Rhodiola Rosea Side Effects
Rhodiola rosea, also called golden root or roseroot, has a reputation as an adaptogen — a herb that helps the body cope with stress and fatigue. Athletes use it to manage heavy training blocks, and students and shift workers take it to stay alert. Most people tolerate it well, but it is not free of side effects or interactions. This guide sets out what is known about its safety.
What rhodiola is used for
Rhodiola rosea is a perennial plant from cold, mountainous regions of Europe, Scandinavia and Siberia. Its root has been used in folk medicine to improve endurance and resistance to cold and altitude. Modern extracts are usually standardised for rosavins and salidroside, the compounds believed to be most active.
In the UK, several rhodiola products hold a Traditional Herbal Registration (THR) from the MHRA. This means they meet manufacturing and safety standards and may be used for the temporary relief of symptoms associated with stress, such as fatigue, exhaustion and mild anxiety, based on traditional use rather than proof of efficacy. Many other rhodiola products are sold as food supplements without a THR.
Clinical evidence is mixed. Systematic reviews by Hung and colleagues and by Ishaque and colleagues found some support for reduced mental fatigue, but most trials were small and of variable quality. A 2022 systematic review on exercise suggested possible benefits for endurance and perceived exertion, again with considerable uncertainty.
Because rhodiola has measurable effects on the stress response and neurotransmitters, it is reasonable to expect side effects in some users and potential interactions with medicines that act on the same systems.
Common side effects
In clinical trials, rhodiola has generally produced few adverse effects, and in several studies side-effect rates were similar to placebo. The effects that are reported tend to be mild and to settle when the dose is reduced or the herb is stopped.
- Restlessness, agitation and insomnia: the most characteristic side effects, consistent with its mildly stimulating profile, especially when taken late in the day.
- Dizziness: reported in some studies of rhodiola for anxiety and depression.
- Dry mouth or, less often, increased salivation.
- Gastrointestinal discomfort: nausea or loose stools in a minority of users.
- Headache and irritability in sensitive individuals.
Taking rhodiola in the morning or early afternoon, and starting at the lower end of the labelled dose, minimises sleep problems. THR products typically provide around 200 mg of extract once or twice daily; trials have used a range of roughly 100–680 mg per day.
Allergic reactions, though uncommon, can occur with any plant extract. Stop taking the product and seek advice if you develop a rash, swelling or breathing difficulty.
Who should avoid rhodiola
The European Medicines Agency's herbal monograph and UK product information identify groups in whom rhodiola is not recommended, largely because safety data are lacking.
| Group | Reason |
|---|---|
| Under 18s | Insufficient safety data |
| Pregnancy and breastfeeding | No adequate studies |
| Bipolar disorder | Possible activating effect; risk of triggering mania has been raised |
| Diagnosed depression or anxiety disorder | Should not replace medical treatment; review with a doctor |
| Upcoming surgery | Theoretical effects on blood pressure and clotting; stop in advance on medical advice |
Persistent tiredness has many medical causes, including anaemia, thyroid disease, coeliac disease, depression and underfuelling. If symptoms last more than two weeks, product leaflets advise consulting a doctor rather than continuing to self-treat.
Athletes experiencing chronic fatigue should also consider overreaching or relative energy deficiency in sport, both of which need changes to training and nutrition rather than an adaptogen.
Possible drug interactions
Laboratory studies suggest that rhodiola extracts may inhibit certain liver enzymes, including CYP3A4 and CYP2C9, and may have mild monoamine oxidase-inhibiting activity. The clinical significance in humans is not well established, but caution is appropriate with medicines that have a narrow safety margin.
Combinations that merit discussion with a pharmacist include antidepressants (SSRIs, SNRIs and especially MAO inhibitors), warfarin and other anticoagulants, medicines for diabetes, blood pressure tablets and drugs metabolised by CYP3A4.
A small trial by Mao and colleagues compared rhodiola with sertraline in major depression; rhodiola produced fewer side effects but also smaller benefits. This does not mean it is safe to substitute or combine them without medical supervision.
Rhodiola is often blended with caffeine, guarana, synephrine or other stimulants in energy and 'fat-burning' products. In those cases the stimulants are a greater source of side effects, such as palpitations, raised blood pressure and anxiety, than the rhodiola itself.
Quality, adulteration and anti-doping
Rhodiola rosea is in demand and wild populations are limited, which encourages adulteration. Analyses of commercial products in Europe and North America have found that some contained other Rhodiola species or lacked the expected marker compounds altogether.
Choosing a product with a THR logo, or one from a manufacturer that publishes independent test results, gives greater assurance of identity and dose. THR products carry a standard leaflet with safety information.
Rhodiola is not on the WADA Prohibited List. However, multi-ingredient supplements can be contaminated with stimulants or other prohibited substances. UK Anti-Doping recommends that athletes assess the need for supplements carefully and use batch-tested products.
Stop taking rhodiola if you notice palpitations, marked anxiety, mood elevation or significant sleep disruption, and tell your doctor about any herbal products at your next appointment.
Editorial conclusions
Rhodiola rosea is generally well tolerated, with the most common side effects being restlessness, insomnia, dizziness, dry mouth and mild digestive upset.
It should be avoided in pregnancy, breastfeeding, under 18s and bipolar disorder, and used only with professional advice alongside antidepressants, anticoagulants or diabetes and blood pressure medicines.
Prefer products with a Traditional Herbal Registration or independent testing, take them earlier in the day and seek medical advice for fatigue that persists.
Our editorial team also recommends the articles on bacopa monnieri for athletes, on cortisol and catabolism and on ashwagandha and stress hormones.
References
- Panossian A, Wikman G, Sarris J. Rosenroot (Rhodiola rosea): traditional use, chemical composition, pharmacology and clinical efficacy. Phytomedicine. 2010;17(7):481–493.
- Hung SK, Perry R, Ernst E. The effectiveness and efficacy of Rhodiola rosea L.: a systematic review of randomized clinical trials. Phytomedicine. 2011;18(4):235–244.
- Ishaque S, Shamseer L, Bukutu C, Vohra S. Rhodiola rosea for physical and mental fatigue: a systematic review. BMC Complement Altern Med. 2012;12:70.
- Darbinyan V, Aslanyan G, Amroyan E, et al. Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression. Nord J Psychiatry. 2007;61(5):343–348.
- Mao JJ, Xie SX, Zee J, et al. Rhodiola rosea versus sertraline for major depressive disorder: a randomized placebo-controlled trial. Phytomedicine. 2015;22(3):394–399.
- European Medicines Agency, Committee on Herbal Medicinal Products. Community herbal monograph on Rhodiola rosea L., rhizoma et radix. London: EMA; 2012.
