Rhodiola Rosea

Shevtsov et al. (Phytomedicine, 2003; PMID 12725561), Darbinyan et al. (2000; PMID 11081987), Spasov et al. (2000; PMID 10839209) and Olsson et al. (Planta Med, 2009; PMID 19016404): randomized trials of Rhodiola rosea for stress and fatigue. Grade C (small trials, self-reported endpoints). Funding: all four trials tested one proprietary standardized extract, and each has a scientist from the institute that developed and sells it among its authors (G. Wikman on the 2000 and 2003 trials, A. Panossian on the 2000 and 2009 trials); none states a funder in its indexed record. Independent evidence: Punja et al. (PLoS One, 2014; PMID 25268730), registered double-blind placebo-controlled trial in 48 nursing students on shift work, 364 mg once or twice daily for 42 days; fatigue was significantly worse on Rhodiola than on placebo on both the primary vitality scale and the cross-validating visual analog scale, with adverse events similar. Ishaque et al. (BMC Complement Altern Med, 2012; PMID 22643043): systematic review of 11 trials, evidence contradictory, every trial at high or unclear risk of bias. Hung et al. (Phytomedicine, 2011; PMID 21036578): systematic review of 11 placebo-controlled trials, noting the lack of independent replication. The outcomes in the positive trials were mostly timed test batteries (fatigue indices) with questionnaires, not self-report alone. Mixed, low-quality evidence with one independent trial finding harm: C.