Related Terms

• ADAPT-232, aliphatic alcohol, Arctic Root®, benzyl alcohol, beta-sitosterol, caffeic acid, Chisan®, cinnamyl glycoside, Crassulaceae (family), daucosterol, Eleutherococcus senticosus Maxim, epigallocatechin, flavonoids, Full Spectrum™ Rhodiola Rosea Extract, gallic acid, galloylepigallocatechin, geraniol, geranyl acetate, geranyl formate, glucopyranosides, golden root, golden root tincture, goldenroot, goldroot, gossypetin, herbacetin, heterodendrin, hongjingtian, hydroquinone, jiangtian, kaempferol, linalool, lotaustralin, Mind Power Rx, monoterpene alcohols, monoterpene hydrocarbons, n-decanol, p-tyrosol, Passion Rx, phenylethyl alcohol, phenylpropamide, protocatechuic acid, queen's crown, REC-7004, rhamnopyranoside, rhizome, rhodakon, rhodalidin, rhodalin, Rhodax®, rhodaxon, Rhodiola algida, Rhodiola alterna, Rhodiola brevipetiolata, Rhodiola crenulata, Rhodiola dumulosa, Rhodiola Energy™, Rhodiola Extended Release, Rhodiola fastigata, Rhodiola ForceTM, rhodiola herb, Rhodiola heterodonta, Rhodiola imbricata, Rhodiola integrifolia, Rhodiolairemelica, Rhodiola kirilowii, Rhodiola quadrifilda, Rhodiola rhodantha, rhodiola root, Rhodiola sachalinensis spp., Rhodiola sacra, Rhodiola semenovii, Rhodiola tibetica, Rhodiola yunnanensis, rhodiolgidin, rhodiolgin, rhodiolin, rhodioloside rhodionidin, rhodionin, rhodioniside, rhodiooctanoside, rhodiosin, rodia riza, rodiola, rosarin, rosavin, rose root, roseroot, roseroot stonecrop, rosin, rosiridin, rosiridol, Russian golden root, Russian root, sacranoside B, salidroside, Sedum rhodiola, Sedum rosea spp., Sedum roseum, SHR-5, Siberian Rhodiola rosea, sitosterol, sterols, tannins, tyrosol, trans-hydroxycinnamic acid, volatile oil, zolotoy koren.

Background

• Rhodiola grows in cold regions and at high altitudes in Europe and Asia, where its roots have traditionally been used to increase resistance to physical stress.

• While there are more than 200 species of rhodiola, Rhodiola rosea is considered preferable, because it contains rosavins. Supplements generally contain a minimum of 3% rosavins.

• Rhodiola is considered an adaptogen, which is an agent that is believed to normalize functioning and stimulate healing of cells. It has been used to prevent fatigue and enhance physical and mental performance. Rhodiola may also provide benefit in bladder cancer, lung disease, and exercise and mental performance, but more studies are needed to confirm these findings.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Abnormal heart rhythms, acetaminophen toxicity, addiction (opiate), adrenal insufficiency, aging, allergy, altitude (mountain) sickness, Alzheimer's disease, anemia, anti-inflammatory, antimicrobial, antioxidant, appetite stimulant, autism, breast cancer, cancer, cerebral ischemia (decreased blood supply to the brain), chelating agent (heavy metals), chronic fatigue syndrome, circulatory disorders, CNS stimulant, cognition, common cold, dementia, dental conditions, diabetes, eating disorders, fibromyalgia, flu, headaches, hepatitis (hepatitis C), heart disease, hernia, high blood pressure, hormonal imbalances, hyperlipidemia (high blood lipids), hypothyroidism (lack of sufficient thyroid hormone), immune function, impotence, insomnia/sleep quality, leukemia, liver protection, lung infections, mania, memory, menopause, menstrual period problems/lack of menstrual period, mood disorders, mucositis (inflammation in the digestive tract), myasthenia gravis (neuromuscular disorder), myocardial ischemia (insufficient blood flow to the heart), nervous disorders, neurologic disorders, neuroprotective, obesity, ovarian cancer, pain, Parkinson's disease, pneumonia, prostate cancer, psychiatric disorders, quality of life, schizophrenia, seasonal affective disorder, sedation, sexual dysfunction, smoking cessation, stomatitis (mouth inflammation), stress, stroke, substance abuse, thyroid conditions, tonic, vaginal discharge, viral myocarditis (virus-induced inflammation of heart muscle).

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

• Although various doses have been studied, there is no proven safe or effective dose for rhodiola. Typically, 100 to 600 milligrams of rhodiola has been used. High doses are considered to be 1,000 milligrams or more daily. Some sources suggest that rhodiola should be taken on an empty stomach and should not be used continuously.

• As an adaptogen, 100-300 milligrams of rhodiola (standardized to 1% salidroside and/or 40-50% phenylpropanoids) has been taken by mouth three times daily.

• For anxiety, 170 milligrams of rhodiola (Rhodax®; Phoenix Laboratories by Bodyonics Ltd.) has been taken by mouth twice daily for 10 weeks.

• For bladder cancer, rhodiola extract of unknown dose has been taken by mouth for unknown duration.

• For depression, 100-1,000 milligrams of rhodiola (standardized to 3% rosavins and 1% salidrosides) has been taken by mouth daily in 2-3 doses on an empty stomach. A dose of 340 milligrams daily (two tablets of SHR-5 once daily) and 680 milligrams (two tablets of SHR-5 twice daily) have been taken by mouth.

• For exercise performance enhancement, the following doses have been taken by mouth: 50 milligrams of rhodiola extract (SHR-5) twice daily for 20 days; 100 milligrams of rhodiola (Rhodiolin, CaliVita International, United States), each capsule containing 100 milligrams of rhodiola concentrate and 5.0 milligrams of zinc, twice daily for four weeks; 200 milligrams of rhodiola extract, standardized to 3% rosavin and 1% salidroside, as an acute dose or once daily for four weeks; 3 milligrams per kilogram of body weight of rhodiola as an acute dose before exercise; and 340 milligrams of Rhodax® (Phoenix Lab; containing 30 milligrams of rhodiola) twice daily (morning and evening) for 30 days.

• For fatigue, 144-576 milligrams of rhodiola (SHR-5 extract) has been taken by mouth daily for up to 28 days.

• For hypoxia, rhodiola (dose unavailable) has been taken by mouth for seven days and for 24 days.

• For lung disease (acute injury), 4 grams of rhodiola has been taken by mouth daily for 7-10 days before surgery and 5-7 days after surgery in patients with severe pulmonary hypertension undergoing cardiopulmonary bypass.

• For mental performance during fatigue, the following doses have been taken by mouth: 100-1,000 milligrams of rhodiola (standardized to 3% rosavins and 1% salidrosides) daily in 2-3 doses on an empty stomach; 170 milligrams of rhodiola extract (SHR-5) daily for two weeks; an acute dose of 3 milligrams per kilogram body weight of rhodiola before exercise; 100-555 milligrams of rhodiola extract (SHR-5) daily for up to 20 days.

Children (under 18 years old)

• There is no proven safe or effective dose for rhodiola in children.

• For lung disease (acute injury), 2 grams of rhodiola has been taken by mouth daily for 7-10 days before surgery and 5-7 days after surgery in patients with severe pulmonary hypertension undergoing cardiopulmonary bypass.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

• Avoid with known allergy or hypersensitivity to rhodiola, its constituents, or members of the Crassulaceae family.

Side Effects and Warnings

• Rhodiola may cause dizziness, dry mouth, increased restlessness, irritability, insomnia, saliva production, and may have hormonal properties.

• Rhodiola may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

• Rhodiola may affect blood pressure. Caution is advised in patients taking drugs, herbs or supplements that affect blood pressure.

• Rhodiola may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

• Rhiodiola may affect the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

• Use cautiously in patients using CNS depressants, as rhodiola may increase the risk of CNS depression or cause sedation or drowsiness. Use caution if driving or operating heavy machinery.

• Use cautiously in individuals with cardiovascular disease, based on unconfirmed reports that rhodiola may increase blood pressure, heart rate, and heart palpitations when taken in combination with other medications.

• Use cautiously in individuals using agents metabolized by P-glycoprotein, as rhodiola has been found to be a potent inhibitor of this transport activity.

• Use cautiously in individuals using antiarrhythmic agents.

• Use cautiously in patients receiving immunosuppressants, as rhodiola may stimulate the immune system.

• Use cautiously in patients using agents containing piperine, such as black pepper.

• Avoid in patients using antidepressants (SSRIs, MAOIs); theoretically, concurrent use may increase the risk of adverse effects, including serotonin syndrome.

• Avoid in patients with known allergy or hypersensitivity to rhodiola, its constituents, or members of the Crassulaceae family.

• Avoid in pregnant or breastfeeding women, due to a lack of safety data.

Pregnancy and Breastfeeding

• Avoid use in pregnant or breastfeeding women due to a lack of safety data.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

• Rhodiola may lower blood sugar levels. Caution is advised when using drugs that may also lower blood sugar. Patients taking drugs for diabetes by mouth or injection should be monitored closely by a qualified healthcare professional. Dosing adjustments may be necessary.

• Rhodiola may alter blood pressure. Caution is advised in patients taking drugs that alter blood pressure, such as ACE inhibitors.

• Rhodiola may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

• Rhodiola may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

• Use cautiously in patients using CNS depressants, as rhodiola may cause sedation or drowsiness. Use caution if driving or operating heavy machinery.

• Rhodiola may interact with acetaminophen, acetazolamide, alpha-glucosidase inhibitors, anti-anxiety agents, antibiotics, anticancer agents, antidepressants (including monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs)), anti-inflammatory agents, antivirals, catechol-O-methyltransferase (COMT) inhibitors, CNS stimulants, drugs that affect blood lipid levels, drugs that affect the heart and vascular system, estrogens, exercise performance-enhancers, heart rate-regulating drugs, agents that affect the immune system, nicotine, opiates, P-glycoprotein-regulated agents, pentobarbital, sedatives, theophylline, or weight loss agents.

Interactions with Herbs and Dietary Supplements

• Rhodiola may lower blood sugar levels. Caution is advised when using herbs and supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

• Rhodiola may alter blood pressure. Caution is advised in patients taking herbs and supplements that alter blood pressure, including ACE inhibitors.

• Rhodiola may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

• Rhodiola may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

• Rhodiola may increase the amount of drowsiness caused by some herbs or supplements. Use caution if driving or operating heavy machinery.

• Because rhodiola may contain estrogen receptor-interacting chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

• Rhodiola may also interact with 5-hydroxytryptophan (5-HTP), adaptogens, antibacterials, antidepressants (including monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs)), anti-anxiety agents, anti-inflammatory herbs and supplements, anticancer herbs and supplements, antioxidants, antivirals, black pepper, blood lipid-lowering herbs and supplements, cranberry extract, pasteurized foods, herbs and supplements that affect the heart and vascular system (including heart rate), exercise performance-enhancers, immune system-modulating herbs and supplements, melatonin, opiates, P-glycoprotein modulators, piperine, sedatives, stimulants, tryptophan, or weight loss herbs or supplements.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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3. Colson SN, Wyatt FB, Johnston DL, et al. Cordyceps sinensis- and Rhodiola rosea-based supplementation in male cyclists and its effect on muscle tissue oxygen saturation. J Strength Cond Res 2005;19(2):358-363. View Abstract

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11. 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 2010;50(1):57-63. View Abstract

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15. Spasov AA, Wikman GK, Mandrikov VB, et al. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen. Phytomedicine 2000;7(2):85-89. View Abstract