TCM Properties

Traditional Use

Tonifies Qi and invigorates Blood — fatigue, altitude sickness, shortness of breath, and palpitations from Qi-Blood deficiency
Clears Lung Heat and stops cough — Lung-heat cough, hemoptysis, and bronchitis
Calms the Heart and settles the mind — palpitations, insomnia, anxiety, and mental fatigue from overwork
Activates Blood and dispels stasis — traumatic injury, bruising, and chest pain from Blood stasis

Tonifies Spleen Qi — poor appetite, loose stools, and weakness from Spleen Qi deficiency
Adaptogenic tonic — foundational use in Tibetan and highland Chinese folk medicine for longevity, cold-climate endurance, and stress resilience

Si Bu Yi Dian (Crystal Mirror of the Four Tantras; Tibetan medical canon): records Hong Jing Tian as a high-altitude tonic that 'nourishes the heart, calms the mind, and enables one to withstand cold and exhaustion at altitude' — foundational text for its highland tonic use, predating integration into the Chinese pharmacopoeia
IMPORT NOTE: XLSX source filed this herb under 'All-Grass' naming convention; the official Chinese Pharmacopoeia 2020 drug part is root and rhizome (Radix Et Rhizoma Rhodiolae), not aerial parts — official species is Rhodiola crenulata (Hook.f. & Thomson) H.Ohba; Latin and pinyin confirm the root drug; data retained as imported from source XLSX

Salidroside (rhodioloside) — phenylpropanoid glycoside; principal bioactive marker; anti-fatigue, neuroprotective, adaptogenic
Rosavins (rosavin, rosarin, rosin) — phenylpropanoid glycosides specific to Rhodiola rosea; adaptogenic, antidepressant; used as standardisation marker alongside salidroside
Tyrosol — simple phenol precursor to salidroside; antioxidant
Herbacetin, rhodionin, tricin — flavonoids; anti-inflammatory, weak anticancer activity
Monoterpene alcohols (geraniol, myrtenol) — essential oil components
Organic acids: gallic acid, chlorogenic acid, oxalic acid

Antidepressant: randomised controlled trial comparing R. rosea extract (340 mg/day), sertraline (50 mg/day), and placebo in 57 outpatients with mild-to-moderate major depressive disorder found comparable Hamilton Depression Rating Scale improvement between Rhodiola and sertraline groups with significantly fewer adverse effects in the Rhodiola group — first RCT evidence supporting the TCM calming and mind-settling application (PMID 25539889)
Adaptogenic and anti-fatigue: salidroside and rosavins reduce stress-induced cortisol elevation, improve work capacity, and shorten recovery time in both clinical and animal studies; mechanism involves AMPK activation, SIRT1 upregulation, and attenuated HPA-axis reactivity — directly validates the Qi-tonifying fatigue and altitude-stress applications
Altitude sickness and hypoxia adaptation: used by Chinese military and Tibetan highland communities for hypoxia adaptation; salidroside protects mitochondrial function, reduces ROS generation, and upregulates hypoxia-inducible factor (HIF-1α) under low-oxygen conditions — provides mechanistic basis for the primary indication of altitude-related fatigue and shortness of breath
CYP3A4 pharmacokinetic interaction: in vitro studies show rosavins inhibit CYP3A4-mediated drug metabolism, raising the possibility of elevated plasma concentrations of co-administered CYP3A4-substrate medications; clinical significance at standard oral doses remains unclear but monitoring is warranted

Concurrent MAOI therapy — theoretical monoaminergic potentiation; avoid combination
Bipolar disorder — stimulating and adaptogenic properties may precipitate manic episodes; use only under specialist supervision

Standard dose: 200–600 mg standardised extract (3% rosavins, 1% salidroside); traditional decoction 3–9 g dried root
SSRIs and SNRIs (fluoxetine, sertraline, venlafaxine): salidroside modulates serotonin reuptake transporter; additive serotonergic effect is theoretical but case reports exist — monitor for serotonin syndrome signs (agitation, hyperreflexia, hyperthermia)
Anticoagulants and antiplatelets (warfarin, aspirin, clopidogrel): platelet aggregation inhibition reported in vitro; increased bleeding risk with concurrent use
CYP3A4-substrate drugs (statins, immunosuppressants, calcium-channel blockers, some antivirals): rosavins may inhibit CYP3A4 — monitor for signs of elevated drug levels
Stimulants (caffeine, ephedrine, methylphenidate): additive CNS stimulation; risk of insomnia, agitation, and elevated blood pressure
Antidiabetic medications (insulin, metformin, sulfonylureas): additive glucose-lowering; monitor blood glucose
Pregnancy: insufficient safety data; avoid