Table 1 Rhodiola rosea summary of clinical evidence

DB RCT

36 male and female non-smokers between 21–24 y.o.a.

Int: 340 mg RR extract containing 30 mg active RR (including rosavin)

CRP blood-levels 5 h and 5 days after exercise were less than placebo and control.

Con(1): placebo

Con(2): no intervention;

CK levels in blood same across groups after 5 hours, but reduced after 5 days in only R. rosea group.

Regimen: for 30 days before and 6 days after exhausting physical exercise.

DB CO RCT

12 resistance-trained males (19–39 y.o.a.)

Int: 1500 mg/day RR for 3 days before exercise test + 1000 mg on day of test Con: placebo;

No significant differences between groups in measures of ATP kinetics and exhaustion.

Regimen: RR followed by 7–14 days washout and same dosing regimen of placebo OR treatment in reverse order

R. rosea Plus starch versus placebo

DB CO RCT

24 healthy physically active male (21.8 ±0.3 y.o.a) and female (20.2 ± 0.3 y.o.a.) students

Int: 100 mg RR +250 mg starch

RR ‘significantly’ delayed time to exhaustion, peak O₂ uptake and CO₂ output.

Con: 350 mg starch

Regimen: 2 days of RR, 5 days washout, 2 days placebo

DB CCT

Int: 100 mg RR +250 mg starch

significantly higher blood lactate levels after 4-wk intake.

Con: 350 mg starch

Regimen: RR or placebo twice/day over 4 weeks

Overall, no change in muscle strength, speed of limb movement, reaction time, sustained attention.

R. rosea plus Cordyceps versus Placebo

DB RCT

17 male competitive cyclists

Int: loading dose of 6 capsules/day for 4 days (every three capsules contain 1000 mg Cordyceps sinensis + 300 mg RR) then maintenance dose of 3 capusles/day for 11 days

No significant difference between or within Tx groups in peak and subpeak exercise variables.

int: 31.6 ± 2.8 (SE) y.o.a.

con: 30.5 ± 2.2 y.o.a.

Con: identical placebo

DB RCT

8 males between 18–34 y.o.a.

Int: loading dose of 6 capsules/day for 6 days (every three capsules contain 1000 mg Cordyceps sinensis + 300 mg RR) then maintenance dose of 3 capsules/day for 7 days

After pre-post endurance test no significant difference between intervention and placebo in muscle tissue oxygen saturation

Con: identical placebo

Design

Population

Intervention/Control

Outcome(s)

DB RCT

60 male and female (20–55 y.o.a) with fatigue syndrome

Int: 4 Verum tablets/day for 28 days (each tablet contain 144 mg Rhodiola extract SHR-5)

Significant improvement in fatigue scores (measured by Pines burnout scale), and significant improvement in two of five CCPT II indices

Con: identical placebo

int: 41.0 ± 7.9 y.o.a

con: 42.1 ± 8.5 y.o.a.

DB CO RCT

56 male and female physicians on night duty

Group A: Standardized extract of 170 mg RR for 2 weeks; 2 week Washout; 2 weeks identical placebo. Group B: treatment in reverse order

Significant improvement in total fatigue score after two weeks on RR;

Group A: 25.5 ± 3.8 y.o.a.

Group B: 27.3 ± 2.9 y.o.a.

DB RCT

121 male military cadets 19–21 y.o.a.

Int: 41 subjects – 2 capsules (185 mg each) RR.

Total antifatigue index scores significantly lower in both RR groups than placebo (p < 0.0001).

20 subjects – 3 capsules RR

“statistically significant beneficial physiological effect in the RR groups versus the placebo group”

Con: 40 subjects – identical placebo

20 subjects – untreated control

DB RCT (pilot study)

40 Male students from India 17–19 y.o.a.

Int: 2 x 50 mg RR tablets twice/day for 20 days

Non-significant improvement in physical work and mental capacity. Significant improvement in general well-being (p < 0.05), mental fatigue (p < 0.01).

Con: identical placebo

RCT

60 male students from India (17–18 y.o.a.)

Int: 660 mg/day for 20 days RR; Con(1): placebo; Con(2): nothing

Measures of subjective self-evaluation, psychological fatigue, situational anxiety, motivation, precision of motor function, process of excitement and need for rest are significantly different within RR group (<0.05). Mean changes in mental work capacity and neuromotor function are not significantly different between groups.