The 6 Surprising Benefits of Sweating You Need to Know

Sweating is commonly known as a means to lower body temperature during the hot summer. But do you know that sweating has health benefits?

Those benefits can lower the risk of dying from infections by countering the effects of hypertension, obesity, unwanted chemicals like xenobiotics,  and diabetes. All of them are illnesses that can increase the risk of dying from COVID-19.

The Skin

What Happens in Severe Burns?

The Skin Glands

The skin contains 3 to 4 million eccrine or sweat glands that maintain body temperature. The apoeccrine sweat glands are located in the axilla and secrete 10 times more sweat. 

Oil or sebaceous glands are found mostly in the face and scalp and the rest of the body. During exercise, the skin can produce 4 to 6 liters of sweat. An individual can sweat as much as 10 liters a day.

I. Sweat Removes Excess Cholesterol and Triglycerides

The oil glands secrete sebum. Sebum is made of triglycerides, cholesterol, and other fats. Too much sebum production can lead to acne.

Acne medication like isotretinoin (Accutane) can stop the secretion of sebum and make acne better. In exchange, there is a subsequent increase in the blood triglyceride and cholesterol levels, LDL, and lowers HDL, increasing the risk of heart disease.

The secretion of fat in the skin depends on the amount of fat you eat. Low-calorie intake deprivation decreases the sebum, and a high-fat diet increases the fat removal in the skin.

II. Sweat Secretes Cytokines

Cytokines are signaling proteins produced by the different body cells to send messages to other cells, like text messages. Cytokines participate in cell growth and immune protection.

Excess visceral or intraabdominal fat produces high amounts of inflammatory cytokines that can contribute to long-standing chronic conditions like insulin resistance,  metabolic syndrome, heart disease, mental problems, diabetes, and skin diseases psoriasis and osteoarthritis.

Some of these inflammatory cytokines, like the interleukins (IL-1α, IL-1β, IL-6, IL-8)  and tumor necrosis factor-alpha (TNF-α), are secreted sweat.

III. Sweat Contains Glucose

The amount of glucose in sweat reflects glucose levels. In the blood Currently, glucose sensors are being developed to monitor blood sugar even while exercising actively. In a diabetic person with a blood sugar of 260 mg/dl (milligrams/100 ml), the sweat glucose may be 10 mg/dl. That may not seem much, but during exercise, the skin can produce 4 to 6 liters of sweat per hour. That is about 400 to 600 mg of glucose!

IV. The Skin Can Remove Unwanted Reactive Oxygen Species

Reactive oxygen species (ROS) or free radicals play an essential role in many body processes, including skin repair and regeneration. On the opposite, ROS can also be involved in skin diseases like vitiligo, psoriasis, non-healing wounds, acne, allergic skin reactions, and skin aging.

Exposure to physical and chemical agents and ultraviolet light causes the ROS in the skin to produce damage.

V. The Antioxidant Systems

To have the right balance of ROS in the body, antioxidant or anti-ROS systems exist. These include the enzymatic systems that include superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX). They work like these; SOD turns a damaging negatively charged free radical like ^•O₂⁻ into O₂ and H₂O_{2  (hydrogen peroxide)}, then CAT will further change the damaging H₂O₂ into the harmless O₂ (oxygen) and H₂O (water).

There is a non-enzymatic antioxidant system in the skin, which includes vitamins C and E and glutathione (GSH).

VI. Elimination of Toxic Substances

A. Bisphenol-A (BPA) is a chemical found in plastic that can cause chromosomal abnormalities. It is common in water bottles, plastic containers, canned foods, including beer. BPA may not be detectable in the blood or the urine, but it can be detected in significant amounts in sweat.

B. Various organochlorinated pesticides (OCP) and their metabolites, including DDT, DDE, methoxychlor, endrin, and endosulfan sulfate, are also excreted into perspiration. OCPs have high toxicity, slow degradation, and accumulate in the body. OCPs have been implicated in Parkinson’s disease, hypertension, heart disease, brain damage, psoriasis, and cancer. Again, these pesticides were not detectable in a regular blood analysis but presented when in the sweat.

C. Phthalate compounds are present in many consumer products. One of the metabolites of phthalate is di 2-Ethylhexy (DEHPl). DEHP has toxic effects on hormones, the testes, ovaries, brain, liver, and heart.  DEHP can remain undetectable in the blood but can be excreted in sweat.

D. Arsenic, cadmium, mercury, and lead are all over our environment.  Arsenic is in rice and the groundwater in Asia. High levels of cadmium in the ground can go to vegetables like the brassica species and shellfish. Mercury can be in fish and seafood. They exert wide-ranging toxic effects on many bodily systems, including the brain, nerves, hormones, kidneys, muscles, immune system, and heart. They can mimic other diseases and remain undiagnosed, especially if the index of suspicion for these metals are low. Usually, patients are not tested for them. Even if the doctors order a blood or urine test, the toxic heavy metals can go undetected. One study has shown that sweat contains arsenic, cadmium, mercury, and lead.

Taking Advantage of the Sweat Glands

High blood sugar, high triglycerides, excessive ROS,  inflammatory cytokines, and environmental toxins all work together in different combinations and result in common diseases (see below).

In physical exertion, the blood vessels in the skeletal muscles and skin dilate to deliver more blood and remove excess heat.  Aside from oxygen and nutrients, the blood carries with it cytokines and ROS produced elsewhere, like the visceral fat in the abdomen.

During exercise, the skin may get as much as 30% of the cardiac output and may receive 6 to 8 liters of blood per minute to make 4 – 6 liters of sweat. While in transit thru the skin, the anti-ROS enzymes act on the circulating ROS and neutralize them to prevent them from causing damage to other organs.

The sweat glands also work hard to dissipate heat by sweating, and with it, some circulating pro-inflammatory cytokines, glucose, triglycerides, and toxins and heavy metals are washed away.

Sweating in a sauna takes advantage of the same benefits as exercising.

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References:

Burns and Insulin Resistance

1. Jeschke et al. Burned adults develop profound glucose intolerance. Crit Care Med. Crit Care Med. 2016 Jun; 44(6): 1059–1066. 
2. Jeschke et al., Long-Term Persistence of the Pathophysiologic Response to Severe Burn Injury. PLoS One. 2011; 6(7): e21245. 
3. Jeschke et al., Severe Injury Is Associated With Insulin Resistance, Endoplasmic Reticulum Stress Response, and Unfolded Protein Response. Ann Surg. Published in final edited form as Ann Surg. 2012 Feb; 255(2): 370–378.
4. Gauglitz et al., Abnormal Insulin Sensitivity Persists up to Three Years in Pediatric Patients Post-Burn. J Clin Endocrinol Metab. 2009 May; 94(5): 1656–1664.

Skin Toxin Excretion

1. Genuis et al., Human Excretion of Bisphenol A: Blood, Urine, and Sweat (BUS) Study. Journal of Environmental and Public Health Volume 2012, Article ID 185731.
2. Ravindran Jayaraj, Pankajshan Megha, Puthur Sreedev. Organochlorine pesticides, their toxic effects on living organisms, and their fate in the environment. Interdiscip Toxicol. 2016 Dec; 9(3-4): 90–100. Published online 2017 May 17. doi: 10.1515/intox-2016-0012
3. Johnson et al., Drug excretion in human eccrine sweat. J Invest Dermatol. 1971 Mar;56(3):182-8.
4. Emmett et al., The excretion of trace metals in human sweat – Annals of Clinical & Laboratory Science, 1978 – Assoc Clin Scientists
5. Sears et al., Arsenic, Cadmium, Lead, and Mercury in Sweat: A Systematic Review. Published in Journal of environmental and public health 2012. DOI:10.1155/2012/184745
6. Genuis et al., Blood, urine, and sweat (BUS) study monitoring and elimination of bioaccumulated toxic elements. Arch Environ Contam Toxicol. 2011 Aug;61(2):344-57. doi: 10.1007/s00244-010-9611-5. Epub 2010 Nov 6. 
7. Stephen J. Genuis, Sanjay Beesoon, Rebecca A. Lobo, and Detlef Birkholz, “Human Elimination of Phthalate Compounds: Blood, Urine, and Sweat (BUS) Study,” The Scientific World Journal, vol. 2012, Article ID 615068, 10 pages, 2012. https://doi.org/10.1100/2012/615068. 
8. Sai Sandeep Singh Rowdhwal, Jiaxiang Chen. Toxic Effects of Di-2-Ethylhexyl Phthalate: An Overview. Biomed Res Int. 2018; 2018: 1750368. Published online 2018 Feb 22. doi: 10.1155/2018/1750368

Glucose in Sweat

1. Marques-Deak et al., Premenopausal, Osteoporosis Women, Alendronate, Depression Study Group. Measurement of cytokines in sweat patches and plasma in healthy women: validation in a controlled study. J Immunol Methods. 2006 Aug 31;315(1-2):99-109. Epub 2006 Aug 10.
2. Hladek et al., Using sweat to measure cytokines in older adults compared to younger adults: A pilot study.  J Immunol Methods. 2018 Mar;454:1-5. doi: 10.1016/j.jim.2017.11.003. Epub 2017 Nov 8.
3. Sonner et al., Biomicrofluidics 9, 031301 (2015); https://doi.org/10.1063/1.4921039
   Submitted: 02 April 2015. Accepted: 30 April 2015. Published Online: 15 May 2015
4. POWER Study Group. Elevated neuroimmune biomarkers in sweat patches and plasma of premenopausal women with major depressive disorder in remission: the POWER study. Biol Psychiatry. 2008 Nov 15;64(10):907-11. doi: 10.1016/j.biopsych.2008.05.035. Epub 2008 Jul 26.
5. Hui Xu, Yun-Wen Zheng, Qi Liu, Li-Ping Liu, Feng-Lin Luo, Hu-Chen Zhou, Hiroko Isoda, Nobuhiro Ohkohchi, and Yu-Mei Li (December 20th, 2017). Reactive Oxygen Species in Skin Repair, Regeneration, Aging, Inflammation, Reactive Oxygen Species (ROS) in Living Cells, Cristiana Filip, and Elena Albu, IntechOpen, DOI: 10.5772/intechopen.72747.
6. Zhou et al., The skin function: a factor of anti-metabolic syndrome. Diabetol Metab Syndr. 2012 Apr 26;4(1):15. doi: 10.1186/1758-5996-4-15.
7. Takemura et al., Free fatty acids, and sterols in human eccrine sweat. Br J Dermatol. 1989 Jan;120(1):43-7.

Image Credits:

1. Skin – U.S. Gov – Wikipedia
2. Vitiligo By James Heilman, MD – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=10313925
3. Lift Heavier https://unsplash.com/photos/eJCPaYMZLLA

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