Meddling with breathing is fraught with perils

Breathing comes as naturally to living creatures as ocean tides come to Mother Nature.

Breathing is fundamental to life, a critical component of the body’s autonomic nervous system (ANS) that regulates involuntary bodily functions, such as heart and respiratory rates, digestion, temperature control and blood pressure.

Because the ANS operates largely unconsciously, most people don’t spend much time thinking about breathing, but, in their eternal quest for health and wellness in body and mind, many have sought ways to manipulate and control it.

They have exerted some control of breathing to achieve specific, positive benefits. Along the way, they prove the adage that like all good things in life, too much can be bad. And that meddling with Mother Nature’s treasures is fraught with perils for the unwary.

In a worst-case scenario, the negative effects of tampering with breathing include premature death.

One well-known, ancient example of breathwork is yogic breathing, known as pranayama. Benefits include improved lung, heart and immune function, reduced stress and better sleep and mood.

Responsible teachers say that pranayama is not risk free. Reported side effects of incorrect, unsupervised or excessive pranayama can include dizziness, anxiety, physical discomfort and raised blood pressure.

A more modern popular system of breathing exercises is plagued with reports of associated hazards, including claims of multiple worst-case scenario fatalities.

The Wim Hof method (WHM) is the eponymous brainchild of Dutch extreme athlete Wim Hof. Its popularity has grown rapidly in the US and Europe and more recently in SA. There is one accredited instructor who appears on Hof’s official website — Lauren Hudson in the Western Cape.

Fans globally include celebrities and elite athletes.

Hof, also known as “The Iceman”, has gained international recognition — and 26 Guinness World Records — for extraordinary feats, including climbing Mount Kilimanjaro in shorts, running a half marathon barefoot in the arctic, swimming under ice for extended distances and enduring extreme cold for prolonged periods.

He credits his capabilities with the WHM. He may also have “various physiological abnormalities that [he] has displayed both in life and in a research setting”, as one writer put it.

Hof acknowledges that his method shares pranayama basics, with notable differences under his three foundational “pillars”:

• Controlled hyperventilation — rapid in-breathing through the nose, relaxed outbreathing through the mouth and breath-holding.
• Cold exposure or “cold therapy” of various forms. Celebrities and athletes have used enclosed cold-air chambers. Hof encourages simpler, cheaper methods, such as ice baths and cold showers, or walking or running in icy weather wearing minimal clothing;
• Commitment — a focused, dedicated mindset covering mental aspects and meditation for mastering his method.

Benefits that Hof promises are legion. These include increased energy, reduced stress and an “augmented immune response that swiftly deals with pathogens”. He references scientific studies in support of claims. Hof has collaborated with researchers to study his method’s physiological effects. 

He is messianic about cold exposure and calls the cold “your warm friend”. Proper exposure to the cold starts a “cascade of health benefits”, Hof says. These include the build-up of “brown adipose tissue and resultant fat loss”.

He may have a scientific point, there.

Adipose tissue is the medical profession’s euphemism for excess fat. Brown fat build-up plays a crucial role in regulating metabolism by burning calories to generate heat. Hence the fat-loss potential to which Hof refers. 

Consistent practice is key, but Hof says that even a single breathing session charges users’ muscles with “enough oxygen to double the number of push-ups [they] can do”. Just one minute spent under ice-cold water can give an energy “jolt” to make them “feel like the Hulk for the rest of the day”.

Supporters of his method report benefits limited only by the imagination. On the website, one fan has reversed all symptoms of autoimmune disease psoriatic arthritis without resorting to pharmaceutical drugs. Another said that the WHM had given him “superpowers”.

Hof promotes safety protocols prominently on the website and in training courses. He warns strongly against performing the breathing exercises in water and recommends that users consult medical professionals before starting his method.

He is also generous with his intellectual property. Hof gives much of it away for free on social media and platforms such as YouTube. He says nothing on his website about his legal woes.

In the most notable case in 2022 in the US, the lawyer father of teenager Madelyn Rose Metzger, 17, filed a $67m lawsuit against Hof. The lawsuit alleged that Hof’s breathing techniques contributed to her death by drowning in the family’s swimming pool in December 2022.

In a response from Hof’s organisation, InnerFire, his son and CEO, Enahm Hof, publicly declared the family’s “shock” at the lawsuit, denied any wrongdoing and called the teenager’s death a “terrible tragedy”.

A California court ruled in Hof’s favour in July 2024. The teenager’s father is appealing the decision.

Of course, Hof may be just another victim of a highly litigious environment in the US, where the risk of lawsuits is significant.

However, at least three other fatalities were reported in 2023, due to similar circumstances involving loss of consciousness during practice of Hof’s method. US investigative journalist Scott Carney, once one of Hof’s most vocal supporters, claims to have documented 31 deaths linked to the WHM over a decade.

Experts argue that Hof’s warnings on his website and in training may not be sufficiently prominent or clear. They said that the practical application of these warnings was often inconsistent with how Hof demonstrates the method in videos. They point to a potential disconnect between Hof’s safety messaging and actual practices shown in promotional materials. 

In other words, they said that Hof sometimes dishes out advice based on a “do as I say; don’t do as I do” principle.

In a YouTube video in 2021, for example, Hof is seen hyperventilating and then plunging his head under icy water and holding his breath.

Dr Mike Tipton, professor of human and applied physiology at the University of Portsmouth in the UK, has described Hof’s action as “the most dangerous thing you can do when you go into cold water”.

Tipton has cautioned that cold water immersion, a key component of Hof’s method, may not be safe for people with certain medical conditions, including asthma and heart disease. He has warned that research in favour of the WHM is often inadequate and biased, making it difficult to draw definitive conclusions about effectiveness.

Dr Frank Pernett, a pulmonologist at Mid Sweden University, has also expressed serious concerns about the WHM, particularly when practised underwater because of this risk. He has warned that combining hyperventilation with water can significantly lower carbon dioxide levels in the blood and delay the brain’s signal to breathe.

Remove that signal and you “gamble with your life”, Pernett has said.

Hudson is aware of safety concerns still swirling around Hof’s method but attributes these mostly to “misunderstandings”.

She called his method “a way of life”, “life-changing” and a “superhighway” to profoundly positive changes in body and mind.

Hof’s training and course manuals are specific and “clear about safety precautions”, she said. There are important safety implications in the WHM method, but practitioners need to know that “they cannot and should not do this type of breathing in water”.

Hudson is always “explicit” about safety precautions when conducting training courses. She regularly emphasises that “WHM breathing and water don’t mix”.

“Breathing, as part of the WHM, should only be done lying flat on your back, somewhere safe,” Hudson said. “That’s it. Not when driving a car, not in a body of water, not when operating heavy machinery.” 

She came across Hof’s method while living in Hamburg, Germany, in 2019 and was instantly smitten with its “beauty and simplicity”. After personally experiencing significant benefits, Hudson qualified in the WHM in 2022. 

Hudson runs innovative Fundamentals training courses and individual breathing sessions in Hof’s method at the Fjord Plunge facility on the Lourensford wine farm in the Helderberg Mountains outside Somerset West. She is also a personal chef and makes vegetarian and vegan food for participants, who range in ages, with the oldest 75. She won’t accept anyone under 18.

 “The most profound form of healing happens at the energy and nervous system levels,” Hudson said. “The safer and more stabilised our nervous system is, the more we are able to integrate, release, heal and expand.”