Updated: January 9, 2023
Rhodiola rosea; also known as golden root, rose root, and arctic root is a herb steeped in traditional medicine. Used for centuries in Europe and Asia, it is becoming increasingly popular in Canada and the US as an adaptogen, but what exactly does it do? And what the heck is an adaptogen?
In this article, we’ll explain everything you need to know about Rhodiola, including its many health benefits, what adaptogens are, and why Rhodiola rosea is one of the fastest-growing herbal adaptogens on the market today.
Table of Contents:
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- What is Rhodiola rosea?
- What does Rhodiola rosea do for your body? Why do people take Rhodiola?
- Does Rhodiola rosea really work? How?
- What is an adaptogen?
- When should I take Rhodiola rosea?
- How much Rhodiola rosea should I take?
- How long does it take for Rhodiola rosea to start working?
- How long will Rhodiola rosea stay in my body after I take it?
- Is Rhodiola rosea suitable for everyone?
- Can you overdose on Rhodiola rosea?
- Can Rhodiola rosea cause anxiety?
- Can Rhodiola rosea affect depression?
- Can Rhodiola rosea boost energy and decrease fatigue?
- Can Rhodiola rosea improve cognition and mental performance?
- Can Rhodiola rosea enhance athletic performance?
- Can Rhodiola rosea help with Erectile Dysfunction?
- Can Rhodiola rosea support heart health?
- Does Rhodiola rosea increase serotonin?
- Can Rhodiola rosea help with quitting smoking?
- Can Rhodiola rosea help with weight loss?
- Does Rhodiola rosea increase estrogen?
- Can Rhodiola rosea help with fighting cancer?
- Does Rhodiola rosea have any negative interaction with cancer
- Does Rhodiola rosea have any negative interaction with medication?
- How should my Rhodiola rosea extract be stored?
- Why do Rhodiola rosea extracts contain alcohol?
- I am sensitive to alcohol or choose alcohol-free products; is there anything I can do to remove the alcohol?
WHAT IS RHODIOLA ROSEA?
Rhodiola rosea; also known as golden root, rose root, roseroot, Aaron’s rod, king’s crown, and arctic root is a perennial flowering plant native to the cold, mountainous regions of North America, Scandinavia, Europe, and Asia.
This tall, circumpolar boreal herb has bright yellow flowers that bloom in summer; deep green, succulent leaves; and a short, reddish-brown, scaly-looking rootstock.
In the Rhodiola genus of plants (Crassulaceae family), there are over 90 subspecies. The most well-known are Rhodiola rosea, Rhodiola integrifolia, Rhodiola rhodantha, and Rhodiola crenulata. Only Rhodiola rosea—the species we are referring to in this article, has the healing properties described below.
WHAT DOES RHODIOLA ROSEA DO FOR YOUR BODY? WHY DO PEOPLE TAKE IT?
Rhodiola rosea roots have been used in Eastern and Ayurvedic traditional medicine for its many health benefits and ability to restore balance to all the body's systems.
Today, people take Rhodiola rosea roots to improve physical and mental performance. Rhodiola is known to manage mild to moderate depression, reduce stress, anxiety, and fatigue, enhance focus and clarity, elevate mood, improve energy, endurance, and strength, and prevent illness.
With current paradigms shifting amid our global mental health crisis, people everywhere are turning to herbal medicine and naturopathic health treatments. The healing powers of plants and other adaptogenic herbs and fungi are being experienced with profound positive results.
As modern science continues to support Rhodiola rosea's health claims, the general trend of any legitimate research (meaning double-blind, randomized clinical trials) to date, supports the claims of Rhodiola rosea’s immunity-boosting, fatigue-fighting, autoimmune-improving properties. These studies have also found that taking Rhodiola regularly helps combat the stress and fatigue that dulls our physical and mental performance. Due to its well-documented success and future promise, Rhodiola rosea-based supplementation will continue to become more mainstream in the years to come.
DOES RHODIOLA ROSEA REALLY WORK? HOW?
Yes, Rhodiola rosea REALLY works! It's what's known as an adaptogen. Adaptogens are a class of superherbs and fungi that help the body adapt to environmental and internal stressors by modulating hormones like cortisol and adrenaline. Rhodiola is unique among the adaptogens class in that it also helps to increase energy levels.
WHAT IS AN ADAPTOGEN?
An adaptogen is the active or medicinal ingredient in certain plants and fungi that impacts how your brain and body "adapt" to dealing with stress, anxiety, and fatigue.
Adaptogens work on a chemical level with the cells in your body as they act to return all your body's systems back to a state of balance. This is called homeostasis.
For example, if you are driving at a high speed and someone cuts you off, your hypothalamus (the primitive brain) responds to the dangerous situation by releasing cortisol, the primary stress hormone in the body. In small, infrequent doses, cortisol is a good thing. It activates the flight/fight/freeze response, which has kept humans alive for thousands of years. In today's fast-paced world; however, humans experience stressful forces acting upon us constantly and often we don't realize it. This creates a chronic release of cortisol, which can lead to many health issues including anxiety, depression, digestive issues, headaches/migraines, muscle pains, cancer, heart disease, high blood pressure, heart attacks, sleep issues, weight gain, and memory/concentration problems.
If you experience consistently high cortisol, taking an adaptogen will help because it responds by decreasing the cortisol level in your body. Conversely, if you experience chronic fatigue (where cortisol levels are consistently low), an adaptogen will respond by increasing the level of cortisol in your body.
While many plants and fungi have adaptogenic-like properties, only a handful can truly be called adaptogens.
The list of genuine adaptogens includes Rhodiola rosea, ashwagandha, ginseng, St. John’s wort, holy basil, schisandra, and cordyceps. This list may evolve over time as research advances; however, by definition, for any herb or fungi to be called an adaptogen, it must fulfill three requirements:
- Non-specific: It helps your body cope with stress (virus, dis-ease, environment, life events) by promoting non-specific resistance.
- Normalizing: It balances ALL of your body's systems as it moves them from a stressed state back into a normalized state of homeostasis.
- Non-toxic: It is "benign," or "non-toxic," meaning it has no negative side effects on normal bodily functions.
Adaptogens assist us in strengthening and building resiliency during times of both acute and chronic stress.
The following are some of the most common advantages of taking adaptogens:
- Boost immunity
- Assist in coping with stress
- Reduce anxiety
- Improve sleep and mood
- Enhance cognitive functions like clarity and focus
- Promote detoxification on a cellular level
- Speed up recovery from illness
- Increase energy, stamina, motivation, and productivity
- Promote longevity and vitality
- Enhance antioxidant uptake
WHEN SHOULD I TAKE RHODIOLA ROSEA?
It depends. Not all Rhodiola rosea is created equal.
If you are taking Wilderland Botanicals Rhodiola rosea tincture, we suggest taking it once daily, first thing in the morning on an empty stomach. As a 1:4 mixture, our tincture is in the "Goldilocks zone" of strength (it's very strong but not too strong), and taking it on an empty stomach ensures you are getting the maximum bioavailable compounds of the plant.
Weaker tinctures (1:5, 1:6 strengths), and supplements in the form of powders, capsules, or tablets need to be taken more often. We have heard of people supplementing two-three times per day; but in our opinion, it is unnecessary. In the literature and studies we have been exposed to, the data does not exist to suggest more is better.
In our experience, dosing more than once per day means you'll likely just have more expensive pee. Also, since it is a known energy booster, dosing later in the day increases your chances of it keeping you up at night. Loss of sleep can create more issues since sleep is the cornerstone of healthy living.
Adopting a healthy practice like Rhodiola in your daily routine will result in an improvement in your long-term mental and physical well-being. As the saying goes, "Mood follows action" and the positive results gained from any healthy practice like Rhodiola come from dedication and consistency.
HOW MUCH RHODIOLA SHOULD I TAKE?
Many factors including your sex, body type, age, and lifestyle (i.e.: sleep, diet, activity levels, etc.), play into how much Rhodiola tincture is optimal for YOU.
For Wilderland customers, adult dosages typically vary in the 4.0-8.0mL range. Child dosage is approximately 0.5-1.0mL, and pet dosage (yes pets can have it too) is in the 0.25-0.75mL range depending on the size and type of animal.
If you are unsure where you should begin, we suggest starting small (1.0-2.0mL) and working your way up to a dose that “feels right” for you. When we say, “feels right,” we mean it. You will literally feel (or not feel) the effects of Rhodiola on a spectrum. When you haven’t taken enough Rhodiola, you likely won’t feel anything. When you’ve taken too much, you may feel an energy buzz (similar to caffeine) but without the jitters.
When you have reached a proper dosage level that is in harmony with your body, you may feel content, light, and “airy.” Again, you are the best judge of how much is right for you and your loved ones.
HOW LONG DOES IT TAKE FOR RHODIOLA ROSEA TO START WORKING?
If you are wondering how long it takes to start experiencing the benefits of Rhodiola rosea, assuming you take the tincture as recommended, it typically takes most people about 1-3 weeks for their bodies to adjust. Since Rhodiola tincture is water-soluble and has high bioavailability, you may start experiencing the benefits immediately.
HOW LONG WILL RHODIOLA ROSEA STAY IN MY BODY AFTER I TAKE IT?
The active compounds in Rhodiola tincture generally stay in your body for about 2-3 days.
IS RHODIOLA ROSEA SUITABLE FOR EVERYONE?
While Rhodiola rosea is suitable for most, we recommend you consult your naturopathic doctor or healthcare provider before using Rhodiola rosea, especially if you are: pregnant or breastfeeding, taking antidepressant medication, hormone replacements, or birth control pills.
CAN YOU OVERDOSE ON RHODIOLA ROSEA?
Through the decades of peer-reviewed research studies, there are no known Rhodiola overdose cases requiring medical intervention, nor are there any major adverse side effects.
While you can technically take too much Rhodiola, it is a completely natural substance and one cannot “overdose” in the same way one can dangerously overdose with pharmaceutical medications or other chemical drugs. Rhodiola overdoses produce similar side effects as caffeine overdoses such as difficulty falling asleep, light-headedness, dry mouth, or excessive saliva production.
Other factors, such as clinical depression, poor lifestyle choices, and poor dosage timing also play important roles in Rhodiola’s harmony with your body. Since 2010, Wilderland has been manufacturing and providing Rhodiola tincture to our customers, friends, and family. In this time, we have not had one known incident of the negative side effects listed above. Stay within the recommended dosage and you will be completely fine. Adjust your dosage as needed.
CAN RHODIOLA ROSEA CAUSE ANXIETY?
No, we have yet to find any valid studies that suggest Rhodiola rosea causes anxiety.
The media, stressful jobs, fast-paced culture, family issues, social situations, a worldwide pandemic—there are many things in life that cause anxiety. Rhodiola rosea is not one of them.
If you ever hear this rumour, feel confident knowing you can put it to rest. Let people know about Rhodiola rosea’s adaptogenic properties and how any study to date including this one and this one, shows Rhodiola’s only known effects on anxiety are positive and calming.
CAN RHODIOLA ROSEA AFFECT DEPRESSION?
Yes, Rhodiola rosea is known to affect depression...but in a positive way!
Many of us are well aware that life's challenges can cause us to feel more than just sadness at times. Some of those stressors, such as separation, job loss, or the loss of a loved one may lead to mental health issues including clinical depression.
Depression is a serious condition requiring specialized care. If you believe you are suffering from depression, it is important to adopt positive self-care practices into your daily routine immediately. It’s also very important to discuss it with someone—ideally getting the opinion of a professional to see whether your depressive symptoms qualify for more extensive treatment beyond self-care.
Now, assuming you're doing all you can to manage your mental well-being and you’re still feeling "meh," adding some mood-lifting Rhodiola rosea to your daily routine might be beneficial. Many of Wilderland’s Rhodiola customers have reported Rhodiola's benefits to us including marked improvement in their mental health conditions. It has also been proven in many studies like this one, this one, this one, and this one to positively support people with mild to moderate depression.
Remember, though, that Rhodiola rosea is not a substitute for therapy or other healthy coping methods. It's simply one of many available tools to help boost your mood.
CAN RHODIOLA ROSEA BOOST ENERGY AND DECREASE FATIGUE?
Yes, Rhodiola rosea is known to boost energy.
Most people who take Rhodiola rosea report that they experience a strong increase in energy when taking it. Many studies including this one, this one, and this one also validate the improvement of energy levels and reduction in fatigue. In addition, one of the most important factors is to recognize how this feeling of increased energy is different than what is experienced with caffeine.
Drinks such as coffee, tea, and especially energy drinks (i.e.: Red Bull, Monster Energy, etc.) contain caffeine. Caffeine is a drug, and it blocks our adenosine receptors, which prevents them from receiving important messages from adenosine. When adenosine binds to our brain receptors, it broadcasts the message that we're tired and need to sleep. When caffeine blocks these messages to the receptors, our bodies are essentially tricked into thinking we're less tired than we actually are.
To make matters even worse, many people often experience the "caffeine hangover and crash" a few hours after taking caffeine. This happens once the caffeine is metabolized and the blocking mechanism fades. Sometimes it feels like the only solution is to re-dose with caffeine to overcome the crash, and often we can get caught in an energy-killing loop that wreaks havoc on both the mind and body.
Rhodiola rosea is different. It doesn’t trick our bodies. like caffeine does. Instead, it actively aids in the reduction of stress and allows us to focus more clearly. Rhodiola rosea's capacity to improve the brain's ability to focus on activities may appear like it's increasing our energy levels, but what it's really doing is allowing us to not be affected by all the distractions. Rhodiola rosea helps our brains work more efficiently with the energy we have rather than providing artificial energy like caffeine. No jitters. No energy-killing loops. Just pure, natural, stimulating clarity. Who can't get behind that?
CAN RHODIOLA ROSEA IMPROVE COGNITION AND MENTAL PERFORMANCE?
Yes, Rhodiola rosea is known to improve cognition and increase mental performance.
Rhodiola rosea's capacity to improve cognitive function helps our brains in a variety of ways.
Rhodiola roots possess a variety of pharmacological properties, due to the abundance of different phytochemicals such as phenols and flavonoids. Furthermore, salidroside, rosavins, and p-tyrosol are responsible for its known positive effects in treating cognitive dysfunction.
This means, we can feel less tired and more alert. Regular users of Rhodiola report they feel like they are “in the zone.” Also, because we can concentrate for longer, we're able to accomplish more tasks. The clarity that comes with Rhodiola rosea, means we aren't disrupted by the constant distractions surrounding us. Our brains can reach a “flow state” because they are used much more efficiently.
Many research studies, including this one have concluded that Rhodiola rosea provides powerful protection to the brain through its ability to reduce oxidative stress, decrease neuroinflammation, block excitotoxicity in neural tissue. Studies also indicate that the enhanced focus Rhodiola rosea offers, results in an improvement in cognitive function. One study in particular went so far as determining Rhodiola rosea as a highly effective therapeutic approach for managing Alzheimer's Disease and other neurodegenerative disorders caused by oxidative stress.
If you want to calm your thoughts and focus on the job at hand, Rhodiola rosea tincture is a good place to start. At the very least, you can rest confident in knowing that Rhodiola rosea won't give you the jitters like a morning cup of coffee.
CAN RHODIOLA ROSEA ENHANCE ATHLETIC PERFORMANCE?
Yes. Did you know the Russian and Asian Olympic teams have been using Rhodiola to improve their physical and mental performance since the 1970s?
Numerous studies spanning decades, including this one and this one show consistent (meaning daily), use of Rhodiola improves exercise performance by improving endurance, reducing physical and mental fatigue, and speeding up recovery times. Even an acute dose of Rhodiola has shown to help improve exercise performance.
This is in part due to Rhodiola's ability to increase pulmonary ventilation, reduce blood pressure, as well as increase red blood cell count. The function of red blood cells is to transport oxygen to your muscles, meaning an increase in your muscles’ energy production – and therefore improved physical performance. Increased red blood cell supply also reduces fatigue, allowing you to stay fresh throughout your sessions; even returning less sore to your next workout.
In addition, Rhodiola can reduce both lactate concentration levels and parameters of skeletal muscle damage after an exhaustive exercise session as well as improve fatty acid consumption.
If you're looking for an edge that is totally natural, totally legal, and sport-approved, look to this amazing herb as it can help:
- Reduce Your Fatigue – meaning you can train at peak levels throughout your workout, and feel less sore for your next session.
- Enhance Your Endurance – so you can hit the weights and cardio harder and longer.
- Improve Your Focus – to form stronger mind-muscle-connection and make the most of every rep.
CAN RHODIOLA ROSEA HELP WITH ERECTILE DYSFUNCTION?
We've read studies on this but are not convinced yet.
While there's anecdotal evidence that Rhodiola rosea can help men with Erectile Dysfunction (ED), the science doesn't appear to be as strong as the other reported health benefits. While more research is needed, there are two small studies showing that Rhodiola rosea may assist males who are experiencing ED.
One study involved 35 men who took Rhodiola rosea once a day for three months. Many of these individuals reported enhanced sexual function, with many reporting that Rhodiola rosea helped them have better sex. The second study looked at sexual endurance and discovered that in some males, Rhodiola rosea helped them perform longer than they previously could.
As Rhodiola rosea gains in popularity, it's likely we'll see more research to either support or debunk this claim. In the meantime, we will have to rely on the experiences of others or test it out for ourselves!
CAN RHODIOLA ROSEA SUPPORT HEART HEALTH?
Yes. Rhodiola rosea can support heart health.
Research has revealed that Rhodiola rosea can resist stress-induced catecholamine release. Catecholamine is a powerful neurotransmitter, which helps the body to respond effectively in stressful situations. Unfortunately, when concentrations of catecholamines become too high it can result in elevated blood pressure leading to an array of uncomfortable symptoms such as headaches, sweating and chest pain and anxiety.
In addition to reduction of catecholamine release, it has been found that Rhodiola rosea can also significantly reduce the levels of Cyclic adenosine monophosphate (cAMP) in the heart. The results of these studies point towards a strong connection between Rhodiola's antistressor and cardioprotective properties with its minimal impact on cardiac output.
DOES RHODIOLA ROSEA INCREASE SEROTONIN?
Yes, Rhodiola rosea increases serotonin production.
Research has shown that Rhodiola rosea helps to stimulate serotonin, as well as norepinephrine, and dopamine activity.
Serotonin is a "feel-good" neurotransmitter produced by the brain. In addition to producing feelings of satisfaction, serotonin aids in the learning of new information, memory recall, and other bodily responses to external stressors.
CAN RHODIOLA ROSEA HELP WITH QUITTING SMOKING?
Yes, Rhodiola rosea can help with quitting smoking.
Smoking is not something most people genuinely enjoy. What smokers enjoy; and one of the major reasons why smokers have a difficult time quitting, is the nicotine found in cigarettes.
Nicotine is a highly addictive chemical. It's found to be more addictive than cocaine and even heroin.
Nicotine is also dangerous. It can cause sharp increases in blood pressure, heart rate, and flow of blood to the heart, while also narrowing the arteries. Nicotine may also cause the arterial walls to harden, which could lead to a heart attack.
Depending on how often you smoke, nicotine can remain in your body for up to eight hours. Also, as with other addictive drugs, there are some withdrawal side effects. All e-cigarettes contain nicotine, and many e-cigarettes and newer tobacco products often contain even more nicotine than conventional cigarettes.
One study performed in 2011 and another study performed in 2012 demonstrated that Rhodiola rosea’s stimulation of serotonin production helped prevent the development of nicotine dependence and reduced the suffering from nicotine withdrawal. While it is not a silver bullet, this decrease in dependency can support smokers in their quest to beat the addiction.
CAN RHODIOLA ROSEA HELP WITH WEIGHT LOSS?
Yes, Rhodiola rosea can help with weight loss by breaking down visceral fat.
Rhodiola rosea contains rosavin, a chemical that acts as a lipase stimulant. Our bodies make lipase naturally, which breaks down visceral fat. Visceral fat; "the bad fat," is fat that sits around our organs. It's called the bad fat, because it is much more dangerous to our bodies than subcutaneous fat. It's so closely connected to our vital organs and because we can't see it we may not be aware of the damage it is doing to our health.
According to studies like this one, when coupled with moderate exercise, Rhodiola rosea can help to decrease visceral fat. Rhodiola rosea not a replacement for a healthy workout routine. It's simply a supplement to your routine.
DOES RHODIOLA ROSEA INCREASE ESTROGEN?
No. Rhodiola rosea does not increase estrogen or have estrogenic effects.
We are often asked by patients who are in breast cancer recovery if Rhodiola rosea has estrogenic effects. Understandably so, because extra estrogen in a breast cancer patient is a bad thing.
Many Western doctors who are not trained properly in natural therapies or who are unaware of the various plant classifications think all Rhodiola is the same. It’s not. There are over 90 subspecies of Rhodiola, and four primary species of Rhodiola: Rhodiola rosea, Rhodiola integrifolia, Rhodiola rhodantha, and Rhodiola crenulata. A research study in 2016, found Rhodiola crenulata induced an early estrogenic response and caused human breast cancer cells to proliferate.
CAN RHODIOLA ROSEA HELP WITH FIGHTING CANCER?
Yes, it appears Rhodiola rosea may help with fighting cancer.
As we know, Rhodiola rosea has antimicrobial, anti-inflammatory, and antioxidant properties. Several medical journals have documented its possible anticancer effects too. In 2019, one study found that Rhodiola rosea tincture had an enhanced antitumour effect with tumours in the lungs.
According to this study, Rhodiola has strong anticancer properties that may be used in the treatment of leukemia. Another study published in 2012 found that salidroside (a bioactive component within Rhodiola) has the potential to slow bladder cancer tumour growth.
A study published in 2015 investigated the impact of salidroside on colon cancer. They studied the impact of high doses of salidroside (10/20/50 μg/ml) on “SW1116 cells” (colon cancer cells). They discovered that it reduced the development of these cells, but the acting mechanisms still require additional research.
It's worth noting that much of the study conducted was done on mice rather than people; however, there are human studies in progress. Many believe that humans may experience similar anticancer effects by taking Rhodiola rosea extract daily.
DOES RHODIOLA ROSEA HAVE ANY NEGATIVE INTERACTION WITH CANCER?
We have not found any valid research to date that proves Rhodiola rosea has any negative interactions with cancer patients.
In fact, there are a few of Wilderland's customers who had cancer and are using Rhodiola. One of which, had early stage four terminal cancer that went into complete remission after adopting our Rhodiola rosea into his daily health regimen. While Rhodiola wasn’t completely responsible for his remission, he believes it was a key component in his overall health strategy. See his testimonial on our customer reviews page.
Of the various Rhodiola species, only Rhodiola rosea has the adaptogenic healing properties, which is one of the main reasons why we are so enthusiastic about this herb.
DOES RHODIOLA ROSEA HAVE ANY NEGATIVE INTERACTION WITH MEDICATION?
Yes, Rhodiola rosea can negatively interact with some medications.
Rhodiola extract is a form of plant medicine and just like any other medicine, it can negatively interact with other pharmaceutical medications. If you are on prescription drugs for anxiety, depression, diabetes, blood pressure, birth control, hormones, and immunity, PLEASE CONSULT WITH YOUR HEALTHCARE PROVIDER BEFORE USE. Negative drug interactions may include reducing the effectiveness of the medication and/or increasing the side effects of the medication and can be quite serious.
HOW SHOULD MY RHODIOLA EXTRACT TINCTURE BE STORED?
Store your Rhodiola rosea tincture in a cool, dark place, such as a kitchen cupboard.
Sunlight and warm temperatures can damage the effectiveness of the tincture (similar to negative reactions in olive oil), which is why we put our tinctures in sterilized, dark amber bottles. The dark glass protects the herbal tincture from the sun’s harmful ultraviolet (UV) light rays. Do not freeze the Rhodiola rosea extract, and do not store it out in the open or near a heat source (such as an oven or dishwasher) as it can damage the extract and decrease its potency.
WHY DO RHODIOLA ROSEA EXTRACTS CONTAIN ALCOHOL?
Alcohol is the best-known solvent for Rhodiola because it extracts the compounds and active ingredients from the plant that are not water-soluble.
For centuries, both water and alcohol in combination have been necessary to extract all the active ingredients of Rhodiola and make them fully “bioavailable.” A solution of water alone is not enough. Alcohol is the best-known edible solvent that can effectively extract the required ingredients from the plant. In addition, alcohol stabilizes Rhodiola and acts as a preservative. For more on the various solvents used to extract plant medicine, visit our article on "Everything You Want to Know About Herbal Tincture."
I AM SENSITIVE TO ALCOHOL OR CHOOSE PRODUCTS FREE OF ALCOHOL; CAN I REMOVE THE ALCOHOL?
If you want to remove the alcohol from your Rhodiola rosea extract, simply bring a glass of cold water to a boil.
Take the boiling water off the stove, add your dose of Rhodiola extract, and let the water sit until it is room temperature. This will evaporate most of the alcohol. Once cool, return the mixture to the bottle and dose as instructed.