Latin name Rhodiola rosea
Rhodiola rosea, belongs to the plant family Crassulaceae, and grows primarily in dry sandy ground at high altitude in the arctic areas of Europe and Asia, such as the mountains of Scandinavia, Iceland, Greenland and Siberia. The plant reaches a height of around 70 cm and produces yellow blossoms. It is a succulent perennial with a thick rhizome which has a rose-like fragrance when cut (hence the species name ‘rosea’). It is the rhizome that is used in medicinal preparations. During the course of evolution, this robust plant has adapted to the harsh conditions of its high altitude habitat (extreme cold, low oxygen, little rainfall and intense irradiation from the sun) by producing a group of potent protective compounds that have many beneficial effects in humans.
Rhodiola rosea has a history and heritage spanning many centuries. Records show that it was prized for its medicinal properties by the Ancient Greeks and used by the Vikings to enhance strength and endurance. The Greek physician Dioscorides first recorded medicinal applications of the root in 77 AD in De Materia Medica. In the Middle Ages, Chinese emperors funded expeditions to find the Golden Root and, in 1775, it was included in the first Swedish pharmacopoeia. Traditional folk medicine used Rhodiola rosea to increase physical endurance, work productivity, longevity, resistance to high altitude sickness and to treat fatigue, depression and nervous system disorders. In Middle Asia, Rhodiola rosea tea was the most effective treatment for cold and flu during severe Asian winters. For centuries, only family members knew where to harvest the wild plant and the methods of extraction (1,2).
The twentieth century saw more than 180 research studies conducted with Rhodiola rosea – almost all carried out by researchers behind the Iron Curtain in the former Soviet Union in the 1960s and 1970s. The Soviet interest was part of a systematic search for medicine that could boost energy, improve concentration and enhance mental and physical performance, to give Soviets an edge. Today, the use of Rhodiola rosea is backed up by a wealth of newly published research. The extract is generally a whole root extract and contains: Phenylpropanoids (rosavins: rosavin, rosarin and rosin);Phenylethanol derivatives (salidroside); Polyphenols, essential oils (monoterpenes), triterpenes and organic acids)
Uses of Rhodiola
A study by Panossian et al. (3) demonstrated that, three mediators of the stress response – phosphorylated stress-activated protein kinase, nitric oxide and cortisol – were significantly increased (by 200–300% from basal levels). The investigators then set out to determine the effect of 7 days’ oral pre-treatment with Rhodiola rosea and found that, in this model, administration of Rhodiola rosea extract effectively prevented the increase in levels of these biochemical markers after acute stress.
A study by Stancheva and Mosharrof (4) examined the levels of noradrenaline, dopamine and serotonin in the brain cortex, hypothalamus and brain stem. Rhodiola rosea led to a decrease in noradrenaline and dopamine levels in the cerebral cortex, but a sharp increase in the level of serotonin. In the hypothalamus, Rhodiola rosea led to an increase in levels of noradrenaline and dopamine, but a slight decrease in serotonin. The noradrenaline, dopamine and serotonin levels in the brain stem all rose with Rhodiola rosea. The authors affirm that Rhodiola rosea selectively influences neurotransmitter levels in the various brain structures. Particularly noteworthy is the substantially raised level of serotonin in both the brain cortex and stem.
Antidepressant and anxiolytic effects
In a study by Perfumi and Mattioli (5) the researchers investigated the effects of a single dose of Rhodiola rosea extract (at 10, 15 and 20 mg/kg) on the central nervous system in stressful situations. The results showed that a single oral administration of extract significantly, but not dose dependently, induced antidepressant-like, adaptogenic, and anxiolytic-like effects. A study by Abidov et al. (6) examined the effects of oral treatment with Rhodiola rosea extract (50 mg/kg) on the ATP content in mitochondria of skeletal muscle. The decrease in ATP after the exercise was significantly less pronounced in the Rhodiola rosea group than in the control group, suggesting that Rhodiola rosea extract activated the synthesis or resynthesis of ATP in mitochondria and stimulated reparative energy processes after intense exercise. Clinical investigations with Rhodiola rosea range from assessing the effects of a single dose in healthy volunteers to measuring the benefits of 4 weeks’ daily treatment in patients suffering from stress-related fatigue (burnout). Together, these studies corroborate the dual mechanism of action of Rhodiola rosea suggested by animal model experiments.
A randomised, double-blind, placebo-controlled, parallel-group clinical study was performed by Shevtsov et al. (7) to measure the effect of a single dose (370 mg) of standardised Rhodiola rosea extract on capacity for mental work against a background of fatigue and stress. The interventions were given after 21 hours’ continuous activity (including night duty). The study showed a pronounced anti-fatigue effect as measured by an anti-fatigue index. The difference was highly statistically significant. In addition, a 10-minute test of mental agility conducted both before and after night duty showed a statistically significant impairment of mental performance in the control groups, with no such impairment seen in the active treatment group
Efficacy in students undergoing examinations
The objective of a study by Spasov et al. (8) was to investigate the beneficial effect of Rhodiola rosea extract in foreign students during a stressful examination period. The study was double-blind, randomised and placebo-controlled, and used a low-dose regimen (100 mg/day) for 20 days. The most significant improvement in the Rhodiola rosea group was seen in physical fitness, mental fatigue and neuromotoric tests. Self-assessment of general well-being was also significantly better in the treatment group. The conclusion is that the study drug gave significant results, even at a dose that was probably suboptimal.
Efficacy in physicians on night duty
The aim of a double-blind, placebo-controlled study by Darbinyan et al. (9) was to investigate the effect of repeated low-dose treatment with a standardised extract of Rhodiola rosea (170 mg/day) on fatigue during night duty among a group of 56 young, healthy physicians. A statistically significant improvement was observed in the treatment group after 2 weeks.
Efficacy in patients with stress-related fatigue (burnout)
This was a randomised, double-blind, placebo-controlled study with parallel groups. 60 individuals were randomised into two groups, one of which received 576 mg/day of Rhodiola rosea extract while the second received placebo. The effects of the extract with respect to quality of life, symptoms of fatigue (Pines’ burnout scale), depression, attention (CCPT II) and salivary cortisol response to awakening were assessed on Day 1 and after 28 days of medication. No adverse events occurred during the study and the medication was very well tolerated. Significant effects of the Rhodiola rosea extract in comparison with placebo were observed in Pines’ burnout scale and three CCPT II indices. Pre- versus post-treatment cortisol responses to awakening stress were significantly different in the treatment group compared with the control group. It was concluded that repeated administration of Rhodiola rosea extract exerts an anti-fatigue effect that enhances mental performance – particularly concentration – and decreases cortisol response to awakening stress in burnout patients with fatigue syndrome (10).
Efficacy in patients with generalised anxiety disorder
The goal of a pilot study by Bystritsky et al. was to evaluate whether Rhodiola rosea extract is effective in reducing symptoms of generalised anxiety disorder (GAD). Individuals treated with Rhodiola rosea showed significant decreases in mean Hamilton Anxiety Rating Scale (HARS) scores at endpoint (P=0.01) (11).
This non-randomized, multicentre, open-label study was conducted on 101 subjects with life-stress symptoms by Edwards et al. The participants received 200mg of extract twice daily for 4 weeks. All tests showed clinically relevant improvements with regards to stress symptoms, disability, functional impairment and overall therapeutic effect. Improvements were observed even after 3 days of treatment, as were continuing improvements after 1 and 4 weeks (12).
There have been isolated reports of allergic reaction and lowered blood sugar levels in some patients taking the product. However, there is no clear relationship between the development of low blood sugar levels and the use of Rhodiola rosea extracts.
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