Rhodiola

Advocates believe that rhodiola is an adaptogen. This herbal medicine term means that this substance is thought to help the body respond to stress and restore normal function.

Rhodiola is used to

• Treat the symptoms of altitude illness

• Improve learning and memory

• Increase energy

• Improve exercise performance

• Reduce high cholesterol levels

• Reduce symptoms of depression

• Reduce fatigue

• Slow down the aging process

There are no high-quality studies in people demonstrating that rhodiola is effective for treating any health condition.

Small studies suggest that rhodiola improves exercise and sports performance (1, 2). In addition, a systematic review of 13 randomized trials including 263 patients evaluated acute or chronic supplementation or a combination of both (3). Acute use was beneficial for endurance performance and rating of perceived exertion. Chronic use was beneficial for anaerobic exercise but not endurance exercise performance. Another review suggests that higher rhodiola doses demonstrate benefit on sprints on bicycle ergometers and resistance training in both trained and untrained people (4). However, because of variability of doses and duration of use, as well as subject characteristics, additional studies are required.

A small study in 89 people taking rhodiola for 42 days showed benefit in treatment of mild to moderate depression (5). In a 12-week, randomized trial including 57 patients comparing rhodiola to sertraline and placebo, depression improved in both sertraline and rhodiola groups, and there was no significant difference between the two. However, rhodiola was less effective than sertraline when compared to placebo but had fewer adverse effects (). In a 12-week, randomized trial including 57 patients comparing rhodiola to sertraline and placebo, depression improved in both sertraline and rhodiola groups, and there was no significant difference between the two. However, rhodiola was less effective than sertraline when compared to placebo but had fewer adverse effects (6). Rhodiola has shown efficacy in combination with a selective serotonin reuptake inhibitor (SSRI, 7). World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments (CANMAT) do not support rhodiola as monotherapy or in combination with other treatments for major depressive disorder (8).

Rhodiola has also been used for stress management (9, 10).

Possible adverse effects of rhodiola include dizziness and either dry mouth or excessive saliva production. A case report described precipitation of a manic episode in a patient taking rhodiola as an exercise supplement (11).

• The use of rhodiola in combination with certain prescription antidepressants may result in increased heart rate, and serotonin syndrome may occur if combined with serotonergic medications.

• Rhodiola could cause hypoglycemia, particularly in people who take antihyperglycemic medications.

• Rhodiola could reduce blood pressure, possibly causing hypotension in people who already have low blood pressure or in those taking antihypertensive medications.

• Rhodiola may increase levels of warfarin.Rhodiola may increase levels of warfarin.

• Rhodiola has anti-inflammatory effects, which, in combination with anti-inflammatory drugs, may result in additive effects causing adverse effects.

• Rhodiola may counteract the effects of immunosuppressants.

(See also table Some Possible Dietary Supplement–Medication Interactions.)

1. 1. Parisi A, Tranchita E, Duranti G, et al. Effects of chronic Rhodiola Rosea supplementation on sport performance and antioxidant capacity in trained male: preliminary results. J Sports Med Phys Fitness. 50(1):57-63, 2010.

2. 2. Noreen EE, Buckley JG, Lewis SL, Brandauer J, Stuempfle KJ. The effects of an acute dose of Rhodiola rosea on endurance exercise performance. J Strength Cond Res. 27(3):839-847, 2013. doi:10.1519/JSC.0b013e31825d9799

3. 3. Sanz-Barrio PM, Noreen EE, Gilsanz-Estebaranz L, Lorenzo-Calvo J, Martínez-Ferrán M, Pareja-Galeano H. Rhodiola rosea supplementation on sports performance: A systematic review of randomized controlled trials. Phytother Res. 2023 Oct;37(10):4414-4428. doi: 10.1002/ptr.7950

4. 4. Tinsley GM, Jagim AR, Potter GDM, Garner D, Galpin AJ. Rhodiola rosea as an adaptogen to enhance exercise performance: a review of the literature. Br J Nutr. 2024 Feb 14;131(3):461-473. doi: 10.1017/S0007114523001988

5. 5. Darbinyan V, Aslanyan G, Amroyan E, et al.Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression. Nord J Psychiatry. 61(5):343-348, 2007. doi:10.1080/08039480701643290

6. 6. Mao JJ, Xie SX, Zee J, et al. Rhodiola rosea versus sertraline for major depressive disorder: A randomized placebo-controlled trial. . Rhodiola rosea versus sertraline for major depressive disorder: A randomized placebo-controlled trial.Phytomedicine. 22(3):394-399, 2015. doi:10.1016/j.phymed.2015.01.010

7. 7. Gao L, Wu C, Liao Y, et al. Antidepressants effects of Rhodiola capsule combined with sertraline for major depressive disorder: A randomized double-blind placebo-controlled clinical trial. . Antidepressants effects of Rhodiola capsule combined with sertraline for major depressive disorder: A randomized double-blind placebo-controlled clinical trial.J Affect Disord. 265:99-103, 2020. doi:10.1016/j.jad.2020.01.065

8. 8. Sarris J, Ravindran A, Yatham LN, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce. World J Biol Psychiatry. 2022 Jul;23(6):424-455. doi: 10.1080/15622975.2021.2013041. Epub 2022 Mar 21. PMID: 35311615.

9. 9. Cropley M, Banks AP, Boyle J. The Effects of Rhodiola rosea L. Extract on Anxiety, Stress, Cognition and Other Mood Symptoms. Phytother Res. 2015 Dec;29(12):1934-9. doi: 10.1002/ptr.5486.

10. 10. Ivanova Stojcheva E, Quintela JC. The Effectiveness of Rhodiola rosea L. Preparations in Alleviating Various Aspects of Life-Stress Symptoms and Stress-Induced Conditions-Encouraging Clinical Evidence. Molecules. 2022 Jun 17;27(12):3902. doi: 10.3390/molecules27123902

11. 11. Whig R, Leo RJ. Mania Associated With Rhodiola Rosea: An Adaptogen With Antidepressant Effects. Prim Care Companion CNS Disord. 2022 Mar 17;24(2):21cr02980. doi: 10.4088/PCC.21cr02980

The following English-language resource may be useful. Please note that The Manual is not responsible for the content of this resource.

1. National Institutes of Health (NIH), National Center for Complementary and Integrative Health: Rhodiola