- Natural Endocrine Solutions Dr. Eric Osansky, DC, IFMCP - https://www.naturalendocrinesolutions.com -

Herbal Spotlight: Rhodiola

Published May 16 2016

There are a lot of wonderful adaptogenic herbs that can help with adrenal problems by supporting the hypothalamic-pituitary-adrenal (HPA) axis.  These include eleuthero, ashwagandha, schisandra, and panax ginseng.  Rhodiola rosea is another wonderful herb that can help people adapt to the stress as well, and it has numerous other benefits that I’ll discuss in this article.

Rhodiola rosea is a popular plant in traditional medical systems in Eastern Europe and Asia with a reputation for stimulating the nervous system, decreasing depression, enhancing work performance, eliminating fatigue, and preventing high altitude sickness (1) [1].  The adaptogenic, cardiopulmonary protective, and central nervous system activities of Rhodiola rosea have been attributed primarily to its ability to influence levels and activity of monoamines and opioid peptides such as beta-endorphins (1) [1].  The active compounds isolated from Rhodiola rosea include tyrosol, salidroside, and rosiridin (2) [2].

What Are Some Of The Conditions Rhodiola Can Help With?

Stress-Related Fatigue.  Numerous studies have shown that rhodiola can help with the fatigue associated with stress.  One double-blind, randomized, and placebo-controlled study investigated the effects of Rhodiola rosea in foreign students during a stressful examination period (3) [3].  The students showed significant improvements in physical fitness, mental fatigue, and neuro-motoric tests.  Another study involving 56 physicians suggested that Rhodiola rosea can reduce general fatigue under certain stressful conditions (4) [4].  Yet another study looked at the efficacy of Rhodiola rosea in individuals who suffered from stress-related fatigue (5) [5].  The authors concluded that repeat administration of Rhodiola rosea exerts an anti-fatigue effect that increases mental performance, particularly the ability to concentrate, and decreases cortisol response to awakening stress in burnout patients with fatigue syndrome (5) [5].

Depression.  Rhodiola rosea can also benefit many people with depression.  A recent study involving 57 subjects looked to compare the effects of Rhodiola rosea vs. sertraline for mild to moderate depression (6) [6].  Sertraline is a selective serotonin reuptake inhibitor (SSRI) that is commonly prescribed to treat depression. The study showed that while rhodiola produced less antidepressant effects than sertraline, it also resulted in significantly fewer adverse events and was better tolerated, and therefore might have a more favorable risk to benefit ratio for individuals with mild to moderate depression (6) [6].  Another study assessed the efficacy and safety of Rhodiola rosea in patients suffering from a current episode of mild to moderate depression (7) [7].  The authors concluded that rhodiola shows anti-depressive potency in patients with mild to moderate depression when administered in dosages of either 340 or 680 mg/day over a 6 week period, and no serious side-effects were reported (7) [7].

Anti-inflammatory and Neuroprotective.  There is also evidence that Rhodiola rosea has anti-inflammatory and neuroprotective properties.  One in vitro study showed that Rhodiola rosea can inhibit the enzymes related to inflammation, which included cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2) and Phospholipase A2 (PLA2) (8) [8].  Another study on rats showed that rhodiola has significant analgesic activity and anti-inflammatory activity (9) [9].  Yet another study showed that Rhodiola rosea can ameliorate the inflammation and neurotoxicity in cortical neuronal cells, which in turn may lead to its usage in the treatment of neurodegenerative diseases (10) [10].

Endurance Exercise Performance.  One study looked to determine the effects of an acute oral dose of Rhodiola rosea on endurance exercise performance, perceived exertion, mood, and cognitive function (11) [11].  The study showed that acute ingestion of rhodiola decreases heart rate response to submaximal exercise and appears to improve endurance exercise performance (11) [11].

Antiviral.  I came across one study which showed that rhodiola has antiviral properties against the dengue virus (12) [12].  Another study showed that Rhodiola rosea may exert protective effects against viral replication following intense and prolonged exercise (13) [13].  And another study showed that salidroside, which is a compound of Rhodiola rosea, has antiviral effects (14) [14].

Pulmonary Hypertension.  There is some evidence in the literature that rhodiola can help with pulmonary hypertension caused by high altitudes (15) [15] (16) [16].  However, this involves Rhodiola crenulata, and not Rhodiola rosea.  There are 96 different species of rhodiola, and while most species have some similarities, they differ with regards to their bioactive components (16) [16].

Dosage, Contraindications, Etc.                                        

Clinical studies report Rhodiola rosea-only products ranging in dose from 50 mg to 660 mg per capsule, to a maximum of 1500 mg/day, which suggests a large margin of safety (17) [17].  Studies reporting a positive effect of Rhodiola rosea on physical performance reported using doses of 200 mg/day and 680 mg/day and those reporting a positive effect on mental fatigue reported using doses between 100–576 mg/day (17) [17].  Kerry Bone, who is a well known herbalist who has written numerous textbooks on herbal medicine recommends for adults to take 20 to 40 mL per week of a 2:1 liquid extract (18) [18].  He also mentions how rhodiola can be combined with other adaptogens and tonics including panax ginseng, eleuthero, ashwagandha, astragalus, shatavar, and damiana (18) [18].

Kerry Bone also advises to be cautious when using rhodiola in depressed patients with hysteric and phobic symptoms, such as bipolar disorder (18) [18].  Rhodiola rosea has demonstrated a very low occurrence of side effects demonstrating a low clinical toxicity, with no known contraindications when used with other herbal or prescription medications (17) [17].

With that being said, one study evaluated the effect of Rhodiola rosea on the activity of some of the cytochrome P-450 enzymes, and it showed that Rhodiola rosea can reduce the metabolic activity of CYP2C9 (19) [19].  There were no significant effects with any of the other CYP enzymes tested.  CYP2C9 is one of the main enzymes involved in the metabolism of warfarin, and as a result, anyone who is taking warfarin might want to be cautious about taking rhodiola.  This enzyme is also involved in the metabolism of other drugs, including phenytoin, tolbutamide, ibuprofen (20) [20], and so taking Rhodiola rosea might increase the effectiveness of these drugs by reducing the metabolism of the CYP2C9 enzyme.

In summary, Rhodiola rosea is an adaptogenic herb which not only can help people to better adapt to the stress, but it has numerous other benefits as well.  This includes helping with stress-related fatigue, depression, it has anti-inflammatory and neuroprotective properties, can improve endurance exercise performance, and even has antiviral properties.  It can be combined with other adaptogenic herbs, and it seems to have a very low occurrence of side effects and low clinical toxicity.  However, Rhodiola rosea reduces the metabolic activity of the CYP enzyme CYP2C9, which can be a concern if you are taking certain drugs such as warfarin, phenytoin, tolbutamide, and ibuprofen.