Mood and Performance Optimization with Rhodiola and Saffron

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Rhodiola and/or saffron may be just what you need to enhance mood, energy, and sexual function

As the summer dwindles and darkness approaches, many of us are looking for things to help sustain us through the darker days and cooler weather. Whether we struggle with energy, mood, or simply just a lack of outdoor activities and motivation when darkness exceeds daylight, it tends to be a time where we are looking for something “more.” Often, there are nutritional deficiencies that may be contributing to a wide array of symptoms such as these that we far too quickly deem “the winter doldrums,” or clinically, as seasonal affective disorder. In addition to vitamin D, magnesium and the B vitamins B12, B6, and folate are essential nutrients that many individuals experience a deficiency of that also can contribute to symptoms of fatigue, depression, or anxiety. ^{[1],[2],[3],[4],[5],[6],[7],[8],[9]}

In addition to addressing nutritional deficiencies that may lead to dysfunction, botanical medicine is often “where it’s at” when addressing a larger scope of problems that have related underpinnings. Botanicals have numerous active constituents leading to the wide array of applications we find when we study their traditional use. Nowadays, botanical extracts are standardized to certain constituents that have been shown to mediate these effects, such that we can better research and apply them clinically. However, despite this standardization, they still contain substantial amounts of other bioactive principles, phytonutrients, and antioxidants which lead to their broad scope of action. Two botanicals that offer an array of benefits with regards to mood and physical function are rhodiola and saffron, discussed at length herein.

Rhodiola: the golden root

Rhodiola (Rhodiola rosea), commonly known as golden or artic root, is an adaptogenic herb with a long history of use in Russia and Eastern Europe, where it grows in high mountainous regions. Rhodiola is revered for its ability to increase the resistance to physical, chemical, and biological stressors.^[10] It was reviewed in the Annual Review of Pharmacology as early as 1969,^[11] and now has an abundance of data that supports its reputation of improving physical and mental capabilities with acute or prolonged administration.

Rhodiola has been shown in clinical studies to positively impact mental health in settings ranging from “burnout,” which we all experience from time to time, to major depression, which some of us unfortunately also encounter.

Improved endurance exercise performance,^[12],[13] reduced lactate levels and markers of skeletal muscle damage after exhaustive exercise,^[14] and increased antioxidant capacity^[15] have all been seen in clinical studies investigating rhodiola’s impact on physical performance. Because rhodiola is an herb found at high altitude, it is perhaps not surprising that some of its demonstrated benefits are also related to this setting, with improvements in sleep quality at altitude in humans^[16] and improved altitude adaptation in animals^[17] being additional observations of scientific studies. A reduction of psychic and physical fatigue and enhanced mental performance in stress-related settings have also been demonstrated in humans with standardized extracts of rhodiola.^{[18],[19],[20]}

Rhodiola has been shown in clinical studies to positively impact mental health in settings ranging from “burnout,” which we all experience from time to time, to major depression, which some of us unfortunately also encounter.^[21] The active constituents found in rhodiola have been shown to impact the levels and transport of neurotransmitters in the brain, in part by acting as an inhibitor of the enzyme monoamine oxidase (MAO)-A which breaks down serotonin, norepinephrine, and epinephrine.^{[22],[23],[24],[25]}

In mildly anxious individuals, 200 mg of a rhodiola extract taken twice daily was shown to significantly reduce self-reported anxiety, stress, anger, confusion, and depression compared to placebo after supplementation for two weeks.^[26] Similar results were observed in a pilot study of individuals with a diagnosis of generalized anxiety disorder, where supplementation of 340 mg of a standardized rhodiola extract daily for 10 weeks significantly decreased anxiety scores.^[27] In depressed individuals, the same amount taken once or twice daily decreased overall depressive symptoms, emotional instability, insomnia, and somatization.^[28],[29] In a study comparing rhodiola to placebo as well as a common antidepressant medication, although the odds of improvement with the medication were slightly greater, there was approximately twice as many adverse events in those treated with the medication.^[30] Adverse events experienced with rhodiola were generally mild and included nervousness and dizziness, while individuals taking the medication reported sexual dysfunction, nausea, palpitations, insomnia, fatigue, and gastrointestinal disturbances.

Because of its effects on neurotransmitter balance, and its observed action as a mild stimulant, rhodiola should be used with caution with medications that impact serotonin and in those with bipolar disorder, as manic episodes may be triggered with the use of antidepressants or stimulants.^[31],[32] Additionally, rhodiola should not be taken later in the day due to possible adverse effects it may have on sleep.

Saffron: red gold for mood and sexual health?

Saffron (Crocus sativus) has long been a revered and expensive botanical.^[33] Known as “red gold,” this valuable spice and medicinal botanical is from the stigma of the plant, hand-harvested from the flower, primarily in Iran and surrounding regions. With approximately 200,000 strands of saffron per pound, it shouldn’t be surprising that a small volume of the herb obtained from such a labor-intensive process would be quite expensive – reputedly costing somewhere between $11 to $35 per gram at local markets in regions where it is harvested.^[34]

Daily supplementation of a saffron extract also has been observed to significantly improve mood and overall symptoms in women with premenstrual syndrome.

Fortunately, very small amounts of this herb have been shown to be effective medicinally. In addition to the antioxidant,^[35] anti-inflammatory,^[36] digestive,^[37] cardioprotective,^[38] and anticarcinogenic^[39] properties of this botanical, it also has been shown to improve mood symptoms in adults and children and sexual function in both men and women. Saffron also boasts cognitive benefits with positive clinical findings in both attention-deficit/hyperactivity disorder and mild to moderate Alzheimer’s disease.^{[40],[41],[42]} Daily supplementation of a saffron extract also has been observed to significantly improve mood and overall symptoms in women with premenstrual syndrome.^[43]

The primary bioactive compounds found in saffron are crocin, crocetin, safranal, and picrocrocin, although trace amounts of the carotenoids lycopene, alpha- and beta-carotene, and zeaxanthin also may exist.^[44],[45] Studies suggest that the carotenoids safranal and crocin interact with GABA receptors,^[46] modulate levels of serotonin,^[47] and alter levels of dopamine and norepinephrine.^[48],[49] Animal studies suggest that crocin mediates the aphrodisiac effects of saffron,^[50] while the whole herb or its extract also have been shown to promote healthy blood flow by activating nitric oxide synthase,^[51],[52] which may be another means by which it improves sexual response in both men and women.

In numerous human studies, treatment with saffron has been shown to significantly improve symptoms of anxiety and depression.

In numerous human studies, treatment with saffron has been shown to significantly improve symptoms of anxiety and depression. In a six-week study of 40 individuals with moderate depression, 30 mg/day of an extract of saffron was shown to significantly improve depression scores (as assessed by the Hamilton Depression Rating Scale for depression) compared to placebo, with scores decreasing more than 12 points in the group receiving saffron and only 5 points in the placebo group.^[53] In a study of adults having both anxiety and depression, 12 weeks of treatment with 50 mg of saffron twice daily had a significant effect on both anxiety and depression scores compared to placebo.^[54] A 2013 meta-analysis of five randomized controlled trials in adults found a large effect size with supplementation of saffron compared to placebo, while when compared to various pharmaceutical antidepressants the effect size was null, indicating these treatments were similarly effective.^[55]

The use of saffron as a treatment for depression and anxiety also has been studied in adolescents. In an eight-week study of adolescents ages 12 to 16 with mild to moderate depression or anxiety, supplementation of 14 mg of a standardized extract of saffron twice daily was associated with greater improvements in self-reported scores of internalizing symptoms, separation anxiety, social phobia, and depression, while significantly greater improvements compared to placebo were seen at varying time points in scores of generalized anxiety and obsessions/compulsions in both the self-reported and parent-reported scores.^[56]

Clinical studies have also shown saffron improves male and female sexual dysfunction, including dysfunction related to the use of antidepressant medications.

Clinical studies have also assessed the effect of saffron on women and men with sexual dysfunction, including dysfunction related to the use of antidepressant medications, which commonly have sexual side effects.^[57] In women ages 18 to 39 with sexual dysfunction (not related to medication use), supplementation with 15 mg of a saffron extract twice daily significantly improved excitement and desire by four weeks, with all aspects of sexual dysfunction except lubrication and pain improved compared to those receiving the placebo by eight weeks.^[58] In healthy men ages 26 to 62 who had erectile dysfunction (not attributable to obvious causes including diabetes), higher doses of a saffron extract (200 mg a day) taken for 10 days was shown to improve various parameters of sexual function including erectile function, as assessed by a standard clinical assessment technique.^[59] Improvements in semen parameters have also been observed with regular saffron supplementation, making it worthy of consideration for infertility issues as well.^[60]

In women who experienced sexual dysfunction after beginning treatment with fluoxetine for major depression, supplementation with 15 mg of an extract of saffron twice daily for 4 weeks significantly improved total sexual function index scores compared to placebo.^[61] Significant improvements were observed in scores related to arousal, lubrication, and pain compared to placebo, although desire, satisfaction, and orgasm were not significantly improved. A similar study looked at the impact of the same therapeutic regime on male sexual dysfunction related to antidepressant treatment, also finding improvements in total scores compared to placebo, with the primary benefits attributed to improved erectile function.^[62] In both of these studies, subjects were age 18 to 45 and stabile on an antidepressant medication for 6 weeks with the onset (or significant worsening) of sexual symptoms associated with treatment initiation.

Saffron has been shown to be very safe and has no known drug-herb interactions.^[63] In each of these studies, the frequency of adverse effects was similar to placebo, and those experienced were mild in severity.

Clearly, the data suggests rhodiola and saffron may have substantial effects on mood as well as different aspects of physical performance. For those who experience dysfunction in these realms, these botanicals may be worthy of further investigation to see if they also may work for you. As always, when using a botanical with potential medication interaction effects, the use of such therapies should be under the guidance of a trained practitioner.

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