Rhodiola benefits

For which claims were the benefits of rhodiola measured?

What does the evidence say for fatigue and burnout?

Olsson and colleagues randomized 60 people aged 20–55 who met the Swedish National Board of Health and Welfare’s criteria for fatigue syndrome; they were given four tablets daily of a standardized R. rosea extract (576 mg extract/day; n = 30) or placebo (n = 30) for 28 days. Quality of life (SF-36), fatigue symptoms (Pines burnout scale), depression (MADRS), attention (CCPT II) and the awakening cortisol response were measured on days 1 and 28. Improvement was seen in both groups on the Pines scale, SF-36 mental health, MADRS and some of the attention indicators; when the groups were compared, rhodiola showed a significant difference over placebo on the burnout scale and on the omissions, hit reaction time and variability indicators of the CCPT II; the cortisol response was also different in the treatment group. No serious side effects were reported. ^[1] One of the authors, A. Panossian, is cited in the 2015 article by Mao and colleagues as an employee of the Swedish Herbal Institute, which supplies the same extract. ^[2]

The authors’ conclusion is toward an “anti-fatigue effect and increase in attention.” The following limits should be kept in mind when reading: a single trial, 60 people, 28 days, a single extract; there was also improvement in various measures in the placebo group. The EMA states that it identified “various shortcomings” in such small clinical trials and accepts the product on a traditional use basis for this reason. ^[6]

Mental fatigue: what did EFSA conclude?

EFSA’s Panel on Nutrition, Novel Foods and Food Allergens (NDA), under Article 13(5), examined a dry rhodiola extract standardized to its rosavin and salidroside content and the claim of reduction of mental fatigue. The Panel considered reduction of mental fatigue a beneficial physiological effect and found the extract sufficiently characterized. However, the applicant presented two published human studies; these studies had been conducted with an extract standardized only for salidroside content and not standardized for rosavins. The Panel, noting that the studies were not conducted with the extract subject to the claim, reported that no conclusion could be drawn from these studies and concluded that a cause-and-effect relationship had not been established. ^[3]

That is, this result is not that “rhodiola does not reduce mental fatigue” but that the evidence in the application was not sufficient to support the claim. The 2009 study by Olsson and colleagues (the fatigue study above) and the 2003 study by Shevtsov and colleagues are listed in the references of the EFSA opinion; that is, the most-cited RCT for fatigue is one of the two studies from which EFSA could not draw a conclusion. ^[3]

What does the evidence say for depression?

In the study by Mao and colleagues, 57 people with mild–moderate major depression received standardized R. rosea extract (n = 20), sertraline (n = 19) or placebo (n = 18) for 12 weeks. There were modest decreases in all three groups on the HAM-D, BDI and CGI/C scores; the difference among groups was not significant (HAM-D p = 0.79; BDI p = 0.28; CGI/C p = 0.17). The HAM-D decrease was −8.2 with sertraline (95% CI −12.7 to −3.6), −5.1 with rhodiola (−8.8 to −1.3) and −4.6 with placebo (−8.6 to −0.6). The odds ratio of overall improvement relative to placebo was 1.90 (95% CI 0.44–8.20) with sertraline and 1.39 (0.38–5.04) with rhodiola; sertraline also did not separate significantly from placebo. The proportion of people with side effects was 63.2% with sertraline, 30.0% with rhodiola and 16.7% with placebo. ^[2]

The study is a “proof of concept” phase II trial; according to the authors, it was designed with the power to detect relatively large differences, not small ones. Superiority of rhodiola over placebo was not shown. It was reported that the study was supported by a grant from NIH’s center for complementary and alternative medicine (NCCAM, today NCCIH) and a research fund at the University of Pennsylvania, that the extract was supplied by the Swedish Herbal Institute, and that the Institute had no role in the study’s design, conduct or report. ^[2] There is no evidence that rhodiola replaces treatment in depression treatment.

What does the evidence say for exercise performance?

Two reviews should be read side by side.

Sanz-Barrio and colleagues (2023). 13 RCTs (263 people) in healthy participants who took no other supplement. Results are heterogeneous: 11 studies reported some favorable effects, and in two studies there was no effect on variables such as perceived exertion, heart rate, antioxidant capacity, lactate, creatine kinase or CRP. According to the authors, acute use showed a favorable effect on endurance performance and perceived exertion; chronic use was favorable on anaerobic performance and ineffective on endurance performance. The authors noted that the risk of bias was unclear or high in most studies and that protocols differed from one another. ^[4]

Wang and colleagues (2025). 26 RCTs (668 healthy participants, mean age 22.0 ± 10.7; mean duration 33 days). VO2max (11 studies; effect size 0.32), time to exhaustion (7 studies; 0.38) and time trial performance (5 studies; −0.40) improved significantly; creatine kinase and lactate fell; there was no effect on inflammation markers such as IL-6 and CRP. In the subgroup analysis, the VO2max improvement was more marked at higher daily doses. The authors noted that heterogeneity between studies requires careful interpretation. ^[5]

The two reviews report different results for endurance with chronic use (Sanz-Barrio: no effect; Wang: improvement). Which is right cannot be said from these data; the difference may be because the studies and analysis methods included in the reviews differ.

What are the shared limits of this evidence?

• The fatigue and depression data rest on single and small trials. ^{[1] [2]}
• The EMA notes the shortcomings of clinical trials in this area and accepts use on a traditional basis. ^[6]
• The exercise reviews were measured in healthy participants; in the Wang meta-analysis the mean age is 22. ^[5]
• The EMA monograph defines adults for use; it does not recommend it under 18 and notes that safety in pregnancy has not been established. ^[7]

This guide does not recommend personal doses.