Rhodiola rosea is an adaptogen with a long history of traditional use against stress, fatigue, and more. Does the science back it up? Learn more here.
What Is Rhodiola rosea?
Rhodiola rosea is a flowering plant that grows in very cold climates and at high altitudes. Its root has been used in traditional medicine in the Caucasus Mountains, Scandinavia, China, and Russia, where practitioners believe that it can improve focus and endurance in both body and mind [1, 2].
Other species closely related to R. rosea are also used in traditional medicine. These include Rhodiola imbricata, Rhodiola algida, and Rhodiola crenulata. Together, these herbs are best known as adaptogens: substances that help combat stress. However, Rhodiola roots and extracts are also being investigated for other potential cognitive and physical benefits [3, 4, 5].
Rhodiola has many other names: in China, it is called hóng jǐng tiān. Elsewhere, it may be called rosenroot, rose root, Arctic root, golden root, or king’s crown. In French, it is l’orpin rose [6, 7, 8, 9, 10].
Snapshot
Proponents:
- May reduce stress and fatigue
- May boost the immune system
- May improve mood
- May increase fat burning
- May improve sexual function
Skeptics:
- Possible dangerous drug interactions
- Clinical research lacking for many purported benefits
Active Components
Salidroside
Salidroside, also known as rhodioloside, is considered to be the most important bioactive molecule in Rhodiola rosea. It is likely responsible for Rhodiola’s effects on the brain [11, 12].
Rosavin
Rosavin has many of the same properties and mechanisms as salidroside, but seems to require a higher dose to produce the same effect [13].
Tyrosol
Tyrosol is present in standardized Rhodiola rosea extracts, but it often goes unlabeled on commercial supplements. Tyrosol is an antioxidant and may also contribute to Rhodiola’s beneficial properties [14].
Mechanisms of Action
Rhodiola is an important herb in traditional medicine in parts of Europe and Asia. According to practitioners, it helps people with stress, anxiety, fatigue, depression, brain fog, burnout, and heart problems. It’s also used to boost the immune system and increase lifespan [15, 2].
That’s an awfully long list – does the research back it up? You might not be surprised to hear that it’s complicated [15, 2].
In cell studies, rhodiola activates AMPK, boosts Nrf2, and blocks the JAK2–STAT3 pathway. Let’s take a deep dive into these important mechanisms.
AMPK Activation
Many of Rhodiola’s reported effects could be attributed to a protein called AMPK. AMPK is important for energy balance and for preventing oxidative stress. It prevents insulin resistance, keeps blood sugar down, and stops fat buildup in the liver. When free radicals build up, AMPK increases the production of antioxidant proteins [16, 17, 18].
Nuclear factor-κB (NF-kB) controls many genes that cause inflammation, and it is very active in inflammatory diseases like arthritis, Crohn’s disease, and atherosclerosis. AMPK reduces inflammation by decreasing the activity of NF-κB [19, 20].
AMPK may also increase the activity of PI3K, an important protein for insulin signaling [17, 21].
Rhodiola extracts and pure salidroside both activated AMPK in cell studies [22, 23, 24].
Nrf2 Activation
Nrf2 is a protein that activates numerous important antioxidant proteins and protects against oxidative stress. In cells, rhodiola’s bioactive components increased the activity of Nrf2 and its antioxidant effects [25, 26].
JAK2-STAT3 Inhibition
In combination, the JAK2 and STAT3 genes form a pathway that increases inflammation. Salidroside from Rhodiola blocked this pathway and thereby reduced inflammation in cell studies [27, 28].
Potential Benefits
Rhodiola has produced positive results in at least one study on each of the potential benefits in this section, but larger and more robust studies are required to confirm its effectiveness. The FDA has not approved rhodiola or its extracts for any medical purpose or health claim. Talk to your doctor before starting a new supplement.
Possibly Effective For
1) Stress Relief
Rhodiola rosea is an adaptogen: a compound purported to combat stress by helping the body (and especially the brain and the immune system) return to and maintain a normal, balanced state [29].
Stress & Burnout
Perhaps because this is rhodiola’s best-known purpose, several human trials have already been conducted.
In 101 volunteers with “life-stress symptoms,” 200 mg of rhodiola extract began to produce significant improvements in their stress levels and daily functioning just three days after starting the trial. After four weeks, all participants had significantly improved. Unfortunately, this study did not have a control group, and a placebo effect was likely [30].
In another study of 80 patients with mild anxiety, 400 mg of rhodiola extract per day for two weeks produced significant reductions in stress, anxiety, and negative emotions. This study did include a control group, but the controls were not given a placebo. The authors concluded that rhodiola was likely responsible for the improvements, but they cautioned that no causal link could yet be drawn with certainty [31].
Finally, in a study of 118 people with burnout, 400 mg of rhodiola extract per day started to produce improvements to stress and mood after one week. Patients continued to improve until the study ended after twelve weeks. Again, however, there was no control group [32].
Fatigue
In a handful of human studies, rhodiola extracts reduced feelings of fatigue in university students and young physicians [33, 34].
Reductions in fatigue were significant compared to the placebo groups, but the studies were small and brief.
HPA Axis
Salidroside, like many adaptogens, acts on the HPA axis: the hypothalamus, the pituitary gland, and the adrenal gland. This system of glands controls many of the body’s stress responses, such as the release of cortisol [29, 35].
Adaptogens like salidroside also affect the expression of Hsp70, a heat-shock protein that helps cells adapt to repeated exposure to the same source of stress. However, the actual effect of salidroside on Hsp70 is unclear [36, 29, 37]:
Some studies suggest that adaptogens like Rhodiola generally increase Hsp70 expression, which increases tolerance to emotional and physical stress in healthy people.
Other studies conclude that salidroside decreases Hsp70 expression in stomach cancer cells, which contributes to its cancer-fighting effects. The bottom line is that healthy and cancerous cells do not behave in the same way. Salidroside’s effects on Hsp70 seem to be always beneficial, but whether it turns this pathway “on” or “off” may depend on the cells it targets and their health.
Mood Mechanisms
Rhodiola extracts, especially salidroside, may decrease the symptoms of depression and generally improve mood [38, 39].
In cell studies, rhodiola extract directly activated four important neurotransmitters: norepinephrine, serotonin, dopamine, and acetylcholine. Low dopamine, in particular, is strongly associated with depression and often overlooked; this plant’s effect on dopamine may explain its mood-lifting effects [15, 40].
In one study, salidroside from Rhodiola significantly decreased inflammatory cytokines and returned neurotransmitter levels to normal in rat brains. These two effects are probably linked; inflammation often contributes to depression [38, 41].
Its antidepressant potential may also come from an ability to inhibit monoamine oxidase (MAO) in cells. MAO breaks down neurotransmitters while blocking them can raise neurotransmitter levels [42].
Monoamine oxidase is also the target of some antidepressant drugs like selegiline, phenelzine, and isocarboxazid. This class of drugs may interact dangerously with rhodiola; see the section on drug interactions below [43, 44].
Insufficient Evidence For
The following purported benefits are only supported by limited, low-quality clinical studies. There is insufficient evidence to support the use of rhodiola for any of the below-listed uses. Remember to speak with a doctor before taking rhodiola supplements, and never use them in place of something your doctor recommends or prescribes.
2) Sexual Function
Rhodiola is sometimes marketed as a libido booster or a remedy for erectile dysfunction. In combination with zinc, folic acid, and biotin, it may be useful for premature ejaculation [45].
However, many claims about improved sexual function originate from a single study. This study, which was conducted on 120 adults over 50, did not include a placebo or control group and was not focused solely on sexual function, but on a variety of physical and cognitive symptoms [46, 47].
In fact, Rhodiola’s potential effect on sexual function is probably linked to its antidepressant properties. One study found that it reduced all symptoms in people with burnout, including sexual dysfunction [32].
Sexual function and stress are, of course, closely related. By increasing stress resilience and antioxidants, this adaptogen may contribute to a healthy libido. In other cases, though, sexual and erectile dysfunction are not linked to stress. In those cases, Rhodiola probably won’t have an effect [32].
All in all, Rhodiola may improve sexual function, especially in people suffering from mental health issues and erectile dysfunction, but much more research is required.
Animal & Cell Research (Lacking Evidence)
No clinical evidence supports the use of rhodiola for any of the conditions listed in this section. Below is a summary of the existing animal and cell-based research, which should guide further investigational efforts. However, the studies listed below should not be interpreted as supportive of any health benefit.
3) Cognition
Nootropics are an eclectic group of substances believed to enhance brain function. The widely-used nootropic is caffeine; a variety of plants may also have nootropic effects, such as ginseng, ginkgo, turmeric, and sage (Salvia) [48, 49, 50, 51].
Some users believe that rhodiola is a nootropic. In animal models, it stimulated activity in the brain and activated the neurotransmitters norepinephrine, serotonin, dopamine, and acetylcholine. However, this has not been observed in human trials [13, 15].
Rhodiola could potentially increase wakefulness and reduce both physical and mental fatigue, but this has not been studied in humans [52, 53, 54].
4) Immune System
Rhodiola extract could potentially improve the body’s natural immune response to threats from bacteria and viruses.
Closing the “Open Window”
Right after high–stress exercise, athletes have a dip in their immune function: a period during which they are more likely to, for example, catch a cold. This period is sometimes called the open window [55].
Rhodiola may help close the open window by boosting immune function at just the right time. In one study, marathon runners took 600mg/day of Rhodiola for a month before and a week after their race [56].
Researchers then took blood samples from the runners and introduced viruses into them. In the runners who had been taking Rhodiola, the virus grew and spread more slowly than in those who had not; this result suggests that people taking Rhodiola supplements may have an extra layer of protection during the open window [56].
Cytokines and Inflammation
Rhodiola activates three important immune response genes – RIG-I, MDA5, and ISG – in a type of white blood cells called monocytes. In one study of the dengue virus, this epigenetic effect increased cytokines in infected cells; these cytokines then improved the cells’ ability to eliminate the virus [57].
Cytokines are often labeled as the “bad guys” because they are high in chronic inflammation. During acute infection, however, your immune system needs the right balance of cytokines to mount a successful attack. However, this pathway may already be over-activated in your body if you suffer from chronic inflammation and autoimmune diseases (Th1 dominance).
T helper cells are a type of white blood cell that activates other immune cells by releasing cytokines. They can be further divided into Th1 and Th2 cells. Th1 cells are important for fighting bacterial infection, while Th2 cells induce allergic reactions and responses against physically larger threats like parasites [58, 59].
In one mouse study, Rhodiola extract increased the production of Th1 cytokines and did not appear to affect Th2 cytokines. It also prevented T cells from dying and improved the overall survival rate of the mice during infection [58, 59].
Overall, Rhodiola enhances the Th1 response, without affecting the Th2 response much. It may even balance the immune system and actively decrease inflammatory cytokines in some cases. See the section on anti-inflammatory properties below for more details [60].
5) Antioxidant Activity
Free radicals are potentially harmful molecules that are produced during energy metabolism in a healthy cell. Free radicals are completely natural, but they need to exist in balance with antioxidants to prevent excessive oxidative stress, which can damage fats, proteins, and DNA. Unfortunately, a lot of free radicals can be created through exposure to radiation or to harmful substances like cigarette smoke, air pollutants, and industrial chemicals [61].
Salidroside from Rhodiola rosea helped restore the balance between free radicals and antioxidants in cell and animal studies. It protected animal brains against poor blood flow and stroke (ischemia). Salidroside activates the Nrf2 pathway, which turns on protective genes, increases antioxidant proteins, and protects cells [62, 12, 63].
Rhodiola may reduce and prevent oxidative stress by activating AMPK. As mentioned, AMPK activates antioxidant proteins; it may also boost the Nrf2 pathway, giving Rhodiola a two-pronged antioxidant mechanism [64, 65].
Aging
Rhodiola’s antioxidant activity may help fight aging, although the mechanisms are not well-studied in humans [66, 15].
For example, osteoporosis, a disease that causes bone density to decrease as a person ages, is partially caused by oxidative stress. In one study, salidroside from rhodiola prevented the loss of calcium in human bone cells and in a mouse model of osteoporosis [67].
6) Bacteria & Acne
Extracts and dried Rhodiola root can kill the bacteria directly exposed to them. In one study, it could fight every species of bacteria studied, including the common disease-causing Staphylococcus aureus, Listeria monocytogenes, and Escherichia coli [68].
Salidroside may also fight acne on contact. Standard acne treatments can trigger antibiotic resistance in bacteria on the skin, making effective alternatives more important than ever. On contact, salidroside disrupted the acne biofilm: the thin, slimy layer of bacterial cells that stick to each other under your skin. Biofilms protect bacteria from damage and they are difficult to get rid of [69, 56].
Rhodiola and its extracts have yet to be studied in human acne trials.
7) Inflammation
JAK2 and STAT3 are two genes that, when combined, form a pathway that increases inflammation. Salidroside prevents the JAK2-STAT3 pathway from being activated; in this way, it decreases inflammation [27, 28].
Rhodiola may selectively decrease the inflammatory cytokines IL-1, IL-6, and TNF-alpha. Its extracts may reduce the expression of these cytokines throughout the body. In one study of mice injected with an E. coli toxin, a large dose of Rhodiola extract significantly lowered inflammation in the kidney and brain [70].
Salidroside, in particular, greatly reduced the expression of these cytokines in immune brain cells called the microglia (cell-based study). Inflammation of these supportive cells in the brain often underlies cognitive dysfunction and diseases like Alzheimer’s [70].
Results on its anti-inflammatory at first seem contradictory. In some studies, it increased the cytokine IFN-gamma; in others, it decreased it. It seems to be beneficial at low doses and becomes toxic at higher levels [58, 71].
This intriguing phenomenon is also known as hormesis. In the right doses, this plant could be hormetic: it may trigger an adaptive stress response that is overall beneficial to health [72, 73].
8) Brain Health
By activating AMPK, Rhodiola may protect nerves and neurons from damage in Alzheimer’s disease and brain injury [74, 17, 12].
Stroke
In a rat study, salidroside protected against the worst effects of brain damage in different types of stroke. Rats given salidroside before suffering brain damage had less inflammation, and the total volume of damaged tissue was significantly smaller. These results suggest that supplementation may increase brain protection in people at risk of stroke [12].
A person’s best chance to recover from a stroke is to seek treatment as soon as possible; the longer it takes to get to a hospital, the less likely a full recovery becomes. In a rat study, salidroside from Rhodiola reduced complications of stroke even when standard treatment was delayed [75].
This adaptogen’s antioxidant effects may explain its ability to protect the nervous system from damage. Free radicals can damage all cells in the brain, including neural stem cells in the growing brain; Rhodiola increases the expression of antioxidant proteins and reduces free radicals in the brain [76, 26].
Parkinson’s Disease
In Parkinson’s disease, neurons die off in a region of the basal ganglia. Increased stress in a part of the cell called the endoplasmic reticulum may be the underlying trigger. In a cell study, salidroside protected the endoplasmic reticulum of basal ganglia neurons from stress [77, 78].
According to the authors, these results suggest that rhodiola should be studied in animal models of Parkinson’s.
9) Heart Health
In the heart and elsewhere in the body, AMPK maintains an oxidative balance: in response to oxidative stress, AMPK activates genes that produce antioxidant proteins and reduces blood pressure. Mutations in the AMPK gene can cause problems with heart rhythm and cause Wolf-Parkinson-White syndrome, a rare heart condition [18, 79].
In animals and cells, rhodiola extract activated AMPK and thereby protected the heart from oxidative stress, lowered blood pressure, and maintained the correct rhythm of the heartbeat [22, 80, 81].
10) Lung Health
We need oxygen to flow constantly through our lungs, but the combination of toxins and oxygen in excess can produce a dangerous cocktail of free radicals and oxidative stress. The lungs are especially vulnerable to oxidative stress [82].
In the lungs, oxidative stress over a long period of time can lead to asthma, respiratory cancers, and chronic obstructive pulmonary disease, or COPD [82].
Possibly by increasing the expression of antioxidant proteins and reducing inflammatory cytokines, salidroside from Rhodiola protected against oxidative damage to the lungs of rats [83].
11) Pain Management
In multiple studies, rhodiola and its extracts reduced pain and swelling in rats with diabetes, arthritis, and injury [84, 85, 86].
Both of its major active components, salidroside and rosavin, appear to reduce pain by decreasing inflammation. In this sense, they are similar to many commonly-used anti-inflammatory painkillers (like NSAIDs) [85, 87].
Cancer Research
Rhodiola is currently under investigation for its potential to slow the growth of tumors [66].
When a tumor grows, it stimulates the growth of blood vessels around itself so that it can receive nutrients and get rid of waste. This process is called angiogenesis. Rhodiola extracts inhibit angiogenesis in animals [88].
Alone, salidroside from rhodiola is being investigated in the context of bladder, breast, stomach, brain, lung, and fibrosarcoma cancers [66].
Other researchers are investigating whether salidroside could increase the potency of conventional chemotherapy drugs [89, 90, 91].
Safety & Potential Risks
Because of some disagreement in the scientific community about the various effects and mechanisms of rhodiola, the FDA has classified it as a poisonous plant. Furthermore, the ingredients and active compounds in commercial Rhodiola supplements may not be accurately labeled. We recommend caution when choosing to supplement [15, 92].
Taken alone, Rhodiola is generally safe and well-tolerated in therapeutic dosages, with only mild to moderate side effects. The most common side effects in people taking this herb for anxiety were dizziness and dry mouth [53].
No studies have been conducted to determine rhodiola’s effect on pregnant or breastfeeding women; nonetheless, this herb is given to pregnant women in traditional Georgian medicine. Until clinical studies look into these effects, we recommend strongly against supplementing with Rhodiola while pregnant or breastfeeding [93, 94, 95, 96].
At a dose of 660 mg/day, combined with vitamin C, it decreased mental fatigue, increased exam scores and language-learning ability in teenagers. Rhodiola’s effects on children have not been formally studied. Rhodiola tea is traditionally given to children in the Caucasus Mountains, but we recommend against giving rhodiola supplements to children [97, 1].
Drug Interactions
Salidroside and rosavin are highly active molecules with diverse effects in the body. As such, anyone taking prescription medication should be careful when supplementing with Rhodiola. Talk to your doctor before supplementing to avoid adverse effects and unexpected interactions
Antidepressants
- MAOIs: Monoamine oxidase inhibitors should not be combined with any substance that increases dopamine or norepinephrine, except by a doctor’s instruction [98].
- SSRIs: Selective serotonin reuptake inhibitors like escitalopram and paroxetine may interact with Rhodiola and produce unwanted side effects like muscle pain, gum pain, and irregular heartbeat. Restlessness, trembling, sweating, and other symptoms of serotonin syndrome can also arise [99, 100].
Diabetes Medication
- Metformin: Rhodiola and metformin have some similar effects because they both activate AMPK and increase the body’s sensitivity to insulin. If you are taking metformin for any reason, talk to your doctor before supplementing [101, 102, 103].
- Any CYP2C9 substrate: Rhodiola inhibits the enzyme that breaks down many oral diabetes medications. See the section below for more details.
Blood Pressure Medication
Rhodiola lowers blood pressure by activating AMPK. We recommend caution when supplementing if you are already taking medication to lower your blood pressure [80].
Many blood pressure medications are also metabolized by CYP2C9. See the section below for more details [104].
CYP2C9 Substrates
Many drugs are broken down by a group of enzymes called cytochrome P450s, or CYPs. In the liver, CYPs metabolize many medications: if CYPs are blocked, these medications will stay in the bloodstream for longer and in higher concentrations. Their effects may then be more intense [105, 7].
Contradictory studies have suggested two opposite effects of Rhodiola on the CYP enzyme CYP2C9. In two studies, it blocked the effects of CYP2C9; in one study, salidroside alone increased the activity of CYP2C9. More research is required to fully understand how this plant and its active compounds affect CYP2C9 [105, 7, 106].
CYP2C9 substrates include any compound metabolized by this enzyme. These medications may reach higher blood levels when combined with Rhodiola extracts:
- NSAIDs like aspirin, ibuprofen (Advil or Motrin) and naproxen (Aleve) [107]
- Anticoagulants like warfarin [104]
- Blood pressure medication like losartan [104]
- Phenytoin, which is prescribed to prevent seizures [105, 108]
Some of these medications, especially warfarin and phenytoin, have a narrow therapeutic index. This means that very small variations in dose can have a wide variety of effects. In some cases, even a change in diet can alter the effect of these drugs. Rhodiola may interact with warfarin and phenytoin in unexpected ways. Consult your doctor before supplementing if you are taking these medications [108, 105, 109].
Other drugs increase or decrease the activity of CYP2C9 and may interact with Rhodiola, but these interactions have not yet been studied. We advise caution when combining this herb with any prescription medication.
Dosage
There is no safe and effective dose of rhodiola or its extracts because no significantly powered study has been conducted to find one. Furthermore, the FDA has not approved rhodiola for any medical purpose or health claim, and in fact, classifies Rhodiola rosea and some related species as poisonous plants.
That being said, it has had a favorable safety profile and produced some promising results in clinical trials.
Rhodiola rosea supplements are available as caplets, tea, or liquid extracts. High-quality extracts, such as those used in medical research, contain at least 3% rosavins and 1% salidroside. Other species of Rhodiola, such as R. crenulata, may contain a much higher concentration of salidrosides [110, 111, 23].
A recent study on Rhodiola supplements found good results with 400 mg/day of dry Rhodiola extract (or 300 – 1,000 mg of the root) to effectively reduce the symptoms of chronic fatigue [53].
Some psychiatrists may recommend rhodiola as part of a strategy to improve ADHD and focus/learning difficulties. One doctor advises his patients to gradually build up to and not exceed 450 mg/day (three 150 mg capsules) and taking the extract half an hour before a meal [1].
Consult your own doctor before taking rhodiola supplements.
Genetics
PRKAA1
PRKAA1 is a gene that produces the most active piece of the AMPK protein. Among women living at high altitudes, variations in this gene affect the birth weight of their children and the width of the artery that feeds the baby in the womb. In particular, women with certain variations in the SNPs rs929785, rs1345778, and rs3805490 had wider uterine arteries and gave birth to heavier babies [112].
This effect may be caused by increased AMPK activity, which has a protective effect in low-oxygen environments. Because Rhodiola activates AMPK, people with variations in these SNPs may react more strongly to it; this interaction has not been confirmed. More research is required to confirm interactions between PRKAA1 and compounds that affect AMPK [112, 113].
COMT
COMT is an enzyme that inactivates and breaks down dopamine (and other monoamines) in the brain. It ensures that dopamine levels don’t stay too high, which is important for the correct function of the prefrontal cortex and basal ganglia [114, 115].
Variations in the COMT gene may affect your personality profile, making you more of a “worrier” or “warrior”. The worrier has lower COMT function, more available dopamine, and stronger memory and attention; the warrior has higher COMT, less available dopamine, and better performance under stress [116, 117].
Rhodiola inhibits COMT and raises the amount of available dopamine in the brain. Thus, people with low COMT function are better off avoiding this adaptogen, as well as all other herbal COMT inhibitors [118].
Ashwagandha and Rhodiola
Rhodiola is often combined with other herbal supplements, including ashwagandha. Some practitioners recommend combining these two herbs to improve ADHD symptoms; however, there are no formal studies on this herbal blend [1].
Ashwagandha decreases stress by reducing the amount of cortisol and other stress hormones in the body. Ashwagandha also improves cognitive function and has antioxidant and immune-boosting effects [119, 120, 121, 122].
However, ashwagandha and Rhodiola have different active components. Ashwagandha’s therapeutic effects are probably caused by withaferin A and withanolide D; Rhodiola’s most active components are salidroside and rosavin. These compounds, in combination, may work better than any one of them alone. However, this has yet to be researched [123, 111].
Takeaway
Rhodiola may work well for people looking to handle stress better, feel more energized and avoid burnout and chronic fatigue. Traditionally, it is also used at high altitudes to increase blood flow, protect the heart, and enhance brain function.
The best evidence available is for rhodiola’s popular use as a stress-buster. Clinical evidence for all other uses is considered insufficient.
This herb has many potent bioactive compounds, including salidroside and rosavin, and drug interactions are possible. Consult your doctor if you plan to start supplementing, especially if you are currently on prescription medications.
