Rhodiola rosea

Pronunciation

Rhodiola rosea (roh-dee-oh-lah roh-zeh-ah)

Summary

The Rhodiola plant consists of over 200 species originating from the Himalayan belt, Tibet, China, and Mongolia. Rhodiola is now cultivated for use in supplements in Europe and North America (7). It is one of the most commonly used plants in Chinese traditional medicine for healthy aging, endocrine activity, cardiovascular health, nervous and immune system stimulation, mental and physical performance, as an adaptogen to fight stress, depression, and anxiety (35). The two major constituents used to evaluate the quality of Rhodiola rosea-derived compounds are salidroside and tyrosol (7). While polyphenols make up approximately 40% of its constituents (6), Rhodiola also contains glycosides, organic acids, essential oils, sugars, fats, alcohols, and proteins (35).

Main Medical Uses

Evidence supports the use of Rhodiola rosea (RR) for treating depression (3, 9, 10, 29), generalized anxiety disorder (44), mental and physical fatigue, and stress (11, 20, 33, 36, 38, 42). RR has been studied for its use in cardiovascular conditions, including chronic stable angina pectoris (8), ischemic heart disease (47), and protection against myocardial damage (37). RR has also been associated with improved performance during endurance exercise (12, 32), antioxidant status (40), and cognition (2).

Dosing and Administration

For an explanation of the classes of evidence, please see the Rating Scales for Evidence-Based Decision Support.

Adverse Effects

Reported adverse effects, typically rare and described as mild in nature, may include headaches at doses of 200 mg per day over 4 weeks (21). Reports of adverse effects are rare between doses of 50 mg to 1500 mg per day, suggesting a wide profile of safety (21). Other reported mild or moderate adverse effects include dizziness and dry-mouth (4).

Proprietary Extracts

Associated Interactions and Depletions

For an explanation of the classes of evidence, please see the Rating Scales for Evidence-Based Decision Support.

Pharmacokinetics

An active constituent of RR, salidroside, is absorbed in the intestine via the Sodium-dependent Glucose Transporter (SGLT1) in rats and equivalent plasma concentrations are achieved with 24 mg/kg and 48mg/kg doses (18). Oral bioavailability of salidroside may vary between doses. It was shown that the bioavailability of 12mg/kg of RR was ~32% (48), 25mg/kg was ~98% (5), and 100mg/kg was ~52% for both salidroside and p-tyrosol (16). After absorption, RR’s effects may be induced within one hour (30,) while the half-life is also approximately one hour (49).

Intravenous administration of salidroside results in increased concentrations in the liver, kidney, and heart tissues. Salidroside’s deglycosylated metabolite, p-Tyrosol, was found in the heart, spleen, kidney, liver, and lungs. Salidroside was found only in the liver following oral administration. P-Tyrosol was in most tissues other than the brain and kidney (17).

An in vitro study demonstrated that RR products display varying degrees of inhibitory potential with CYP3A4, CYP2D6, and CYP1A2. The bioactive constituents rosavin, rosarin, rosin, salidroside, and tyrosol were not deemed to cause this inhibition (43). In addition to CYP3A4, P-gp has also been shown to be inhibited by RR in vitro (19).

Urinary excretion of salidroside was 64% of the original dose, whereas 0.19% was excreted as p-Tyrosol. Urinary excretion of salidroside was 23.80% of the original doses, whereas 2.25% was excreted as p-Tyrosol (17).

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