Rhodiola is one of my favorite botanicals! In fact, it was one of the first Western botanicals that I studied way back in the day (the 90's). One of the reasons I was so intrigued with this herb, was because of its versatility and powerful therapeutic effects. 30 years later, and I'm still in awe of this herb, and recommend it to many of my patients, who after using it, are just as amazed.
The patients I usually recommend this botanical to, have succumbed to the heavy effects of stress; whether it be from work, school, caregiver stress or any other type of stress that takes its toll on the body and mind.
The most common symptoms reported by these patients are:
What is rhodiola?
Rhodiola belongs to a special class of herbs known as adaptogens, which includes other famous herbs like, Siberian Ginseng (Eleuthero) and Astragulus.
The term "adaptogen" was introduced during the 50's by the Russian Toxicologist Nicolai Lazarev, who was studying substances that could prevent fatigue and increase resistance to physical and mental stress.
According to Nicolai Lazarev, “an adaptogen is a pharmacological substance capable of inducing in an organism a non-specific state of increased resistance enabling it to counteract stress signals and adapt to exceptional effort.”
Lazarev's pioneering work was heavily influenced by Hans Selye, the scientist who developed the stress model, “General Adaptation Syndrome”, which describes the effects of stress on the human body. 
When we are faced with "danger" or any type of stressor, our sympathetic nervous system (SNS) goes into over-drive and initiates the "fight" or "flight" response, which gives us that energy boost (adrenaline) to over -come the situation. The parasympathetic nervous system (PNS) is supposed to calm us down after the danger / stress has passed. The problem for most people, especially Westerners, is that we are stressed all the time. We have become a chronically over-stimulated society that runs on stress, essentially suppressing the (PNS) and never giving it a chance to do its job and calm us down.
Adaptogens to the rescue! Through the use of an adaptogen like rhodiola, we are able to take the edge off and help even the score between the (SNS) and the (PNS). Rhodiola increases the body’s resistance to stressors, restores balance to the nervous system and allows the body to heal itself.
How does rhodiola work?
Rhodiola rosea L. contains a variety of compounds ranging from antioxidants and organic acids to flavonoids, but the constituents that are responsible for its adaptogenic properties are: Rhodioniside, rhodiolin, rosavin, rosin, rosiridin, salidroside (synonym: rhodioloside and rhodosin) and p-tyrosol.
Based on a vast accumulation of data, rhodiola works primarily through the central nervous system. Much of this activity occurs along the hypothalamic-pituitary-adrenal (HPA) axis, which moderates the body’s “fight” or “flight” response to acute stress. 
In the brain, rhodiola is able to alter chemicals in the brain by inhibiting monoamine oxidase (MAO) A, which is a gene that contributes to the development of depression. 
Rhodiola can reduce the amount of cardiac damage caused by stress by modulating the release of neurotransmitters like cortisol and cyclic-AMP in the heart. 
By improving cerebral blood circulation and brain metabolism rhodiola can increase concentration and memory , as well as, protect against fatigue / burn-out and increase mental performance through the influence on the HPA axis, moderating certain survival proteins that are activated under stress, and altering levels of nitric oxide, which regulates physiological functions and aids in cellular metabolism. 
The Remarkable Three
The majority of the studies used a dosage of 200mg - 400mg. per day. Manufactures normaly put 100mg in a capsule and recommend that it be taken 2-3 times per day.
The dosage recommended on the manufacturers bottle should be followed, but one thing to keep in mind is that dosages may need to be modified depending on one's weight, age, gender metabolism and whether the stress is acute or chronic.
Always consult with your practitioner before taking a supplement, there can be drug-herb and herb-herb interactions.
Contraindications & Adverse Reactions
Herb - Drug Interactions
Posted by: Scott Stewart, MSAc., Dipl. Ac., LAc.
For thousands of years acupuncture practitioners have been guided by family knowledge passed down from one generation of doctor to the next, by invaluable manuscripts - many of which have been destroyed, and more recently, by the Chinese medical classics, which have guided modern practitioners in every aspect of Traditional Chinese Medicine (TCM), even in the midst of our modern age of science and technology.
Our knowledge of point locations comes from the same classical books, and the wisdom from present day lineages that share their observational & clinical experiences. For the most part, the methods and techniques of the modern day practitioner are still the same as they were thousands of years ago; the only difference is that we have more sophisticated technologies that can illuminate the internal world of our bodies by displaying it on a computer screen. These high-resolution three dimensional images show us what the ancient ones amazingly discovered through much cruder means.
For example, around 2200 BCE, there was no technology to aid primitive man in their exploration of the human body, but yet they still found a way to discover some of its secrets. At that time, tribal shaman were responsible for healing the sick. Amazingly, they had no tools or innovative pieces of equipment to help them distinguish one acupoint from another or even a real acupoint from a non - acupoint. Instead, they used their tactile sense of touch as they palpated the patient’s skin and body, noticing differences in skin texture, temperature, resilience and shape. They used this information to formulate therapeutic strategies, and as hundreds and thousands of years went by they began to record this data into manuscripts; depicting the location, actions and indications of each point they had carefully discovered.
Later, during the Shang Dynasty (1700 - 1100 BCE) a new technology emerged that reshaped every one’s life, including acupuncturists. The Bronze Age had arrived and the stone needles & animal quills of the past were being replaced with bronze medical needles, and later these would be followed by iron, and then gold and silver needles. The use of metal needles, which were heated up, led to the discovery of the meridians; because the patient was able to sense the heat as it flowed through the body along specific pathways.
This is just one of many examples that can be found all over the world, in which technology led to new discoveries that essentially propelled, in this case, acupuncture into a new era of diagnoses and treatments.
Now, fast forward to our modern medical age, in which we are on the cup of a new futuristic era that is being driven by microprocessors, complex algorithms, higher resolutions, advanced 3D imaging, and the start of a new biotech chapter with the integration of artificial intelligence, nanotechnology and 3D printing. These technological innovations will have positive repercussions throughout both Eastern and Western medicine.
Recent Technological Innovations and Acupoint Research
Over the last few decades one of the biggest driving forces behind the success in acupuncture point research, has been due to the progress made in imaging technologies. A considerable amount of the accumulated data that we have on point specificity has been the result of these improved imaging devices like functional Magnetic Resonance Imaging (fMRI), Positron Emission Tomography (PET), and the latest in the state - of - the - art computerized tomography (CT) scans with enhanced 3D imaging capabilities. As these devices continue to develop, they provide researchers with powerful and invaluable tools that can be utilized in the investigation of the intricacies that underlie acupuncture’s therapeutic influence over the body.
"Fast forward to our modern medical age, which is driven by microprocessors, complex algorithms, higher resolutions and 3D imaging."
New discoveries almost always follow technological innovations, and this is no different in the field of acupuncture research. Over the past 10 years, there has been increased interest in using the latest advances in diagnostic imaging technologies to study acupuncture points and meridians, in order to reveal their morphological structures, their unique features, and their hidden mechanisms. In the following paragraphs, you will read about some of the most important research of the last decade that has exploited these new technologies and led investigators to a more profound understanding of the mechanics that govern acupuncture.
The bulk of the studies below focus on validating point location by comparing verum (real) acupoints to sham points (non-acupoints) in terms of whether they activate the same areas of the brain or not. This indicates that needling at a particular point location as opposed to a randomly chosen area of the body elicits a very specific effect that can only be obtained by needling that acupoint.
FMRI evidence of acupoint's specificity in two adjacent acupoints
Manual acupuncture was performed on the three points during an fMRI scan. As seen in figure 2 and figure 3, Both LR3 and ST44 were shown to activate specific cerebral patterns in the contralateral primary somatosensory area (SI) and the ipsilateral cerebellum. LR3 and ST44 also elicited specific regions in the brain that were distinct from one another. 
Verum and sham acupuncture exert distinct cerebral activation in pain processing areas: a crossover fMRI investigation in healthy volunteers
Another study examined ST44 compared to a sham point (figure 1), using fMRI to investigate neural activity. Stimulation of ST44 showed increased activity in the prefrontal cortex, parietal cortex and the temporo-occipital regions of the brain. (figure 2, A. ST 44)
Remarkably, the sham point also showed stimulation, but this occurred in the primary and secondary somatosensory (s1 and s2) cortex areas. (figure 2, B. Sham)
Fig. 3 Cerebral effects of acupuncture, contrasting verum and sham stimulation. Blue-coded activation sites: increase for Sham minus ST44; red-coded sites: ST44 minus sham. The most important activation sites were marked with a circle and indicated by a number: 1—primary somatosensory cortex (S1); 2 post—posterior insula (y>0); 2 ant—anterior insula (y<0); 3—anterior cingulate cortex (ACC); 4—ventrolateral prefrontal cortex (VLPFC); 5—inferior parietal cortex (IPC); 6—thalamus. R right; A anterior
These findings validate the location and therapeutic potential of ST44, and interestingly demonstrate the possible reason why some sham procedures produce some therapeutic value. The brain region associated with the stimulation of the sham point is known for being responsible for affective pain processing. Whereas, the true (verum) acupuncture point elicited a reaction from parts of the brain that process discriminative somatosensory and cognitive pain. 
Point Location and Action
Specific cerebral activation following true and sham Waiguan (SJ 5) needling functional magnetic resonance imaging evidence
In 2010, research was conducted with fMRI on 18 healthy student volunteers, who were put into 3 groups of 6. One group received true acupuncture at Triple Energizer 5 (TE5, a.k.a. Waiguan). Sham needling was administered to the second group at TE5, and the third group was treated with true acupuncture at a nearby sham acupoint.
The fMRI demonstrated that stimulation of TE5 compared to sham needling activated the right superior frontal gyrus (BA8), and the left cerebellum. More specifically, needling at TE5 activated the right parietal lobe pertaining to the post-central gyrus (BA2), left cerebellum, and the right inferior semi-lunar lobule. 
This area of the brain is referred to as the Broadmann area (BA8). It’s responsible for writing, language and auditory functions , movement of the upper limbs , impulsive and aggressive behavior (via the insular cortex) ; the cerebellum controls coordination in the limbs and trunk, as well as, playing a role in posture & maintaining balance. BA2 as part of the post-central gyrus is related to the appreciation of sensation on the opposite side of the body.
According to TCM theory, TE5 or Waiguan is indicated for pain of the neck, shoulder and arm, impaired movement of the arm, shaking of the hand, impaired hearing and other ear disorders, as well as, anger, headache, dizziness, redness, pain and swelling of the eyes, etc. 
As the field of medicine becomes more entwined with technology, we will read about many more new discoveries and validations of theories in both Eastern and Western medicine. These high tech developments, which arise in exponential waves, can expand our knowledge of human anatomy and neuroscience, as well as, all other corners of medical science, aiding researchers in making new discoveries and clarifying misconceptions. This is certainly the case in Eastern medicine, in which we now are slowly uncovering the magnificent truth about the mechanics of acupuncture which operate at many different levels of physiology, ranging from the grossest materialism to the other extreme of immaterialism, which was once considered occult, but now more appropriately may be associated with the realm of quantum mechanics. The horizons are grand, but there is still much work to do in terms of fine tuning research designs and diversifying study participants.
As can be seen in the small sample above, most of the research that has come out over the past 10 years has focused on small populations of healthy individuals and only investigated single, double or triple acupoint cerebral activation.
There is a strong need to expand and improve study design, by examining unhealthy individuals across different age groups who are suffering from various diseases, including both psychological and physical illnesses, in order to truly understand the significance of acupoints and their affect on varying regions of the brain they activate.
Another area that should be high on the research list, is the investigation of acupoint combinations, especially those that are commonly used in clinical settings. What is the effect of these combinations when they stimulate multiple brain regions simultaneously? And do they activate the same regions as they do when stimulated as a single acupoint?
Afterthought on Technological Innovations and the Human Ego
Even with all the intended benefits, the irony of technological advancement still remains, it will always be limited in its capabilities to keep pace with our own unquenchable curiosities to deconstruct our bodily terrains. Medical science continues to pursue the reduction of the material body beyond the naked perception which is obliterated by a digitized pixelation under a macro zoom, just so we can better comprehend the body's mysteries; and more to the point, control and manipulate those mysteries. In this sense, technology becomes irrelevant as a tool due to its failure to keep up with humanities thirst for omnipotence.
In a recent meta-analysis, researchers analyzed the results of 29 trials and 17,922 patients suffering from chronic pain. Conditions included: neck pain, shoulder pain, low-back pain, headaches & migraines, and osteoarthritis of the knee.
From the original data set, 20 trials and 6,736 patients were used for the final conclusions, due to the fact that they included long-term follow-up data, which ultimately demonstrated that after a course of treatment, the effects of acupuncture treatments persist over a 12 month period.
It is a well-established fact that chronic pain causes changes in brain connectivity between specific regions in the brain that are associated with increased attention to pain, emotional rumination, nociceptive memory and avoidance learning.
In a recent Harvard Medical School study, based on this research, clinicians found that repeated verum (true) acupuncture compared to sham acupuncture was able to restore balance in connectivity between the dysregulated brain regions associated with pain.
In other studies, acupuncture has been found to more efficacious, produces longer lasting results, and more cost-effective than conventional medicine in the treatment of pain.
Also see chronic low-back pain
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In August 2015, a study was published by a group of University of California researchers who were investigating the effectiveness of specific acupoints to reduce both systolic (top #) and diastolic (bottom #) blood pressure (BP) in patients suffering from mild to moderate hypertension.
The study participants were selected based on having a diagnosis of hypertension and not being treated with any hypertensive medications. The 65 patients who qualified for the study were split into two groups; 33 patients went into a treatment group, and 32 into a control group.
The treatment group received EA at acupoints (P5, P6, ST36, ST37) that have been found in past experiments to be effective at lowering BP. The control group received EA at acupoints (LI6, LI7, GB37, GB39), which have no stimulating affect on any cardiac regions in the brain, and are indicated for non-cardiovascular conditions.
After 8 weeks of receiving weekly EA treatments for 30 minutes, the researchers found that the treatment group obtained a significant reduction of 70% in both systolic and diastolic BP readings.
The effects of the treatment group lasted for 1 month compared to no reduction in the control group. The study findings also highlighted the mechanism by which EA was able to elicit an effect. There were substantial decreases in norepinephrine (↓41%), renin (↓67%), and a reasonable decline in aldosterone (↓22%); all substances that contribute to BP regulatation.
In conclusion, EA can be a useful therapy in lowering the risk of such cardiovascular diseases as: heart failure, myocardial infarction, stroke, and peripheral arterial disease in hypertensive patients.