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Limited evidenceStress & mood

Rhodiola Rosea

Rhodiola is one of the better-studied adaptogens, but that is a low bar: the fatigue trials are small and mostly at high risk of bias, and the one rigorous depression trial found it no better than placebo. A plausible mild anti-fatigue effect with weak proof behind it.

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What the science says

  • Physical and mental fatigue Limited evidence

    Ishaque's 2012 systematic review found 11 controlled trials; only 2 of 6 physical-fatigue trials and 3 of 5 mental-fatigue trials reported benefit, at doses of roughly 100-576 mg/day. Every included study had a high or unclear risk of bias, and the reviewers concluded the literature is contradictory and cannot establish efficacy.

  • Mild to moderate depression Limited evidence

    In a 12-week phase II trial of 57 adults with major depression, HAM-D scores fell 5.1 points on Rhodiola, 4.6 on placebo and 8.2 on sertraline, with no statistically significant difference between groups (p = 0.79). Rhodiola was clearly better tolerated (adverse events 30% vs 63% for sertraline), but that is a tolerability finding, not an efficacy one.

  • Exercise performance Limited evidence

    Acute-dosing studies of 200-370 mg have reported longer time to exhaustion, but pooled in the 2012 review only 2 of 6 physical-performance trials were positive and all were methodologically weak. There is no reliable evidence of an ergogenic effect.

Dosage & safety

Studied doseTrials used 100-680 mg/day of root extract standardized to about 3% rosavins and 1% salidroside (SHR-5 / WS 1375 preparations). A common regimen is 200-400 mg/day taken in the morning; acute anti-fatigue studies used single doses of 200-370 mg. Effects, if any, are reported within days rather than weeks.
SafetyGenerally well tolerated for up to 12 weeks; dizziness, dry mouth and mild GI upset are the usual complaints, and the sertraline comparison trial recorded adverse events in 30% on Rhodiola versus 16.7% on placebo. It is stimulating for some people, so late-day dosing can cause insomnia or agitation. Case reports describe activation and manic switching in bipolar disorder. In vitro it inhibits CYP3A4 and P-glycoprotein, so use caution with narrow-therapeutic-index drugs, and avoid combining with MAOIs or stacking with other serotonergic agents. No safety data in pregnancy or breastfeeding. Not prohibited in sport, but adulteration of Rhodiola products with cheaper Rhodiola species is well documented.

How to take it

TimingTake it in the morning; late-day dosing causes insomnia and agitation in a sizeable minority.
With food?Food is not required - take it with breakfast or on an empty stomach, whichever you tolerate.
Worth knowingAdulteration with cheaper Rhodiola species is well documented, so buy a product with a rosavin and salidroside assay on its certificate of analysis.

Interactions

With medications

  • MAOIs, SSRIs, SNRIs and other serotonergic drugs

    Rhodiola has monoamine-modulating activity and stacking serotonergic agents raises the risk of serotonin toxicity. do not combine without medical supervision

  • narrow-therapeutic-index drugs metabolised by CYP3A4 or transported by P-glycoprotein

    Rhodiola inhibits both in vitro, which could raise blood levels of the drug. check with your pharmacist before combining

With other supplements

  • 5-HTP, SAMe and St John's wort

    Additive serotonergic load with no added benefit. do not stack them

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Does rhodiola rosea help with fatigue?

The evidence for rhodiola is limited: a 2012 review found only 2 of 6 physical-fatigue trials and 3 of 5 mental-fatigue trials reported benefit, and every study had high or unclear risk of bias. A mild anti-fatigue effect is plausible but not established.

Does rhodiola work for depression?

In a 12-week trial in 57 adults with major depression, rhodiola was not statistically better than placebo, while being better tolerated than sertraline. The evidence for rhodiola in depression is limited.

How much rhodiola should I take and when?

A common rhodiola regimen is 200-400 mg/day of root extract standardised to about 3% rosavins and 1% salidroside, taken in the morning. Late-day dosing causes insomnia or agitation in some people.

Can I take rhodiola with antidepressants?

Do not combine rhodiola with MAOIs, SSRIs, SNRIs or other serotonergic drugs without medical supervision, because of the risk of serotonin toxicity. Rhodiola also inhibits CYP3A4 and P-glycoprotein in vitro, so check with a pharmacist before using it with narrow-therapeutic-index drugs.

Scientific references

Where to buy

Swanson Vitamins, Rhodiola Rosea Extract, 60 Capsules

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