Rhodiola Rosea

Research suggests Rhodiola rosea may help: (1) Stress-related fatigue and burnout: multiple randomized controlled trials and recent systematic reviews/meta-analyses report small-to-moderate improvements in fatigue, perceived stress, and well-being versus placebo, though study heterogeneity and risk of bias temper confidence (evidence: moderate). (2) Cognitive performance under stress/sleep loss: some small RCTs in students, physicians, and shift workers show modest improvements in attention, reaction time, or mental performance during acute stress or sleep deprivation; other trials are neutral (evidence: mixed to moderate). (3) Mild-to-moderate depressive and anxiety symptoms: a placebo-controlled RCT found modest symptom reductions and better tolerability than sertraline; pooled analyses suggest small benefits with generally low-to-moderate quality evidence; not a substitute for standard care in major depression (evidence: moderate for mild symptoms). (4) Exercise capacity/perceived exertion: findings are inconsistent—some studies show improved time to exhaustion or reduced perceived exertion, others show no effect (evidence: emerging). (5) Stress biomarkers: limited human data indicate small reductions in cortisol and improvements in stress-related physiological markers; more research needed (evidence: emerging).

Generally well tolerated in short-term use (about 2–12 weeks) at studied doses. Common: dry mouth, dizziness, headache, gastrointestinal upset, irritability/jitteriness, and insomnia (especially if taken late in the day). Less common: palpitations, restlessness, transient blood pressure or heart rate changes. Rare but serious: possible serotonin syndrome when combined with serotonergic drugs; hypoglycemia in individuals on glucose-lowering therapies; allergic reactions; potential precipitation of mania/hypomania in susceptible individuals. Many effects are dose- and timing-dependent (overstimulation more likely at higher doses or with late-day dosing). Long-term safety data are limited.

Typical supplemental doses in clinical studies use standardized extracts (e.g., SHR-5) containing about 3% rosavins and 1% salidroside. Commonly used ranges: 200–400 mg once daily for stress-related fatigue; around 400 mg/day for burnout; 200–300 mg taken acutely 30–60 minutes before cognitively demanding tasks; approximately 340–680 mg/day in depressive symptom trials. Optimal dosing varies by extract, individual response, and indication; many studies dose in the morning or early afternoon to minimize insomnia.

Pregnancy and breastfeeding (insufficient safety data). Bipolar disorder or history of mania/hypomania (risk of mood switching). Concomitant use with MAO inhibitors, or combination with multiple serotonergic agents (SSRIs/SNRIs/triptans/linezolid) without medical supervision. Uncontrolled hypertension, significant cardiovascular disease, or arrhythmias (stimulatory potential may affect BP/HR). Diabetes or hypoglycemia when using glucose-lowering medications (risk of additive effects; requires close monitoring). Bleeding disorders or use of anticoagulant/antiplatelet drugs (theoretical antiplatelet effects; evidence limited—use caution). Autoimmune diseases or use of immunosuppressants (immunomodulatory effects; caution advised). Known allergy to plants in the Crassulaceae family. Elective surgery: discontinue 1–2 weeks prior to reduce potential bleeding and BP/HR variability.