Rhodiola rosea (golden root)

Rhodiola is sold as a «natural preworkout» promising improved endurance and reduced training fatigue. Small RCTs in 20-30 subjects showed heterogeneous results: some demonstrated moderate VO2max and time-to-exhaustion improvements on cycle ergometry, others no effect. EFSA 2010 approved no physical performance claim for rhodiola. In IRONMAN/UCI Pro endurance athletes, it is not on the IOC consensus statement 2018 list of sports supplements (only creatine, caffeine, beta-alanine, bicarbonate, nitrates are approved). If rhodiola was recommended as a substitute for a supervised training plan, consider seeking a second opinion from a sports physician.

Rhodiola is sold as a «natural energiser» for office workers with burnout and patients with chronic fatigue. Several small RCTs in 50-100 subjects showed moderate reductions in fatigue scores at 200-600 mg/day of standardised SHR-5 extract. No Cochrane systematic review on rhodiola in chronic fatigue syndrome. EMA HMPC 2012 recognises «traditional use for symptoms of weakness» without requiring evidence. NICE ME/CFS 2021 (NG206) recommends pacing and multidisciplinary follow-up; rhodiola is not in guidelines. If rhodiola was recommended for persistent fatigue without workup (ferritin, TSH, HbA1c, depression and sleep apnoea screening), consider seeking a second opinion.

Rhodiola is sold as a «natural antidepressant» promising a «safe SSRI alternative». Small RCTs in mild-to-moderate depression (Darbinyan 2007, Mao 2015) showed heterogeneous results with small samples. NICE 2022 and SEP 2014 list CBT and SSRIs first-line for mild-to-moderate depression; rhodiola is not included. If rhodiola was recommended for depression instead of a psychiatric consultation, consider seeking a second opinion.

Rhodiola rosea is widely sold as a «natural anti-stress» and «adaptogen for emotional burnout». Several small RCTs showed moderate reductions in stress scores in students before exams and workers with burnout. EMA HMPC 2012 recognised rhodiola as a traditional herbal medicinal product «for relief of stress symptoms», but this designation does not require efficacy evidence – only 30 years of traditional use. EFSA 2010 approved no health claim for rhodiola. NICE 2022 and SEP 2014 list SSRIs and CBT for anxiety disorders; rhodiola is not mentioned. If rhodiola was recommended for GAD, panic attacks or clinically significant anxiety instead of psychotherapy and an antidepressant, consider seeking a second opinion.