Sauna science, opened up
Big questions.
Room for doubt.
Heat clearly changes how the body responds. Its long-term health benefits are harder to pin down. Cold water can ease soreness, but recovery comes with trade-offs. Here’s what the research can tell us so far.
56 studies · 34 claims · Original sources linked
The research, in perspective
A few useful findings to start with. Open one to see what it means, what is uncertain, and the research behind it.
This is a reason to keep investigating sauna and heart health. It is not a way to calculate your own benefit, or a reason to aim for more sessions.
People chose their own sauna habits. Other differences in their lives could help explain the result. Several familiar sauna headlines also come from this same Finnish group, rather than independent confirmations.
Low certainty. Could well change. Treat it as a lead, not a fact.
KUUME’s editorial assessment · Reviewed 2026-09-27 · How we read research
Large effect. Sudden cardiac death 0.37 (0.18–0.75); heart-disease death in men and women 0.23 (0.08–0.65). Rates for 4–7 vs 1 session a week.
Size and certainty answer different questions. This describes the research result, not a prediction for you.
See the full claim and its context →Observational study · 2015
Sauna and heart health: what a 20-year study foundObservational study · 2018
Sauna and heart health: a study that included womenObservational study · 2020
Hot baths in Japan: a second country, a similar linkSystematic review · 2018
What 40 sauna studies can tell usFeeling less sore over the next few days is a useful outcome in its own right. It does not automatically mean better performance or bigger training gains.
Most trials were small and involved young, active men. People knew whether they were in cold water, which can influence how they rate soreness. Reviews share trials, so more reviews do not always mean more independent evidence.
Moderate certainty. Probably right. New research could still shift it.
KUUME’s editorial assessment · Reviewed 2026-09-27 · How we read research
Medium effect. Self-rated soreness: standardized difference −0.55 at 24 hours to −0.93 at 72 hours (Cochrane). A review of 9 trials called it slightly better than rest.
Size and certainty answer different questions. This describes the research result, not a prediction for you.
See the full claim and its context →Systematic review · 2012
Cold water after exercise: soreness, recovery and uncertaintySystematic review and meta-analysis · 2016
Cold water and soreness: does temperature or time matter?Systematic review and meta-analysis · 2022
Cold water after exercise: when the benefit shows upSystematic review and meta-analysis · 2023
Cold water compared with other recovery methodsSystematic review and meta-analysis · 2022
Cold water and recovery: timing changes the pictureSystematic review and meta-analysis · 2026
Cold water after soccer: recovery depends on the measureShort-term comfort and long-term adaptation are different goals. A recovery habit can help with one without helping the other.
This finding concerns repeated cold-water immersion alongside a training program. It does not show that one occasional dip undoes a workout. The strength findings should not be applied to endurance training.
Moderate certainty. Probably right. New research could still shift it.
KUUME’s editorial assessment · Reviewed 2026-09-27 · How we read research
Medium effect. Strength gains: standardized difference −0.60 (−0.87 to −0.33). Endurance gains: no difference (−0.07 and 0.00).
Size and certainty answer different questions. This describes the research result, not a prediction for you.
See the full claim and its context →Systematic review and meta-analysis · 2021
Cold water after strength training: smaller gainsRandomized controlled trial · 2026
Cold water after intervals: no clear change in training gainsAn immediate body response and a lasting health benefit answer different questions. We can be confident about the first while still investigating the second.
The lab experiment measured a short exposure in healthy young adults. It could not tell us whether repeated sauna sessions prevent illness or replace exercise.
High certainty. Well established. New research is unlikely to change the picture.
KUUME’s editorial assessment · Reviewed 2026-09-27 · How we read research
Large effect. Heart rate up to about 131 beats a minute; systolic blood pressure down about 16 mmHg during 30 minutes at 73°C.
Size and certainty answer different questions. This describes the research result, not a prediction for you.
See the full claim and its context →Laboratory experiment · 2012
What one 30-minute heat session did in the labNarrative review · 2018
What one research group’s sauna review can tell usNarrative review · 2021
Sauna and healthspan: what a review of the mechanisms suggestsExcretion is a real finding worth investigating. To establish a detox benefit, research also needs to measure lasting changes in body levels and health.
Collection methods and exposures vary. The historical worker mercury case combined chelation, sweating and physiotherapy. Several chemical-excretion papers reuse the same 20 volunteers, so they are not independent confirmations.
Low certainty. Could well change. Treat it as a lead, not a fact.
KUUME’s editorial assessment · Reviewed 2026-09-27 · How we read research
Size not reported. No single treatment effect to size. Concentration in a sweat sample is not the total amount removed or the change in body stores.
Size and certainty answer different questions. This describes the research result, not a prediction for you.
See the full claim and its context →Systematic review · 2012
Metals in sweat: what the older research foundRandomized-order crossover experiment · 2022
Running and sauna produced different metal concentrationsSingle-session sweat analysis · 2022
An infrared study found high metal concentrations in sweatA plausible explanation is a starting point for research. It does not tell us whether a treatment works, for whom, or how it compares with existing care.
This claim in our library rests on a theory paper with informal reports. It does not establish cold showers as a treatment for depression. Evidence about a brief mood change would answer a different question.
Not tested. Not tested yet: an idea without human data.
KUUME’s editorial assessment · Reviewed 2026-09-27 · How we read research
Size not reported. Nothing measured.
Size and certainty answer different questions. This describes the research result, not a prediction for you.
See the full claim and its context →A closer look
We keep two questions separate: how sure are we that it’s true, and if it is, how big is the effect?
A large effect can still be uncertain. Several papers can also come from the same group of people.
Further right means more certainty. Higher up means a larger effect, if it is real. Select a claim to read what supports it.
34 claims about heat and cold, scored
If it’s true, how big is the effect?Compared with not doing it, in the studies.
How sure are we that it’s true?Would better studies change the answer?
Grouped by how sure we are that each claim is true. The bars on each claim show how big the effect is, if it’s true.
High certainty
Well supported
Moderate certainty
Well supported
Low certainty
Some support
Very low certainty
Early signal
Not tested certainty
No evidence yet
Every claim
The same 34 claims as a list, grouped by what the evidence supports. Each one links to the studies behind it.
High or moderate certainty. What we would stand behind today.
Your heart rate rises and blood pressure dips in the sauna.
During 30 minutes at 73°C, heart rate climbed to about 131 beats a minute and blood pressure dipped. That the body responds this way is well established. Whether it adds up to the benefits of exercise is a separate question.
3 studies: What one 30-minute heat session did in the lab · What one research group’s sauna review can tell us · Sauna and healthspan: what a review of the mechanisms suggests
High certaintyLarge effectBody signals
Sudden cold water puts real strain on the body.
Sudden immersion in cold water sets off a gasp, fast breathing and heart strain within the first minutes. It is a known cause of drowning. It is the best-established finding about cold water in our library, which is why it comes with a safety note.
Safety: Go into cold water gradually, keep it short, and never swim alone in open water.
2 studies: Cold water immersion: hazard, treatment, or both? · Cold water and hormones: a one-hour lab experiment
High certaintyLarge effectIllness and death
Cold water triggers a surge of noradrenaline and dopamine.
Cold water sets off a strong fight-or-flight response: noradrenaline rose 2- to 5-fold and did not fade over 12 weeks of regular dips. The famous dopamine figure comes from ten men sitting in 14°C water for an hour, not a two-minute plunge, and mood was not measured.
2 studies: Cold water and hormones: a one-hour lab experiment · Cold exposure and stress hormones over 12 weeks
Moderate certaintyLarge effectBody signals
Cold water after exercise eases muscle soreness.
Across many small trials, people who got into cold water after hard exercise reported somewhat less soreness over the next days than people who rested. The trials could not be blinded, and the best temperature and time are not settled.
6 studies: Cold water after exercise: soreness, recovery and uncertainty · Cold water and soreness: does temperature or time matter? · Cold water after exercise: when the benefit shows up · Cold water compared with other recovery methods · Cold water and recovery: timing changes the picture · Cold water after soccer: recovery depends on the measure
Moderate certaintyMedium effectHow you feel or perform
Regular cold water after strength training holds back strength gains.
Regular cold water after lifting was linked to smaller strength gains in controlled training studies. Endurance is a separate question: a 2026 trial in 16 men found no clear change in interval-training gains. That trial adds context, not strength evidence.
2 studies: Cold water after strength training: smaller gains · Cold water after intervals: no clear change in training gains
Moderate certaintyMedium effectHow you feel or perform
Low certainty. A real lead, and could well change with better research.
Regular sauna means fewer deaths from heart disease.KIHD
In one long Finnish study, the people who used the sauna most often had fewer fatal heart events. They chose their own habits, so this is a link, not proof that sauna caused it.
4 studies: Sauna and heart health: what a 20-year study found · Sauna and heart health: a study that included women · Hot baths in Japan: a second country, a similar link · What 40 sauna studies can tell us
Low certaintyLarge effectIllness and death
Regular sauna means fewer strokes.KIHD
Strokes were less common among the most frequent sauna users in the Finnish study, and among people who took a hot bath almost daily in a large Japanese study. Two countries point the same way. Both are links, with habits asked once.
2 studies: Sauna and stroke: what a long Finnish study found · Hot baths in Japan: a second country, a similar link
Low certaintyLarge effectIllness and death
Regular sauna protects against dementia.KIHD
Dementia diagnoses were less common among the most frequent sauna users. These are the same Finnish men as the heart study, so it is not separate confirmation, and it shows a link, not prevention.
1 study: Sauna and brain health: a promising link, with limits
Low certaintyLarge effectIllness and death
Regular sauna means fewer respiratory diseases, like pneumonia.KIHD
Respiratory diseases, including pneumonia, were diagnosed less often among more frequent sauna users in the Finnish study, with a step-by-step pattern. Men only, one region, habits asked once.
1 study: Sauna and respiratory disease: what one long study found
Low certaintyMedium effectIllness and death
Heat switches on protective proteins in your cells.
Heat raised a cell-stress protein (HSP72) by about half on average in a small lab group, with huge differences between people. Whether that protects health has not been tested in people.
3 studies: What one 30-minute heat session did in the lab · Passive heat and exercise: a small look at post-meal blood sugar · Sauna and healthspan: what a review of the mechanisms suggests
Low certaintyMedium effectBody signals
Sauna after a workout adds to what training does.
In one Finnish trial, inactive adults who took a 15-minute sauna after each workout gained a little more fitness and had lower blood pressure after eight weeks than people who only exercised. One small trial, and the same people showed no extra gain in heart rate variability.
1 study: Sauna after a workout: what an eight-week trial added
Low certaintyMedium effectBody signals
Cold showers mean fewer sick days.
In a trial of 3,018 Dutch adults, ending a daily shower cold went with fewer self-reported days off sick. They were ill just as many days. People knew their group, so expectation may explain part of it.
2 studies: Cold showers and sick days: 3,000 people, one winter · Cold water and wellbeing: what the trials show so far
Low certaintyMedium effectIllness and death
Regular sauna helps you live longer.KIHD
Frequent sauna users died less often from any cause in the Finnish study. But in the same men, fitness was linked to a bigger difference than sauna was. Sauna is not a stand-in for being fit.
4 studies: Sauna and fitness: what a joint analysis found · Sauna and heart health: what a 20-year study found · Sauna and healthspan: what a review of the mechanisms suggests · What one research group’s sauna review can tell us
Low certaintySmall effectIllness and death
Cold water speeds up recovery of performance.
Recovery depends on timing and the activity. A 2026 soccer review found better strength recovery and some improvement in jumping, but no clear sprint benefit. All prediction intervals included no effect, so another setting could see little or no benefit.
4 studies: Cold water after exercise: when the benefit shows up · Cold water and recovery: timing changes the picture · Cold water compared with other recovery methods · Cold water after soccer: recovery depends on the measure
Low certaintySmall effectHow you feel or perform
A few weeks of regular heat lowers blood pressure.
The newer review found no clear blood-pressure change when all heating methods were pooled. Whole-body heating showed a possible benefit of about 4 mmHg, while local heating did not. Different methods and small trials make a general sauna claim uncertain.
4 studies: Regular heat: a newer review gives a more cautious answer · Heat and blood pressure: what 15 studies add up to · Sauna after a workout: what an eight-week trial added · Finnish sauna and heart patients: a trial that found no change
Low certaintySmall effectBody signals
Cold water makes you feel better.
Pooled trials found stress was lower 12 hours after cold water, but not at other times. Single trials reported better sleep and slightly better quality of life. The one trial that measured mood found no change.
2 studies: Cold water and wellbeing: what the trials show so far · Cold showers and sick days: 3,000 people, one winter
Low certaintySmall effectHow you feel or perform
Heat therapy helps people with heart failure.
In small, short, supervised trials, mostly in Japan, infrared heat therapy improved markers of heart strain and pumping in people with heart failure. A 2026 pilot with a mild sauna improved exercise capacity, but had no comparison group and the gains faded. Long-term effects are unknown.
3 studies: Heat therapy and heart failure: what small trials suggest · Sauna and heart failure: a small pilot in a common type · What 40 sauna studies can tell us
Low certaintySize not reportedBody signals
Sweat can carry arsenic, cadmium, lead and mercury out of the body.
Researchers have measured these elements in sweat, sometimes in substantial amounts in exposed workers. That supports an excretion route. How much ordinary sauna lowers body stores, or improves health, remains uncertain.
3 studies: Metals in sweat: what the older research found · Running and sauna produced different metal concentrations · An infrared study found high metal concentrations in sweat
Low certaintySize not reportedBody signals
Very low certainty. One small study, or a thin margin. A reason to keep looking.
Regular sauna protects against psychotic disorders.KIHD
Psychotic-disorder diagnoses were much less common among frequent sauna users in the Finnish study. It is one finding, never repeated, with a very wide range and a broad diagnosis category.
1 study: Sauna and psychosis: what one long Finnish study found
Very low certaintyLarge effectIllness and death
Heat can ease depression.
In one small trial, a single session of medical whole-body heating lowered depression scores compared with a sham, for six weeks. In a 2025 pilot, adding heat to talk therapy did no better than a sham. Both used clinical heating, not a sauna.
2 studies: Heat and mood: what a small clinical trial tested · Heat, talk therapy and depression: a pilot with a twist
Very low certaintyLarge effectHow you feel or perform
Regular sauna means fewer colds.
In a 1990 study of 50 people, the sauna group reported fewer colds, about half as many in the last three months. Colds lasted just as long once they started. Small, old, and people were not randomly assigned.
1 study: Sauna and common colds: what a small early trial found
Very low certaintyLarge effectIllness and death
Sauna raises growth hormone.
Two hours a day at 80°C for a week sent growth hormone up about 16-fold in 10 men, briefly. It was an extreme protocol with no control group, and five of seven women had a disrupted menstrual cycle. Not something to copy.
Safety: This protocol disrupted most of the women’s menstrual cycles. It is not something to copy.
1 study: A week of intensive sauna: what it did to hormone levels
Very low certaintyLarge effectBody signals
Regular sauna keeps blood pressure down over the years.KIHD
Frequent sauna users developed high blood pressure less often over 25 years in the Finnish study. The margin is thin: the uncertainty range reaches almost to no difference at all.
1 study: Sauna and blood pressure: what a 25-year study found
Very low certaintyMedium effectIllness and death
Cold plunges speed up your metabolism.
Ten days of mild cold, six hours a day, made existing brown fat more active in 17 lean adults. Winter swimmers showed a different pattern. Nobody has shown that a short plunge changes weight or metabolism.
2 studies: Cold acclimation and brown fat: what 10 days changed · Winter swimmers and brown fat: what a small study found
Very low certaintySize not reportedBody signals
Sweat can carry some plastic-related chemicals and flame retardants.
The BUS papers found BPA, phthalates, some PCBs and PBDEs in sweat. They reuse one small participant group. A different BPA patch study detected little. These findings concern particular chemicals and collection methods, not a demonstrated reduction in body stores.
5 studies: BPA appeared in sweat, including when blood tests missed it · Plastic-related chemicals were found in sweat · PCBs and PFAS gave different answers in sweat · Flame retardants appeared in sweat, but not urine · A different BPA test found very little in sweat
Very low certaintySize not reportedBody signals
A combined sauna, exercise and supplement program eases some Gulf War illness symptoms.
A pilot trial reported improvements in some symptom and mental-health scores; its physical-health summary remained uncertain. Sauna, exercise, niacin and supplements were given together. The study did not report pollutant clearance, so it cannot show that detoxification caused the improvements.
1 study: A combined program improved some Gulf War illness symptoms
Very low certaintySize not reportedHow you feel or perform
Daily sweating may help lower mercury levels after occupational exposure.
One thermometer worker recovered after chelation followed by sweating and physiotherapy. Serum, urine and sweat mercury reportedly normalized. This is a clinical lead, but the contribution of sweating cannot be separated from other treatment, exposure changes or time. It was not a miners trial.
2 studies: A mercury-exposed worker recovered after combined treatment · Metals in sweat: what the older research found
Very low certaintySize not reportedBody signals
Studies looked for an effect and did not find one.
Regular heat keeps blood vessels healthy.
An older review suggested better artery widening, but it included non-randomized studies. The newer review of randomized trials found no clear improvement in artery widening or stiffness. Small trials leave uncertainty; the broad claim is not supported by the current randomized evidence.
4 studies: Regular heat: a newer review gives a more cautious answer · Heat and blood pressure: what 15 studies add up to · Hot baths and blood vessels: a small controlled trial · Finnish sauna and heart patients: a trial that found no change
Low certaintyNo effect foundBody signals
Sauna and cold water raise testosterone.
Two small studies looked, and neither found a meaningful change in testosterone. Cortisol fell after the sauna-and-cold rounds.
2 studies: Sauna, cold water and testosterone: what one study found · A week of intensive sauna: what it did to hormone levels
Low certaintyNo effect foundBody signals
Heat helps control blood sugar.
The newer randomized-trial review found no clear overall improvement in fasting glucose or HbA1c. Earlier pooled diabetes studies were also inconclusive. Acute experiments measure a different question and do not establish better long-term control.
5 studies: Regular heat: a newer review gives a more cautious answer · Heat and type 2 diabetes: a hopeful title, a thin result · One infrared sauna session and blood sugar: no help · Passive heat and exercise: a small look at post-meal blood sugar · Heat therapy for diabetes: an early idea, not a treatment
Low certaintyNo effect foundBody signals
Sauna can stand in for exercise.KIHD
Heat raises your heart rate like light exercise, but that is where the likeness ends in our library. In the Finnish study, fitness was linked to a bigger difference than sauna, and a hot bath did not match cycling on blood sugar over the day.
3 studies: Sauna and fitness: what a joint analysis found · Passive heat and exercise: a small look at post-meal blood sugar · What one research group’s sauna review can tell us
Low certaintyNo effect foundIllness and death
Sweating efficiently removes PFHxS, PFOS and PFOA.
The BUS study found little or none of these three common PFAS in sweat, including in people with raised serum levels. This does not support efficient removal through sweat. One small study cannot settle every PFAS or every exposure setting.
Very low certaintyNo effect foundBody signals
Infrared sauna after a fire lowers urinary smoke-exposure markers.
A small randomized trial found lower average urinary PAH metabolites after sauna, but the range included no difference. The estimate is promising but inconclusive. These are smoke chemicals, not heavy metals, and lower urine concentrations do not establish total removal or better health.
Very low certaintyNo effect foundBody signals
An idea without human data. Nothing to score.
Cold showers can treat depression.
This comes from a theory paper. The idea is plausible on paper, but no clinical trial was done, so there is nothing to score yet.
1 study: Cold showers and mood: a hypothesis with no clinical trial
Not tested certaintySize not reportedNothing measured yet
Scores last reviewed 27 September 2026, from 56 studies.
One study, many headlines
Many of sauna’s biggest headlines come from the Kuopio Ischaemic Heart Disease study (KIHD): middle-aged adults in eastern Finland, asked once about their sauna habits and followed for 15 to 26 years, 1,600 to 2,300 people per analysis. Here are its findings side by side.
4 to 7 sauna sessions a week, compared with 1
79% fewerlikely 48% to 92%
Heart-disease death, men and women
77% fewerlikely 35% to 92%
66% fewerlikely 29% to 84%
63% fewerlikely 25% to 82%
62% fewerlikely 19% to 82%
High blood pressureCould also be no effect
47% fewerlikely 2% to 72%
4 or more sauna sessions a week, compared with 1 or fewer
41% fewerlikely 6% to 63%
PneumoniaCould also be no effect
37% fewerlikely 0% to 61%
Death from any cause, compared with men low on both sauna and fitness
Frequent sauna with low fitness
22% fewerlikely 4% to 36%
High fitness with little sauna
37% fewerlikely 26% to 46%
How to read it. Each bar shows how many fewer cases the frequent sauna users had than the comparison group. The outlined band is where the true figure likely sits (the 95% confidence interval). When the band reaches back to “no difference”, sauna may have made none. These are shares of the comparison group’s cases, not anyone’s personal odds. A large share of a rare illness is still few people.
Every bar points the same way, and every one comes from the same study. Nine results from one study are not nine confirmations. The finding needs other countries, other habits, other groups.
The bands for high blood pressure and pneumonia reach almost back to no difference. The bar is the headline; the width of the band is the honesty.
In the same men, being fit went with even fewer deaths than frequent sauna did. Sauna is no stand-in for exercise, and the people who did both did best.
| Outcome | Comparison | Fewer cases | Likely range | Rate ratio (95% CI) |
|---|---|---|---|---|
| Psychotic disorders | 4–7 vs 1 session a week | 79% fewer | 48% to 92% | 0.21 (0.08–0.52) |
| Heart-disease death, men and women | 4–7 vs 1 session a week | 77% fewer | 35% to 92% | 0.23 (0.08–0.65) |
| Dementia | 4–7 vs 1 session a week | 66% fewer | 29% to 84% | 0.34 (0.16–0.71) |
| Sudden cardiac death | 4–7 vs 1 session a week | 63% fewer | 25% to 82% | 0.37 (0.18–0.75) |
| Stroke | 4–7 vs 1 session a week | 62% fewer | 19% to 82% | 0.38 (0.18–0.81) |
| High blood pressure | 4–7 vs 1 session a week | 47% fewer | 2% to 72% | 0.53 (0.28–0.98) |
| Respiratory disease | 4+ vs 1 or fewer sessions a week | 41% fewer | 6% to 63% | 0.59 (0.37–0.94) |
| Pneumonia | 4+ vs 1 or fewer sessions a week | 37% fewer | 0% to 61% | 0.63 (0.39–1.00) |
| Death from any cause, frequent sauna with low fitness | vs men low on both sauna and fitness | 22% fewer | 4% to 36% | 0.78 (0.64–0.96) |
| Death from any cause, high fitness with little sauna | vs men low on both sauna and fitness | 37% fewer | 26% to 46% | 0.63 (0.54–0.74) |
Find a question that interests you. Every summary includes what the study found, its limits and the original source.
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56 articles
A systematic review brings together 40 studies of regular dry sauna bathing. The picture is promising, varied and still incomplete.
A Finnish study followed 2,315 men and found an association between more frequent sauna use and fewer fatal heart events. Here is what that finding can and cannot tell us.
A review found some evidence of less muscle soreness after cold-water immersion. Small trials and inconsistent methods leave practical questions open.
Researchers found a link between sauna habits and later dementia diagnoses in Finnish men. The study raises an interesting question; it does not establish prevention.
Cold water can be dangerous and, in some contexts, medically useful. This review from safety researchers weighs both sides and finds the evidence varies by claim.
In a trial of 3,018 Dutch adults, ending a daily shower with 30 to 90 seconds of cold went with fewer self-reported sick days from work. People were ill just as many days, and everyone knew their group.
The finding, the context, the limits. Every summary links to its original source.
These are KUUME’s editorial readings, not a medical review or a promise about a KUUME ritual.
How we score
We score claims, not single studies. A claim like “sauna means fewer heart deaths” can rest on several studies, and one study can feed several claims. Each claim gets two separate answers. Think of a weather forecast: how sure is it, and how much rain? A forecast can be sure of a drizzle, or unsure of a storm. That’s why we never merge the two into one score.
01
How likely is it that better studies would change the answer?
02
How much changed, compared with not doing it, in the people studied. A big effect can still be one we’re unsure of.
Effects are relative, in the people studied. “Less than half the rate” is not your personal odds, and not a drop of 50 percentage points.
Large effectLow certainty
One Finnish study, where people chose their own habits. A link, not proof that sauna caused it.
Some support
Large effectHigh certainty
Measured directly while people sat in the heat, each compared with themselves. It fits basic physiology.
Well supported
A change in a blood marker is not the same as living longer.
Hot baths, infrared therapy, a heating device and an hour in 14°C water are not your Tuesday sauna. We say which it was.
Eight claims lean on the same Finnish study. Eight results from one study are not eight confirmations, so we count groups of people, not papers.
Every score shows its steps, so anyone can see why a claim sits where it does, and argue with a step rather than with a star rating.
We adapted GRADE, the approach Cochrane and the World Health Organization use to rate evidence. Randomized trials start at high and observational studies start at low. A score goes down for small numbers, a single group of people, habits asked about only once, a different kind of heat or cold, or a range that reaches “no effect”. It goes up when the effect is large, or when more sauna goes with a steadily bigger effect.
Scores are an editorial reading by KUUME, not a medical review. Every score shows its steps, links every study and carries the date it was last reviewed. When we add a study, the claims it feeds are scored again, and the change is dated.