The Growing Popularity of an Ancient Herb
Rhodiola rosea, also known as arctic root or golden root, is an adaptogenic herb that grows in the cold, mountainous regions of Europe and Asia [1.3.2]. It has a long history of use in traditional medicine in Russia and Scandinavia to help the body adapt to and resist physical, chemical, and environmental stress [1.3.2, 1.4.8]. In the United States, it is available as an over-the-counter herbal supplement and is commonly used to manage stress, combat fatigue, and improve mental and physical performance [1.2.4, 1.3.5]. Despite its potential benefits, it's crucial to be aware of its potential interactions with other substances.
Critical Medication Interactions to Know
Rhodiola can affect various systems in the body, including neurotransmitters like serotonin and dopamine, blood sugar levels, and blood pressure [1.5.8, 1.6.2]. Because of these effects, it can interact with several classes of prescription and over-the-counter medications.
Antidepressants (SSRIs, SNRIs, and MAOIs)
A significant area of concern is the combination of rhodiola with antidepressants. Rhodiola may inhibit monoamine oxidases (MAO) and influence neurotransmitters like serotonin [1.2.4, 1.4.8].
- Serotonin Syndrome: When taken with serotonergic drugs like Selective Serotonin Reuptake Inhibitors (SSRIs) or Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), there is a theoretical risk of serotonin syndrome [1.2.1, 1.2.6]. This is a potentially life-threatening condition caused by excessive serotonin in the brain [1.2.6]. Symptoms can include agitation, rapid heart rate, and restlessness [1.2.1, 1.5.8]. One case report detailed a patient developing serotonergic syndrome after taking rhodiola with paroxetine (an SSRI) [1.3.8].
- MAOIs: You should not take rhodiola if you are taking prescription Monoamine Oxidase Inhibitors (MAOIs), a class of antidepressants, due to the risk of additive effects [1.3.6, 1.4.5].
Blood Pressure and Diabetes Medications
Rhodiola may lower both blood pressure and blood sugar levels, which can lead to complications if you are already taking medications for these conditions [1.6.1, 1.6.2].
- Antihypertensive Drugs: Taking rhodiola along with medications designed to lower blood pressure could cause it to drop too low, a condition known as hypotension [1.6.1]. People with low blood pressure should use rhodiola with caution [1.6.4].
- Antidiabetes Drugs: Similarly, combining rhodiola with insulin or other antihyperglycemic medications could cause blood sugar to fall to dangerously low levels (hypoglycemia) [1.6.2, 1.6.6]. It's essential to monitor blood sugar closely if using both [1.6.1].
Blood Thinners and Anti-inflammatory Drugs
Rhodiola may affect blood clotting and how the body metabolizes certain drugs.
- Anticoagulants/Anti-platelet Drugs: The herb may increase the effects and levels of blood thinners like warfarin (Jantoven) [1.2.1, 1.4.1]. This can increase the risk of bleeding [1.4.6]. It should also be avoided with anti-platelet drugs like clopidogrel and even over-the-counter options like aspirin and ibuprofen [1.4.6].
- CYP2C9 Substrates: Rhodiola can inhibit the CYP2C9 enzyme, which is responsible for breaking down many common medications in the liver [1.3.4, 1.2.6]. This could alter the effects and side effects of drugs like losartan (Cozaar) and phenytoin (Dilantin) [1.2.2, 1.3.5].
Other Notable Interactions
- Immunosuppressants: Because rhodiola may stimulate the immune system, it could interfere with medications designed to suppress it, such as those taken after an organ transplant or for autoimmune diseases like multiple sclerosis and rheumatoid arthritis [1.2.2, 1.4.1, 1.4.6].
- Stimulants: Theoretically, rhodiola could have an additive effect when taken with stimulant medications, such as those used for ADHD [1.2.6, 1.3.5].
- Birth Control and Thyroid Medication: Some sources suggest caution when combining rhodiola with birth control pills or thyroid medication, though research is limited [1.3.2, 1.3.7].
Comparison of Potential Rhodiola Interactions
| Medication / Substance Class | Potential Interaction Effect | Severity Level | Source |
|---|---|---|---|
| Antidepressants (SSRIs, MAOIs) | Increased risk of serotonin syndrome, rapid heart rate. | High | [1.2.1, 1.3.6, 1.5.8] |
| Antihypertensive Drugs | Blood pressure may drop too low (hypotension). | Moderate | [1.6.1, 1.6.2] |
| Antidiabetes Drugs | Blood sugar may drop too low (hypoglycemia). | Moderate to High | [1.6.1, 1.6.2, 1.6.6] |
| Blood Thinners (e.g., Warfarin) | Increased effect of medication, higher risk of bleeding. | Moderate to High | [1.2.1, 1.4.6] |
| Immunosuppressants | May counteract the medication's intended effect. | Moderate | [1.2.2, 1.4.1] |
| Stimulants (e.g., for ADHD) | Potential for additive stimulant effects. | Low to Moderate | [1.2.6, 1.3.5] |
Who Should Avoid Rhodiola?
Certain individuals should exercise particular caution or avoid rhodiola altogether:
- Pregnant or breastfeeding women [1.3.2, 1.4.1].
- Individuals with bipolar disorder, as rhodiola's antidepressant activity could potentially trigger mania [1.3.5, 1.4.6].
- People with autoimmune diseases like rheumatoid arthritis or multiple sclerosis, as rhodiola might stimulate the immune system [1.4.1, 1.4.6].
- Those scheduled for surgery, due to its potential effects on blood clotting and blood pressure [1.4.8].
Conclusion: Prioritize Safety and Consultation
While Rhodiola rosea offers potential benefits as an adaptogen, its capacity to interact with a wide range of medications cannot be overlooked. The most significant risks involve combinations with antidepressants, blood pressure and diabetes medications, and blood thinners [1.2.1, 1.6.1, 1.6.4]. Due to these potential interactions and effects on the liver's drug-metabolizing enzymes, it is essential to consult with a healthcare provider before adding rhodiola to your regimen, especially if you take any prescription medications or have an underlying health condition [1.2.3, 1.3.3].
Authoritative Link: Rhodiola - Memorial Sloan Kettering Cancer Center
