Index of Herbs

Monograph

Rhodiola

Rhodiola rosea

Updated October 4, 2026

Oil painting of rhodiola (Rhodiola rosea) with yellow flower clusters among boulders above a Nordic fjord, with a botanical inset of the golden rootstock, a stem, and a flower

Key points

  1. 01

    Traditional, not proven

    The EU accepts rhodiola as a traditional remedy for stress symptoms such as fatigue, but EMA and NCCIH both say the clinical evidence is insufficient to prove it works.

  2. 02

    Small trials, mixed results

    Positive fatigue and depression trials are small and often industry-linked. A US depression trial found no significant difference from placebo, and reviews flag high risk of bias.

  3. 03

    EU dose is modest

    EMA’s traditional dose is 144–400 mg a day of a defined ethanol extract, for adults only. See a doctor if symptoms last more than two weeks.

  4. 04

    Adulteration is common

    About a fifth of products tested in one study lacked rosavin, the marker for Rhodiola rosea. Registered medicines were more reliable than online supplements.

  5. 05

    Watch drug interactions

    Rhodiola modestly slowed CYP2C9 in humans, relevant to warfarin, phenytoin, and losartan. Case reports link it with reactions when combined with antidepressants.

Rhodiola is the flagship of the herbs sold as adaptogens, a term for remedies said to raise the body’s resistance to stress. The medicine is the rootstock of a small succulent from Arctic coasts and northern mountains, often called golden root or Arctic root. It has a regulatory foothold in Europe: in March 2024 the EU’s herbal committee reaffirmed rhodiola as a traditional herbal medicine for the relief of symptoms of stress, such as fatigue and exhaustion, at 144–400 mg a day of a defined ethanol extract. Swedish tablets have been in medicinal use since 1987.

Traditional status is not proof of efficacy, and the agencies say so plainly. EMA’s assessment report concludes that there is not sufficient evidence of clinical efficacy for fatigue or exhaustion, because the published trials have considerable deficiencies. NCCIH’s April 2025 summary says there isn’t enough reliable evidence to determine whether rhodiola is useful for any health-related purpose. The most cited positive trials are small, and many were run by researchers linked to the company that makes the leading extract. An international psychiatric taskforce did not support rhodiola for mood disorders.

The cautions are concrete. A human study found that rhodiola modestly slows the liver enzyme CYP2C9, which handles warfarin, phenytoin, and losartan, and reports describe agitation and serotonin-type reactions when it was combined with antidepressants. Product quality is a real problem: about a fifth of commercial products tested in one study contained no rosavin, the marker that identifies Rhodiola rosea. Persistent exhaustion has medical causes that need diagnosis, and depression needs proper treatment. Nothing here is medical advice.

In this monograph

01 The plant

Botanical profile

Rhodiola rosea L. belongs to Crassulaceae, the stonecrop family of fleshy-leaved succulents; older floras placed it in Sedum, as Sedum rosea or Sedum rhodiola. NCBI Taxonomy files it as taxon 203015. NCCIH lists arctic root, golden root, rose root, rosenroot, and king’s crown as common names. It is a perennial with a thick, fragrant rootstock from which upright stems, up to about 70 cm tall according to Brown and colleagues (HerbalGram 2002), carry crowded fleshy leaves and end in dense heads of small yellow flowers. EMA explains that the name refers to the rose-like fragrance of the freshly cut underground parts. Panossian, Wikman, and Sarris (Phytomedicine 2010) describe it growing in crevices of mountain rocks and on sea cliffs in the Arctic regions of Europe, Asia (mainly Siberia), and North America, including Britain, and further south on mountains.

The medicinal part is the dried rhizome and root. EMA notes that what is commonly called the root is mostly rhizome, an underground stem with irregular thickening, and that the main commercial source is the Altai region of Asia. Wild harvesting has a long and troubled history. Brown and colleagues report that demand rose sharply in the late 1980s, that wild stands were over-harvested, and that other Rhodiola species were substituted. Panossian and colleagues note that the genus has about two dozen species, several of which grow in the Altai and can be mistaken for R. rosea.

Around 140 compounds have been isolated from the root and rhizome (Panossian 2010). The two that matter most for quality are salidroside (also called rhodioloside; PubChem CID 159278, C14H20O7), a phenylethanoid glycoside found in many Rhodiola species, and the rosavins, a group of cinnamyl alcohol glycosides (rosavin, rosin, and rosarin) that are characteristic of R. rosea. Tyrosol, monoterpene glycosides such as rosiridin, flavonoids, proanthocyanidins, and a trace of essential oil are also present (EMA). Extraction solvent changes the profile: EMA cites work showing that 70% ethanol extracts rosavins efficiently but yields less salidroside than 40% ethanol, so extracts are not interchangeable. Booker and colleagues (Phytomedicine 2016) tested about 40 commercial products and found that roughly one fifth contained no rosavin, and most of the rest had less rosavin than registered medicines and appeared to be adulterated with other Rhodiola species, notably R. crenulata.

02 Lineage

History

Brown and colleagues trace the earliest medicinal record to the Greek physician Dioscorides, who described a plant called rodia riza in the first century, though identifying ancient plant names with modern species is always uncertain. The best-documented history is Scandinavian. Panossian and colleagues note that Linnaeus, in his Materia Medica of 1749, recommended the root for headaches, hysteria, hernias, and discharges and as an astringent, and that it appeared in the first Swedish national pharmacopoeia in the eighteenth century. An Icelandic book of useful plants from 1783 recommended it for headache, diarrhoea, mouth pain, and strengthening the head. Sami people in northern Sweden reportedly chewed bits of the root on long journeys. The popular claim that Vikings used it for strength is, in Panossian’s word, speculative.

Rhodiola’s modern reputation was built in the Soviet Union. Brown and colleagues describe a 1961 expedition to the Altai Mountains led by the botanist G. V. Krylov that identified the prized golden root as R. rosea, after which Soviet scientists studied its effects on stress, fatigue, and performance. EMA’s assessment report records that in 1969 the USSR Ministry of Health recommended medical use and industrial production of a liquid extract, and that in 1975 a fluid extract made with 40% ethanol was accepted for large-scale production. Much of that research was published in Russian and other Slavic or Scandinavian languages, and reviewers have repeatedly noted a lack of independent replication, one reason Western regulators treat it cautiously.

In the West the leading product came from Sweden. EMA records that tablets of the SHR-5 extract were sold as a natural remedy in Sweden from 1987 and registered as a traditional herbal medicine in 2008, with registrations for a related extract following across the EU. Clinical trials of SHR-5, many co-authored by researchers from the Swedish Herbal Institute, which makes the extract, appeared from 2000 onward. The EU’s Committee on Herbal Medicinal Products adopted its first rhodiola monograph on 27 March 2012 and a revision on 20 March 2024, both granting traditional use only. In the United States rhodiola is sold as a dietary supplement, which, NCCIH notes, does not need FDA approval before it is sold.

03 Chemistry

Active compounds and how it works

Nobody knows for certain how rhodiola works in people, or whether a single mechanism exists. Panossian and colleagues review laboratory and animal findings that rhodiola extracts modulate the stress system, including cortisol release through the hypothalamic-pituitary-adrenal (HPA) axis, stress-activated protein kinases, nitric oxide, and heat shock proteins. In the Olsson trial (Planta Medica 2009), the cortisol response to awakening changed differently in the rhodiola and placebo groups, a hint of an HPA effect in humans. MSKCC notes that salidroside is neuroprotective and antioxidant in cell studies, that extracts inhibit the brain enzymes monoamine oxidase A and B in the laboratory, which could plausibly relate to mood effects, and that animal data on cognition mostly carry a high risk of bias.

Absorption is quick and short-lived. EMA’s assessment report describes a study in 16 volunteers given 288 mg of SHR-5: salidroside appeared in blood immediately, rosavin after an hour, both peaked at about two hours, and both had fallen below detection by eight hours. EMA notes that no pharmacodynamic data are required for a traditional-use product, and its monograph makes no claims about mechanism. The adaptogen idea itself, a substance that non-specifically increases resistance to stress, grew out of Soviet research; it describes what researchers hoped to find rather than an established pharmacological class.

04 In practice

Common uses

Stress-related fatigue is the main claim and the best-tested one. Olsson, von Schéele, and Panossian (Planta Medica 2009) randomized 60 Swedish adults aged 20 to 55 with a diagnosis of fatigue syndrome to 576 mg a day of SHR-5 or placebo for 28 days. Both groups improved substantially, a strong placebo effect, but the rhodiola group did better on a burnout scale and some attention measures. EMA’s assessor noted that the burnout score moved only from 4.27 to 4.01 with rhodiola versus 4.33 to 4.26 with placebo (p = 0.047) and judged the trial too small to support well-established use. Several open-label studies, in which everyone knew they were taking rhodiola, reported improvements in 100 to 118 people with stress, burnout, or chronic fatigue symptoms at 200 mg twice daily, but uncontrolled studies cannot separate the herb from expectation and the passage of time.

The wider evidence is weak. Ishaque and colleagues (BMC Complementary and Alternative Medicine 2012) reviewed 11 controlled trials: two of six trials on physical fatigue and three of five on mental fatigue reported benefit, and every study had a high risk of bias or reporting flaws. Blomkvist, Taube, and Larhammar (Planta Medica 2009) re-examined the statistics and found considerable shortcomings in all but one of the studies claiming significant effects. Early trials in healthy night-duty physicians, military cadets, and students during exams reported less mental fatigue, but EMA notes they involved healthy volunteers and unvalidated tests and cannot show clinically relevant effects in patients.

Depression: EMA’s assessment report describes a 2007 Armenian trial in 89 people with mild to moderate depression, in which 340 or 680 mg of SHR-5 daily for six weeks lowered Hamilton depression scores from about 24 to 16, while placebo scores barely moved; the assessor called the near-absent placebo response untypical and the significance questionable. A more rigorous US trial by Mao and colleagues (Phytomedicine 2015) randomized 57 adults with major depression to rhodiola, sertraline, or placebo for 12 weeks. Scores fell in all three groups with no significant difference between them (Hamilton score changes of −5.1 with rhodiola, −8.2 with sertraline, and −4.6 with placebo), though rhodiola caused fewer side effects than sertraline. The 2022 WFSBP and CANMAT taskforce guidelines (Sarris, World Journal of Biological Psychiatry) did not support rhodiola for mood disorders.

Anxiety: EMA summarizes a 10-week pilot study in only 10 people with generalized anxiety disorder taking 340 mg a day, with no placebo group; anxiety scores fell, but the design cannot show cause. Exercise: Sanz-Barrio and colleagues (Phytotherapy Research 2023) reviewed 13 randomized trials with 263 healthy participants. Results were heterogeneous; single doses may modestly improve endurance and perceived exertion, regular use may help anaerobic performance but not endurance, and most studies had unclear or high risk of bias. In one of the better-described trials summarized by EMA, a single 200 mg dose lengthened time to exhaustion from 16.8 to 17.2 minutes, and four weeks of use changed nothing. Altitude: a small study at a simulated 4,600 metres found no effect on blood oxygen.

05 The apothecary

Preparations and traditional use

EU traditional use (EMA/HMPC/24177/2023, revision 1, adopted 20 March 2024): dry extract of the rhizome and root (drug-to-extract ratio 1.5–5:1, extracted with 67–70% ethanol), in tablets or capsules, 144–200 mg per dose once or twice daily, total 144–400 mg per day, for adults and the elderly. Not recommended under 18. If symptoms persist for longer than two weeks, or worsen, consult a doctor or qualified health practitioner. The two extracts behind most European registrations and trials are SHR-5 (144 mg tablets, one or two daily in Sweden) and a related extract sold at 200 mg twice daily.

Older Soviet practice used a liquid extract (1:1 in 40% ethanol), 5–10 drops two or three times daily, 15 to 30 minutes before meals, for 10 to 20 days (Saratikov 1974, cited by EMA). Teas and vodka tinctures are traditional too, but nobody has measured what they deliver. Trials of the standardized European extracts used roughly 100–680 mg daily, mostly for two to 12 weeks; NCCIH says rhodiola is possibly safe for up to 12 weeks, and longer-term safety is unknown. Because insomnia and nervousness are among reported side effects, take it earlier in the day if it disturbs sleep.

Choose carefully. Booker and colleagues found that registered traditional herbal medicines were consistent, while many unregistered supplements bought online lacked rosavin or appeared to contain other Rhodiola species. In the UK and EU, look for a traditional herbal registration; elsewhere, look for the full name Rhodiola rosea, the plant part, the extract ratio or rosavin and salidroside content, and independent quality certification. Avoid multi-herb stress or cortisol blends, which make it impossible to know what you are taking, and remember that rhodiola used in traditional Chinese medicine often comes from other species, such as R. crenulata, with different chemistry (Booker).

Safety

Before you use rhodiola

06 Caution

Side effects

Rhodiola appears well tolerated in short trials. EMA’s monograph lists headache, nausea, abdominal pain, diarrhoea, skin rash, and itching, all with frequency not known, and notes that no overdose has been reported. NCCIH lists dizziness, headache, insomnia, and either dry mouth or excessive saliva production. MSKCC lists dizziness and dry mouth, which were the most common adverse events in the generalized anxiety pilot. EMA’s assessor added that many trial publications report adverse events only by broad organ class, mostly nervous system and gastrointestinal complaints, which limits what can be said about frequency.

Rates vary with how carefully side effects are recorded. In an open-label study of 101 people taking 200 mg twice daily, 36 (about 36%) reported at least one adverse event, mostly nervous system or digestive complaints, none serious, and two stopped early, though investigators judged those events unlikely to be related (EMA). In the Mao depression trial, 30% of people on rhodiola reported adverse events, compared with 63% on sertraline and 17% on placebo; nervousness and dizziness were reported with rhodiola. Most trials lasted only weeks and enrolled small numbers of people, so uncommon or delayed effects could easily have been missed.

Rare and serious reports usually involve combinations. MSKCC describes a 26-year-old woman who developed a fast, irregular heartbeat after taking rhodiola with her antidepressant for three days. EMA’s assessment report lists European pharmacovigilance reports with antidepressants, including a suspected serotonin syndrome in a 68-year-old taking paroxetine and 400 mg of rhodiola daily, plus agitation, insomnia, sedation, and other symptoms with various psychiatric drugs. Causation in such reports is uncertain, but they are a reason not to add rhodiola to psychiatric medicines without advice.

07 Caution

Contraindications

Do not use rhodiola if you are allergic to it (EMA). Children and adolescents under 18 should not use it, because safety has not been established for lack of data (EMA). Pregnancy and breastfeeding: EMA says safety has not been established and use is not recommended; NCCIH says little is known. EMA also notes that tests for reproductive toxicity, genotoxicity, and carcinogenicity are not available, and that this missing genotoxicity data is why it could not be added to the EU list of herbal substances for traditional use.

Depression and anxiety disorders: NCCIH reminds readers that depression can be a serious illness that needs a health professional. Rhodiola has not been shown to work for major depression, and the 2022 WFSBP and CANMAT taskforce of psychiatric experts did not support its use in mood disorders (Sarris). Stopping or delaying effective treatment in favour of it is a real risk. MSKCC advises caution for people taking prescription antidepressants, and the same logic applies to other psychiatric medicines. Anyone with thoughts of self-harm needs urgent help, not a supplement.

Fatigue should be investigated, not self-treated indefinitely. Persistent tiredness can come from anaemia, thyroid disease, diabetes, sleep apnoea, depression, medication effects, infections, and many other treatable causes. EMA’s two-week rule exists for this reason: if symptoms last beyond two weeks or worsen while taking rhodiola, see a doctor. People with heart rhythm problems should be cautious given the case report of tachyarrhythmia, and anyone taking warfarin, phenytoin, or losartan should read the interactions section first.

08 Caution

Drug and herb interactions

EMA’s monograph states that no clinically relevant interactions have been observed, but its own assessment report and other sources describe signals worth respecting. Thu and colleagues (European Journal of Clinical Pharmacology 2016) gave 13 healthy volunteers a cocktail of probe drugs before and after 14 days of a commercial rhodiola product. The ratio of losartan’s active metabolite to losartan fell by 21%, indicating reduced CYP2C9 activity; the other enzymes tested (CYP1A2, 2C19, 2D6, and 3A4) were not significantly affected. The authors called the effect modest but potentially relevant for CYP2C9 drugs with a narrow margin, such as warfarin and phenytoin, a caution MSKCC repeats. NCCIH also notes that interactions between rhodiola and losartan have been reported.

Laboratory studies show that rhodiola inhibits CYP3A4 and the drug transporter P-glycoprotein, with unknown clinical relevance (MSKCC); the human cocktail study did not find a CYP3A4 effect. Rhodiola extracts inhibit monoamine oxidase in vitro, and MSKCC flags a theoretical risk of added serotonergic effects with antidepressants, added blood pressure lowering with antihypertensives, and added blood pressure raising with stimulants. Given the case reports with SSRIs and other psychiatric drugs, talk to your prescriber before combining rhodiola with antidepressants, antipsychotics, sedatives, or stimulants. If you take warfarin, expect your INR to be checked more often if you start or stop rhodiola.

09 Questions

Frequently Asked Questions

Possibly, a little, but the evidence is weak. The EU recognizes rhodiola as a traditional remedy for symptoms of stress such as fatigue and exhaustion, based on long use. The best-known placebo-controlled trial, in 60 people with stress-related fatigue, found a small benefit on a burnout scale after four weeks, and EMA judged it too small to prove efficacy. Reviews find most rhodiola trials flawed. NCCIH says there isn’t enough reliable evidence to know whether it helps.

It is the herb most often given that label, along with ashwagandha, ginseng, and holy basil. Adaptogen is a concept from Soviet pharmacology for substances said to increase resistance to stress in a general way. It describes a hope rather than a proven drug class, and each herb has to be judged on its own trials and safety.

It has not been shown to. An early Armenian trial reported large benefits, but EMA questioned it because the placebo group barely changed. A better-designed US trial found no significant difference between rhodiola, sertraline, and placebo, and international psychiatric guidelines do not support rhodiola for mood disorders. St John’s wort has much stronger evidence for mild depression but far more drug interactions. Depression needs proper assessment and treatment.

EMA’s traditional-use dose for adults is 144–200 mg of a defined dry extract (1.5–5:1, extracted with 67–70% ethanol) once or twice daily, up to 400 mg a day. It is not recommended under 18. If symptoms last more than two weeks or get worse, see a doctor. Supplements vary widely, so the milligrams on a label may not be comparable to the extracts tested.

The evidence is mixed and low quality. A 2023 review of 13 small trials in healthy people found that single doses might slightly improve endurance and perceived effort, and regular use might help short, intense efforts, but most studies had unclear or high risk of bias. Gains in the better trials were small, such as seconds added to a 17-minute exhaustion test.

Most people tolerate it in short courses. Reported side effects include headache, dizziness, insomnia or nervousness, dry mouth or excess saliva, nausea, abdominal pain, diarrhoea, rash, and itching. NCCIH says it is possibly safe for up to 12 weeks; longer use has not been studied well.

Ask your prescriber first. There are case reports of a fast, irregular heartbeat and suspected serotonin syndrome when rhodiola was added to antidepressants. In a human study it slowed the enzyme CYP2C9, which clears warfarin, phenytoin, and losartan, and NCCIH notes reported interactions with losartan. Laboratory studies also show effects on CYP3A4, P-glycoprotein, and monoamine oxidase.

You often cannot tell from the label. In a UK study of about 40 products, roughly a fifth contained no rosavin, the marker compound for Rhodiola rosea, and many others appeared to contain cheaper Rhodiola species. Registered traditional herbal medicines were the most consistent. Look for the full species name, the extract ratio or rosavin content, and independent quality testing.

10 References

Sources

These references support the history, clinical, and safety claims on this page. They are not an endorsement of any product.

  1. Rhodiola

    National Center for Complementary and Integrative Health (NIH), 2025

    Consumer evidence summary (updated April 2025): not enough reliable evidence for any health purpose; possibly safe for up to 12 weeks; dizziness, headache, insomnia, saliva changes; losartan interaction reported.

  2. Rhodiola

    Memorial Sloan Kettering Cancer Center, About Herbs, 2026

    Clinical summary (updated April 2026): limited human data; MAO inhibition and salidroside mechanisms in vitro; tachyarrhythmia case with an antidepressant; CYP3A4, CYP2C9, and P-glycoprotein interaction cautions.

  3. European Union herbal monograph on Rhodiola rosea L., rhizoma et radix (Revision 1)

    European Medicines Agency (EMA/HMPC/24177/2023), 2024

    Adopted 20 March 2024: traditional use for symptoms of stress such as fatigue and exhaustion; 144–400 mg daily of a 67–70% ethanol dry extract; not under 18 or in pregnancy; side effects; no clinically relevant interactions observed.

  4. Assessment report on Rhodiola rosea L., rhizoma et radix (Revision 1)

    European Medicines Agency (EMA/HMPC/24186/2023), 2024

    Reviews Soviet history, Swedish use since 1987, all major trials with assessor critiques, pharmacokinetics, adverse event and pharmacovigilance data, and concludes well-established use cannot be supported.

  5. Rosenroot (Rhodiola rosea): traditional use, chemical composition, pharmacology and clinical efficacy

    Phytomedicine (PubMed 20378318), 2010

    Panossian, Wikman, and Sarris: about 140 constituents; Scandinavian and Soviet history; proposed stress-system mechanisms. Two authors are affiliated with the maker of SHR-5.

  6. Rhodiola rosea: a phytomedicinal overview

    HerbalGram, American Botanical Council, 2002

    Brown, Gerbarg, and Ramazanov: Dioscorides and Linnaeus references, the 1961 Altai expedition, late-1980s over-harvesting and species substitution, rosavins specific to R. rosea.

  7. A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract SHR-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue

    Planta Medica (PubMed 19016404), 2009

    Olsson et al.: 60 adults with fatigue syndrome, 576 mg daily for 28 days; strong placebo response; small advantage on burnout scale and attention measures; altered cortisol awakening response.

  8. Rhodiola rosea versus sertraline for major depressive disorder: a randomized placebo-controlled trial

    Phytomedicine (PubMed 25837277), 2015

    Mao et al.: 57 adults, 12 weeks; no significant difference among rhodiola, sertraline, and placebo; adverse events 30% vs 63% vs 17%.

  9. Rhodiola rosea for physical and mental fatigue: a systematic review

    BMC Complementary and Alternative Medicine (PubMed 22643043), 2012

    Ishaque et al.: 11 controlled trials; 2 of 6 physical and 3 of 5 mental fatigue trials positive; all at high or unclear risk of bias.

  10. Perspective on Roseroot (Rhodiola rosea) studies

    Planta Medica (PubMed 19468971), 2009

    Blomkvist, Taube, and Larhammar: statistical shortcomings in all but one study claiming benefit; evidence insufficient for therapeutic claims.

  11. Rhodiola rosea supplementation on sports performance: a systematic review of randomized controlled trials

    Phytotherapy Research (PubMed 37495266), 2023

    Sanz-Barrio et al.: 13 trials, 263 healthy participants; heterogeneous results; possible acute endurance benefit; most studies at unclear or high risk of bias.

  12. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: the WFSBP and CANMAT Taskforce

    World Journal of Biological Psychiatry (PubMed 35311615), 2022

    Sarris et al.: international taskforce of 31 experts; rhodiola not supported for mood disorders.

  13. Effect of commercial Rhodiola rosea on CYP enzyme activity in humans

    European Journal of Clinical Pharmacology (PubMed 26613955), 2016

    Thu et al.: 13 volunteers, 14 days of rhodiola; 21% reduction in losartan metabolic ratio (CYP2C9); no significant effect on CYP1A2, 2C19, 2D6, or 3A4.

  14. The authenticity and quality of Rhodiola rosea products

    Phytomedicine (PubMed 26626192), 2016

    Booker et al.: about 40 products; roughly one fifth lacked rosavin; most others lower in rosavin than registered products and apparently adulterated with other Rhodiola species.

  15. Salidroside

    PubChem, National Library of Medicine (NIH), 2026

    Key phenylethanoid glycoside of rhodiola, also called rhodioloside; CID 159278, C14H20O7.