Rhodiola Rosea Benefits, Side Effects and the Liver Question

The plant in brief

Rhodiola, a root from the cold.

Rhodiola, or Rhodiola rosea, is a succulent in the stonecrop family (Crassulaceae), like the stonecrops of our rock gardens. It grows in cold regions and at altitude: Scandinavia, Siberia, the Arctic, but also the Alps and the Pyrenees. It is known as roseroot, golden root or arctic root. When cut fresh, its root gives off a scent of roses, hence its name.

It has a long history of folk use in Scandinavia and Russia, against the fatigue of long winters. From the 1960s onwards, Soviet researchers studied it extensively, often in work that is hard to access. More recent trials, notably in Sweden, have revisited the question with modern methods.

The European Medicines Agency (EMA) has published a monograph on rhodiola root under traditional use: a use recognised because of its long history, not an efficacy demonstrated by trials. That sums up its status well. Our page devoted to rhodiola presents the plant in more detail.

Rosavins and salidroside

Standardised to 3% and 1%: why it matters.

Two families of molecules serve as markers for rhodiola. Rosavins (rosavin, rosin and rosarin) are specific to Rhodiola rosea: they are not found in other rhodiola species. Salidroside, on the other hand, also occurs in other species, notably cheaper Chinese rhodiolas.

Most commercial extracts are standardised to about 3% rosavins and 1% salidroside, a ratio close to that of the natural root. This dual standardisation has three advantages.

• It confirms the right species: a product with no rosavins is probably not Rhodiola rosea.
• It allows comparison with the trials, which almost all used standardised extracts.
• It ensures a roughly consistent content from one batch to the next, which raw root powder does not.

This is far from a detail. An analysis of products sold in the UK (Booker et al., 2016) showed that some of them contained no rosavins, or contained species other than the one stated. Reading the standardisation on the label is your first line of protection.

The benefits studied

Rhodiola benefits: fatigue first, the rest second.

Rhodiola has been tested in three main areas: stress-related fatigue, mood and physical performance. The results are more solid for the first, and much weaker for the other two.

Summary based on the trials and the systematic review listed in the sources. In Europe, no health claim is authorised for rhodiola.

A 2012 systematic review (Ishaque et al.) sifted through eleven controlled trials on physical and mental fatigue. Its authors judged the results encouraging but inconsistent, and the quality of the studies too variable to draw conclusions. They called for larger trials. That still holds today.

Side effects

Rhodiola side effects: rare, and often linked to timing.

In trials, rhodiola was well tolerated, with adverse effects that were infrequent and mild. The most commonly reported ones are explained by its rather stimulating profile: they mainly appear when it is taken too late or at a high dose.

If you are sensitive to caffeine, watch out for the combined effect: rhodiola and coffee taken together can make you jittery. Our article on coffee and anxiety explains why some people react more strongly than others.

Rhodiola and the liver

Rhodiola and liver damage: where does the fear come from?

“Rhodiola liver damage” is one of the most common searches about this plant. Yet clinical trials have not found any liver injury, and rhodiola is not among the plants whose liver toxicity is well established. The fear has several origins, which are worth knowing.

• Confusion with other plants: ashwagandha, high-dose turmeric and black cohosh have been the subject of published cases of liver injury. They are sold on the same shelf, and often in the same blends.
• Drug metabolism: in the lab, rhodiola extracts slow down certain liver enzymes, the cytochromes, which clear many medicines. That is a risk of interaction, not direct toxicity.
• Product quality: an adulterated or contaminated product may contain something other than what is stated.
• Blends: a supplement combining five or six plants makes it hard to identify which one is responsible for an effect.

In practice: if you have liver disease, or take several medicines, ask your doctor's advice before starting a course. And with any supplement, stop and see a doctor if you notice unusual fatigue, dark urine or jaundice. Our guide to the dangers of ashwagandha details these warning signs.

Contraindications

Rhodiola contraindications: who should avoid it.

The EMA monograph advises against rhodiola for under 18s and during pregnancy and breastfeeding, for lack of data. Other situations call for caution, because of its effect on mood and on drug metabolism.

If your fatigue has lasted for weeks, rhodiola is not the first answer: anaemia, a thyroid problem or burnout may be the cause. Our article on persistent fatigue tells you when to see a doctor, and the one on the signs of burnout helps you take stock. If you have dark thoughts, call the Samaritans helpline on 116 123, free and open 24 hours a day.

Dose and timing

200 to 400 mg in the morning, not in the evening.

The trials used very variable doses, from 170 to 680 mg of standardised extract a day. Most products offer 200 to 400 mg of standardised extract, to be taken in the morning. Here is a sensible way to go about it.

Start with the lowest dose offered, especially if you are sensitive to stimulants. More is not better: in the Olsson trial, 576 mg was enough, and higher doses showed no clear advantage. For revision periods, our 10 habits to stay focused count for more than any plant.

Saffron, griffonia, ashwagandha

Rhodiola and saffron, griffonia and rhodiola: are the combinations worth it?

In pharmacies, rhodiola is rarely sold on its own. It is often combined with saffron, griffonia or ashwagandha. Each combination has its logic, and its limits.

A combination is not necessarily more effective than each plant on its own: it is rarely tested as such. And it multiplies the risk of interactions.

Rhodiola or ashwagandha? Both are classed as adaptogenic plants, but their profiles are almost opposite: rhodiola rather in the morning for fatigue, ashwagandha rather for tension and sleep. Our guide to ashwagandha benefits details its trials, and our guide to the levers for lowering cortisol puts these plants in their proper place.

Choosing it well

Rhodiola reviews: what to read on the label.

Reviews of rhodiola are very mixed: some people describe a real boost in the morning, others feel nothing, and others still become jittery. Individual sensitivity matters, but so does product quality. Before you buy, check the following points.

For your days, Mush n Go has put together two formulas: Energy combines cordyceps, maca, ginger and vitamin C, which contributes to the reduction of tiredness and fatigue, and Anti-Stress brings together ashwagandha, reishi, holy basil, schisandra and vitamin B6. To compare other energising plants, read our guide to panax, red ginseng or Siberian ginseng.

Sources

1. Darbinyan V. et al. (2000). Rhodiola rosea in stress induced fatigue: a double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty. Phytomedicine, 7(5).
2. Olsson E. M., von Schéele B., Panossian A. G. (2009). 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, 75(2).
3. Darbinyan V. et al. (2007). Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression. Nordic Journal of Psychiatry, 61(5).
4. Mao J. J. et al. (2015). Rhodiola rosea versus sertraline for major depressive disorder: a randomized placebo-controlled trial. Phytomedicine, 22(3).
5. Ishaque S. et al. (2012). Rhodiola rosea for physical and mental fatigue: a systematic review. BMC Complementary and Alternative Medicine, 12.
6. Booker A. et al. (2016). From traceability to quality: a comparative study of commercial Rhodiola rosea products. Phytomedicine, 23.
7. European Medicines Agency, HMPC. Community herbal monograph on Rhodiola rosea L., rhizoma et radix.

Keep reading

Further reading.

Rhodiola is one of the plants used for fatigue and stress. Discover our other guides, or take a look at Energy.