Getting Toasty in Antarctica

A perspective on gettin 'toasty' during a winter-over in Antarctica, from the great, late Nicholas Johnson interviewing a co-worker over at bigdeadplace.com:

To be perfectly honest, I became Toasty, and not in a good way. I began to hold semi-decent conversations with the several mannequin heads in my room. I had shaved my eyebrows off. I was drinking liquid morphine with someone named Big Hand George. A pair of panties belonging to my friend’s girlfriend lay under my bed as a reminder to my rusted morals. My plan to disappear from station and live in a snow cave at the end of the winter fell through disastrously; I was found face down in front of the fridge at work clutching a half-eaten five-pound summer sausage. Hypothermia had kicked my ass. The employee who found me helped me to my feet and said, “Bro, you got to go home.” And at that point it became crystal clear: home was no longer Antarctica. 

What exactly is getting toasted / toasty / becoming toast down under?

Toast, adj.
Also toasty. A term used to describe a Polie [South Pole station worker] who has been at the South Pole too long.  Toasty symptoms include forgetfulness, slow or slurred speech, short attention span, staring, lethargic and/or antisocial behavior and self absorption.  Polies are most commonly afflicted during the month of August.

From a 1999 winter-over crew, found at this link

Weird, kinda sounds like med school, except August isn't really peak season for us.

 You can read countless blog accounts with Antarctic winter-over antics from the stations at McMurdo, the Pole, and Palmer all over the internet, so I won't bore you with by trying to recreate these incidents, but some of them are both hilarious and violent and therefore well-worth researching.   By the way, the term "winter over" means a worker who spends the austral summer on the continent, when there's generally no air traffic between the months of mid-February and late August.

On the whole, the consensus is that something funny happens when a small group of people (50 or so) spend a lot of time in twilight (2 months or so) to complete darkness (4 months or so) without being able to come and go as they please.

Mt. Erebus, outside of McMurdo Station, one of the three year-round stations in Antarctica.

 This is exactly what happens every winter in Antarctica, after the bases become sequestered from outside contact due to un-flyable weather. I got kind of interested in how much of this is purely psychological vs. biological after I read Nick Johnson's book "Big Dead Place," which I highly recommend. [It's sort of an Antarctic Fear & Loathing.]

 4 months in the dark with 50 co-workers is kind of a stressful enough situation to find oneself in, but the question is how much do humans really need the sun, warmth, or other people, really?

 Yes, I'm aware of those lights you can put in your house for 'phototherapy' to help with depression, and what's called seasonal affective disorder. I've always wondered if these were the kind of things that were just soothingly recommended by psychiatrists, the same way we tell people to drink green tea to stave off cancer. I think green tea is delicious, and that's why you should drink it, but there's at lot of other factors besides the green tea as to why you get cancer, or why people don't do well while isolated in the dark and when it's -30 F on a warm day.  That being said, phototherapy gets some credit here.  It's not just hippies, depressed housewives, and people practicing 'holistic medicine' that love them some light boxes...

"You know, this light box, sunflower, and cup of green tea really are doing wonders for my soul-crushing depression, Betty.  My psychiatrist says I have seasonal affective disorder."

Gettin' toasty is actually related to polar T3 syndrome, a term first coined in 1986 by Dr. Lester Reed, and it might be the reason for the infamous 'Antarctic Stare' that plagued polar explorers of yore.  Described as a "mild fugue state [also] known as 'long eye'", the Antarctic stare may be accompanied by irritability, depression, social isolation, insomnia, and cognitive impairment.  Collectively all these symptoms are called 'winter-over syndrome.'

A lively bunch:  Part of the crew of the Australasian Antarctic Exploration, 1911-1914

Most of the more recent research has been done by a dude named Larry Palinkas, a medical anthropologist out of University of California San Diego (ironically, a city most synonymous with warmth and sun...)  He collab'd on his publications with an award-winning tango dancer / NASA psychiatrist named Marc Shepanek, who seems to be based out of DC these days.  Their publications are fairly recent:  in 2010, they published the results of a medication / phototherapy vs. placebo / dim light trial that went on during the 2002-2004 seasons in Antarctica.  Their conclusion was that light therapy lead to a significant reduction in thyroid stimulating hormone (TSH), increase in T3, and "prevents an increase in anger and depressive symptoms in winter."

What I think is cool is that there's perhaps a two-pronged mechanism that explains polar T3 syndrome.  Your thyroid hormones, T3 (active hormone that acts on cells) and T4 (precursor to T3), work overtime to keep you warm in really cold weather. And Antarctica is really cold, like really really cold in the austral summer.  You use up your circulating T3 and T4, so there is an overall elevation in thyroid releasing hormone (TRH) and thyroid stimulating hormone (TSH).  These have been shown to peak in Antarctica in November and July, with a decrease in March (high summer in Antarctica).  Vitamin D, produced in our skin via a reaction requiring UV light, also plays a role in the action of T3 on cells it seems.  Vitamin D levels have to be high enough for the thyroid hormone receptor response in tissues (and this thyroid hormone receptor is also sensitive to cortisol, so that further complicates the picture...)

Indeed vitamin D is one of those sexy medical topics right now:  low levels of vitamin D appear to be correlated with autoimmune thyroid disease.  And no one's really quite sure how much vitamin D we really need; everyone's arguing about this at the moment.

Anyway, what I'm trying to point out is that there's a mechanism here.

There's still some things from the study that don't make sense to me:  the phototherapy appeared to increase free T3 and decrease TSH independently of T3/T4 supplementation.  That seems a bit strange, because I would expect the greatest benefit from both supplement with T3/T4 and light therapy... but these are questions for those endocrinology lab rats with NIH funding, not procrastinating students.

There was an awfully small sample size (13 people on the T3/T4 + light therapy protocol), and that could be an issue with this particular study.

Another consideration to Palinkas' and Shepanek's study is that they didn't measure the 2002-2004 participants vitamin D3 levels, which would have been nice.  After all, phototherapy was used in conjunction with the T3/T4 supplements did statistically to improve scores on their various psychological tests assessing mood and function.

One possible confounder though:  that light box thing... participants were mislead to believe that different wavelengths of light were being testing in the bright light vs. dim (control) light.  I see how that is plausible, but people could probably generally figure that kind of thing out.  That could perhaps have been a problem with assessing mood / function on patients with the placebo therapy.  Another nice additive that I thought about would be some ultrasound studies of the participants' thyroid glands with some nice data points for before- and after-winter-over.  Or maybe pre- and post-initiation of therapy with this particular study. I really love ultrasound though, so that's just me.

Anyway, consider your light boxes and vitamin D supplements as ya head down for a season on the ice.  I wish I was going with you.  Don't catch that arctic stare, yo.

The infamous Nimrod Expedition, and old Ernest Shackleton in 1907