Rhodiola sacra, a species closely related to Rhodiola rosea, has been used in traditional Tibetan and Chinese medicine for centuries. Its use is primarily aimed at increasing the body's resilience to stress, enhancing energy, and supporting mental and physical performance. Traditional healers have often recommended Rhodiola species for fatigue, altitude sickness, and as a tonic for overall vitality, which indirectly relates to adrenal function by addressing stress and fatigue—conditions commonly associated with adrenal medulla activity.

However, the direct association of Rhodiola sacra with support of the adrenal medulla specifically is based on broader traditional use for stress adaptation rather than targeted evidence. The adrenal medulla is responsible for producing catecholamines like adrenaline and noradrenaline during the stress response. While there is evidence from studies on Rhodiola rosea (the better-studied species) that some Rhodiola extracts may modulate stress responses and reduce levels of stress-induced fatigue in humans and animals, research specifically linking Rhodiola sacra to direct adrenal medulla support is lacking.

In summary, the use of Rhodiola sacra to support the adrenal medulla is justified by traditional medicine practices rather than direct scientific validation. Evidence from modern studies is largely extrapolated from related species and focuses on general adaptogenic effects rather than specific actions on the adrenal medulla.