical records. Prepared and approved by the medical team whole-body hyperthermia treatment 141211 Breakspear Medical Group Ltd. Registered in England 2035350 Registered office: Hertfordshire House, Wood Lane, Hemel Hempstead, Hertfordshire HP2 4FD 4/9 What to expect Working towards getting rid of years of built-up pollutants, viruses, bacteria and other invading organisms from the body is not an easy, quick procedure. We have asked patients who have used the IRATHERM® for feedback to help others prepare for the experience. Our data show that most patients’ impressions of the procedure were good. It is normal to experience sweating at any setting of the IRATHERM®. At moderate to fever-range temperatures, thermoregulatory stress may occur. Most patients have stated that the heat feels very intense and some have mentioned that at times this intense heat was uncomfortable. Be sure to let the attendant know if you are uncomfortable, so that the heat level can be adjusted. Some patients felt rejuvenated and refreshed after their sessions. Many patients reported feeling very tired after the experience and a few felt worse later. This after-effect is normal; you have started a detoxification process and the harmful pollutants are being forcefully expelled from your body. If your after-experience is very uncomfortable, please speak to your doctor before your next treatment session. The most important thing to remember is that IRATHERM® sessions are an intense, accelerated method of detoxifying the body by rapidly releasing toxins stored in fat cells. Many patients may not feel the benefits immediately. Therapy programmes (such as 9 therapies within 3 weeks) show more generalised effects than single therapies. Studies have proven that this method of treatment is beneficial (see section “Studies on the effects of hyperthermia on health”) . The first few visits are just small steps in a life-altering treatment programme. Patients’ IRATHERM® experiences “I realised how important it was to keep hydrated afterwards when my eyes felt dry.” “When I had completed my first session, it was like after a hard gym workout. I felt exhausted and my legs felt like noodles but at the same time I felt elated and high all evening.” “I feel much fresher and confident of further improvements in energy levels.” “The heat didn’t seem too bad except near the end of the 100% section. But as the heat was reduced, I returned to normal quickly.” “It's like exercise; not very pleasant while you’re doing it but good for you in the long term.” “The first and second treatments were the worst. After 3 treatments, I started improving and after 6, I was much better than I had been in over a year…” Prepared and approved by the medical team whole-body hyperthermia treatment 141211 Breakspear Medical Group Ltd. Registered in England 2035350 Registered office: Hertfordshire House, Wood Lane, Hemel Hempstead, Hertfordshire HP2 4FD 5/9 Studies on the effects of hyperthermia on health One well known standardised detoxification programme, which uses sauna to raise the body temperature, is the Hubbard Sauna Detoxification Regimen.1 This protocol was used to improve the health status of New York’s 9/11 rescue workers exposed to various toxicants, such as PCBs, various drugs and pesticides. The protocol was specifically developed to mobilise fatstored toxins and enhance their elimination while restoring metabolic balance. For the protocol to accomplish any significant body burden reduction, all detoxification pathways must be exploited. Therefore, it states that along with raising body temperature, it is necessary to use nutritional supplementation, primarily using regulated graduated doses of niacin and other cofactors and micronutrients, which will further promote mobilisation of stored toxicants and stimulate circulation. In an article published in 2006,2 which was explaining a hypothesis for the “Lance Armstrong Effect” (how a man diagnosed with very advanced testicular cancer could be treated successfully to go on to win multiple Tours de France), it was explained that studies show clearly that cancer cells are very sensitive to the effect of heat. Cancer cells are killed much more easily when cultured over 42°C, compared with normal cells. However, this effect is variable across different types of cancer cells and is being studied with great interest in order to improve therapeutic effects of chemotherapy and radiotherapy. There are many studies on the effects of heat on immunity. The antigenicity of molecules is often increased with temperature by unfolding the protein. Heat also stimulates the immune response through heat-induced immune cell functions and the transfer of the immune cells to infected sites. The response of all cells to heat stress initiates the synthesis, distribution and function of a family of proteins termed “heat shock proteins.” These proteins are involved in a wide variety of cellular functions and defences, including dynamic protein folding, chaperoning functions, and transport throughout the cell. It is likely to be within this area of chemistry that part of the benefits of hyperthermia is conveyed when using IRATHERM®. In another paper,3 studying the effect of a course of treatment with hyperthermia on fibromyalgia, patients were randomly allocated to receiving whole-body hyperthermia where core body temperature was raised to 38.1°C, twice per week over 3 weeks. Significant changes were seen in those receiving hyperthermia treatment, with a reduction in sensory and affective pain; 20% of the participants reported side effects from the hyperthermia which went away completely within 30 minutes. This is the first randomised controlled clinical trial to demonstrate the benefit of hyperthermia. All previous articles were from uncontrolled studies or small, non-randomised trials on a single application of heat. In a small study4 of how hyperthermia can affect the endocrine and immune system, levels of cortisol, adrenocorticotrophic hormone (ACTH), growth hormone (GH) and populations of white cells were measured before, during and after sessions of hyperthermia. All patients tested had increased levels of lymphocytes, neutrophils and total white blood counts during the treatment. The increased levels reduced after 4 days (and were not measured after that). All patients also had a rise in cortisol, ACTH, GH and most importantly, increases in the partial pressures of oxygen in circulation were seen, together with an increase in the pH (alkalinity) of the blood. The authors also measured populations of the lymphocyte cells, which showed increases in CD56, CD57, CD4 and CD8. At Breakspear, we have measured many immune parameters, including CD57 and total lymphocyte counts which are often rather low. Therefore it may be of benefit, at least in the short term whilst the treatment course is ongoing, for patients with low immune markers to have IRATHERM® treatment. Fourteen firemen exposed to polychlorinated biphenyls (PCBs) and their byproducts generated in a transformer fire and explosion had neurophysiological and neuropsychological tests six months Prepared and approved by the medical team whole-body hyperthermia treatment 141211 Breakspear Medical Group Ltd. Registered in England 2035350 Registered office: Hertfordshire House, Wood Lane, Hemel Hempstead, Hertfordshire HP2 4FD 6/9 after the fire.5 They were re-studied six weeks later after undergoing two to three weeks of an experimental detoxification program consisting of medically supervised diet, exercise, and sauna. Retesting following the detoxification program showed significantly improved scores on: three memory tests, block design, trails B, and embedded figures. Thus, there was significant reversibility of impairment after the detoxification interval. __________ 1. Kerr K. Reducing body burdens using sauna methods of detoxification: a summary of methods and nd results from the World Trade Center Rescue Workers Cohort. Proceedings of the 42 Annual Meeting of the American Academy of Environmental Medicine; 2007 November; Palm Springs, CA. 2. Coffey DS, Getzenberg RH, DeWeese TL. Hyperthermic biology and cancer therapies: a hypothesis for the "Lance Armstrong effect". JAMA. 2006;296:445-8. 3. Brockow T, Wagner A, Franke A, Offenbächer M, Resch KL. A randomized controlled trial on the effectiveness of mild water-filtered near infrared whole-body hyperthermia as an adjunct to a standard multimodal rehabilitation in the treatment of fibromyalgia. Clin J Pain. 2007;23:67-75. 4. Tomiyama-Miyaji C, Watanabe M, Ohishi T, Kanda Y, Kainuma E, Bakir HY, et al. Modulation of the endocrine and immune systems by well-controlled hyperthermia equipment. Biomed Res. 2007;28:11925. 5. Kilburn KH, Warsaw RH, Shields MG. Neurobehavioral dysfunction in firemen exposed to polychlorinated biphenyls (PCBs): possible improvement after detoxification. Arch Environ Health. 1989;4:345-50. Prepared and approved by the medical team whole-body hyperthermia treatment 141211 Breakspear Medical Group Ltd. Registered in England 2035350 Registered office: Hertfordshire House, Wood Lane, Hemel Hempstead, Hertfordshire HP2 4FD 7/9 Summary At Breakspear, we offer treatments using various types of medical equipment which add to our doctors’ armoury of possible therapies for a wide variety of conditions. We have been advocating sauna therapy for years because increasing the body’s temperature has been proven effective in detoxification programmes. The IRATHERM® bed is a new and exceptional way of raising the body’s temperature to levels that traditional sauna just cannot provide. For more information on the benefits of hyperthermia treatment, please refer to the “References and further reading” section. Upon request, we can provide further information about how hyperthermia affects: • • • • • • • • • • • • • the human body the immune system the skin renal excretion environmental toxins and drug residues endocrine hormones evaluation of mercury and metal toxicity percutaneous absorption of metals and drugs detoxification of chemicals healing of wounds activation of supplements enzyme activity thermal regulation Feel free to discuss any thoughts or concerns with your doctor, especially if you have conditions such as heart problems, Type 1 diabetes, acute infections or are pregnant. After your IRATHERM® experience, please complete an IRATHERM® Patient Questionnaire. We appreciate receiving feedback and will consider all comments and recommendations. We hope this booklet has helped explain the treatment and procedures to you. We anticipate you will enjoy the benefits of your state-of-the-art IRATHERM® experience. Prepared and approved by the medical team whole-body hyperthermia treatment 141211 Breakspear Medical Group Ltd. Registered in England 2035350 Registered office: Hertfordshire House, Wood Lane, Hemel Hempstead, Hertfordshire HP2 4FD 8/9 References and further reading Adachi H, Katsuno M, Waza M, Minamiyama M, Tanaka F, Sobue G. Heat shock proteins in neurodegenerative diseases: pathogenic roles and therapeutic implications. Int J Hyperthermia. 2009;8:647-54. Biro S, Masuda A, Kihara T, Tei C. Clinical implications of thermal therapy in lifestyle-related diseases. Exp Biol Med (Maywood). 2003;228:1245-9. Capitano M, Mace T, Nemeth M, McCarthy P, Reparsky EA. A novel strategy for improving neutrophil recovery following total body irradiation. Soc for Thermal Med Joint Annual Meeting; 2010 April; Clearwater Beach, FL. Capitano ML, Ertel BR, Repasky EA, Ostberg JR. Fever-range whole body hyperthermia prevents the onset of type 1 diabetes in non-obese diabetic mice. Int J Hyperthermia. 2008;2:141-9. Fisher DT, Vardam TD, Muhitch JB. Fine-tuning immune surveillance by fever-range thermal stress. Immunol Res. 2010;1-3:177-88. Hagiwara S, Iwasaka H, Shingu C, Matsumoto S, Hasegawa A, Asai N, et al. Heat shock protein 72 protects insulin-secreting beta cells from lipopolysaccharide-induced endoplasmic reticulum stress. Int J Hyperthermia. 2009;8:626-33. Heckel M. [Whole-body hyperthermia and fever therapy.] Stuttgart: Hippokrates; 1990. Hoffmann G. [Therapy with water-filtered infrared-A heat radiation.] Dtsch Arztebl. 2002;99:A579. Kerr K. Reducing body burdens using sauna methods of detoxification: a summary of methods and results from the World Trade Center Rescue Workers Cohort. Proceedings of the 42nd Annual Meeting of the American Academy of Environmental Medicine; 2007 November; Palm Springs, CA. Kihara T, Biro S, Ikeda Y, Fukudome T, Shinsato T, Masuda A, et al. Effects of repeated sauna treatment on ventricular arrhythmias in patients with chronic heart failure. Circ J. 2004;68:1146-51. Kurz A. Local and systemic hyperthermia in surgical patients. Soc for Thermal Med Joint Annual Meeting; 2007 May; Washington, DC. Lee C, Repasky EA. Fever-range thermal stress suppresses inflammatory cytokine production in LPSactivated peritoneal macrophages. Soc for Thermal Med Joint Annual Meeting; 2007 May; Washington, DC. Lee CT, Repasky EA. Temperature flips On/Off switch for macrophage activation during inflammation. Soc for Thermal Med Joint Annual Meeting; 2010 April; Clearwater Beach, FL. Mace TA, Zhong L, Kilpatrick C, Zynda E, Lee C-T, Capitano H, et al. Differentiation of CD8+ T cells into effector cells is enhanced by physiological range hyperthermia. J Leukoc Biol. 2011. [published online] Masuda A, Koga Y, Hattanmaru M, Minagoe S, Tei C. The effects of repeated thermal therapy for patients with chronic pain. Psychother Psychosom. 2005;74:288-94. Masuda A, Miyata M, Kihara T, Minagoe S, Tei C. Repeated sauna therapy reduces urinary 8-epiprostaglandin F(2alpha). Jpn Heart J. 2004;45:297-303. Masuda A, Munemoto T, Tei C. [A new treatment: thermal therapy for chronic fatigue syndrome]. Nihon Rinsho. 2007;65:1093-8. Matsushita K, Masuda A, Tei C. Efficacy of Waon therapy for fibromyalgia. Intern Med. 2008;47:14736. Prepared and approved by the medical team whole-body hyperthermia treatment 141211 Breakspear Medical Group Ltd. Registered in England 2035350 Registered office: Hertfordshire House, Wood Lane, Hemel Hempstead, Hertfordshire HP2 4FD 9/9 Meffert B, Hochmuth O, Steiner M, Scherf H-P, Meffert H. Effects of a multiple mild infra-red-A induced hyperthermia on central and peripheral pulse waves in hypertensive patients. Med Biol Eng Comput. 1991;29:NS45-8. Meffert H, Müller GM, Scherf H-P. [Mild infrared-A hyperthermia for the treatment of rheumatic diseases: sustained decrease in activity of polymorpho-nuclear leucocytes.] Int Sauna Arch. 1993;4:125-31. Meffert H, Scherf H-P, Meffert B. [Mild infrared-A hyperthermia: effects of serial irradiation on healthy people and patients suffering from hypertension and systemic scleroderma.] Aktuelle Derm. 1993;19:142-8. Mischke M. [Effects of single and a series of infrared-A hyperthermia in patients with arterial hypertension of WHO stage I and II.] [Dissertation] Berlin: Humboldt-Universität; 1991. Multhoff G. Hyperthermia classic commentary: Activation of natural killer (NK) cells by heat shock protein 70, Gabriele Multhoff, Int J Hyperthermia. 2002;18:576-85. Int J Hyperthermia. 2009;3:176-9. Obst H, Hecht H-C, Schuhmann E, Schlittermann H, Steinhausen D. [Total-body hyperthermia to 42ºC with water-filtered IR radiation.] Proceedings of the 24th Scientific Conference of the German Association for Medical Physics; 1993 October; Erlangen, Germany. Scherf H-P, Meffert H, Bäumler H, Dittmann K, Siewert H, Strangfeld D, et al. [Effects of a single mild infrared-A hyperthermia on body temperature, heart rate, blood pressure and blood viscosity in healthy people and hypertensive patients in WHO stage I and II.] Dermatol Monatsschr. 1989;175:733-40. Scherf H-P, Meffert H, Mischke M, Schollak K-P. [Physical therapy of arterial hypertension: a single mild infrared-A hyperthermia allows predictions concerning results of further therapies.] Phys Rehab Kur Med. 1991;1:38-40. Schleenbecker HG, Schmidt KL. [Effects of an iterative mild whole-body hyperthermia on pain in fibromyalgia.] Phys Rehab Kur Med. 1998;8:113-7. Schmidt KL. [Hyperthermia and fever.] Stuttgart: Hippokrates; 1987. Schnare DW, Ben M, Shields M. Body burden reductions of PCBs, PBBs and chlorinated pesticides in human subjects. Ambio. 1984;13:378-80. Takahashi KA, Tonomura H, Arai Y, Terauchi R, Honjo K, Hiraoka N, et al. Hyperthermia for the treatment of articular cartilage with osteoarthritis. Int J Hyperthermia. 2009;8:661-7. Tarner IH, Ladner UM, Uhlemann C, Lange U. The effect of mild whole-body hyperthermia on systemic levels of TNF-alpha, IL-1 beta and IL-6 in patients with ankylosing spondylitis. Clin Rheumatol. 2009;4:397-402. Wehner H, von Ardenne A, Kaltofen S. [Whole-body hyperthermia with water-filtered infrared radiation: technical-physical aspects and clinical experiences.] Int J Hyperthermia. 2001;17:19-30. Prepared and approved by the medical team whole-body hyperthermia treatment 141211 Breakspear Medical Group Ltd. Registered in England 2035350 Registered office: Hertfordshire House, Wood Lane, Hemel Hempstead, Hertfordshire HP2 4FD
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