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Reishi Mushroom

Scientific Name(s): Ganoderma lucidum (Leysser ex Fr.) Karst
Common Name(s): Ganopoly, Ling chih, Ling zhi, Lingzhi, Reishi, Spirit plant

Medically reviewed by Drugs.com. Last updated on Jul 13, 2023.

Clinical Overview

Use

The polysaccharide content of reishi mushroom is responsible for possible anticancer and immunostimulatory effects. Reishi may also provide hepatoprotective action, antiviral activity, and beneficial effects on the cardiovascular system, rheumatoid arthritis, chronic fatigue syndrome, and diabetes. Few clinical trials have been conducted.

Dosing

The Pharmacopoeia of the People's Republic of China recommends 6 to 12 g reishi extract daily. Ganopoly (a Ganoderma lucidum polysaccharide extract) in doses up to 5.4 g daily (equivalent to 81 g of the fruiting body) for 12 weeks has been used in a few clinical trials.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

Reishi mushroom may enhance the adverse/toxic effects of agents with antiplatelet properties, anticoagulants, herbs (anticoagulant/antiplatelet properties), NSAIDs, salicylates, and thrombolytic agents.

Adverse Reactions

Adverse reactions are mild and may include dizziness, GI upset, and skin irritation.

Toxicology

There are few reports of toxicity with the use of reishi mushroom.

Scientific Family

Botany

The reishi mushroom is a purplish-brown fungus with a long stalk, brown spores, and a fan-shaped cap with a shiny, varnish-coated appearance. Reishi grows on decaying wood or tree stumps1 preferring the Japanese plum tree but also found on oak. The mushroom is native to China, Japan, and North America but is cultivated throughout other Asian countries. Cultivation of reishi is a long, complicated process. The reishi grows in 6 colors, each thought to have different characteristics and known as: Aoshiba (blue reishi), Akashiba (red reishi), Kishiba (yellow reishi), Shiroshiba (white reishi), Kuroshiba (black reishi), and Murasakishiba (purple reishi).2, 3

History

Reishi has been used in traditional Chinese medicine for more than 4,000 years for treating fatigue, asthma, cough, and liver ailments, and to promote longevity.2 The Chinese name lingzhi means "herb of spiritual potency."2 A Japanese name for the reishi is mannentake, meaning "10,000-year-old mushroom." Reishi's use is documented in the oldest Chinese medical text, which is more than 2,000 years old.4 Cultivation of reishi began in the 1980s. A survey conducted in Hong Kong found G. lucidum to be the third most common herbal preparation taken by preoperative surgical patients.5

Chemistry

The reishi mushroom is high in polysaccharide content with at least 36 different compounds identified6 including beta-d-glucan and GL-1.2, 3, 7 Triterpene constituents also have been analyzed.8 Triterpene antioxidants, including ganoderic acids A, B, C, and D; ganoderol A and B; ganoderol A; lucidenic acid B, and ganodermanontriol have been found in reishi.1, 2, 6, 9, 10, 11 Terpenoids 1, 2, and 3, and terpenes lucidenic acid O and lucidenic lactone are also present.3, 6, 12 A peptidoglycan from reishi contained approximately 7% protein and 76% carbohydrate.13 Certain enzymes from reishi have been reported14 as well as minerals such as calcium, magnesium, and potassium. Lanostan, coumarins, ergosterol, and cerevisterol are also components of reishi.2, 3, 12

Uses and Pharmacology

Antiviral effects

Polysaccharides isolated from reishi have been proven effective in vitro against herpes simplex virus types 1 and 2.(46) Reishi isolates also have been tested against other viral strains, including influenza A, and demonstrated effectiveness against their replication.(47)

Cancer

Anticancer effects of reishi have been reported largely from in vivo experiments, and data from clinical trials have been published. It is generally accepted that the anticancer effects are due to immune enhancement(3, 15) and may be exhibited from diverse chemical constituents in reishi.(6, 16, 17) Experiments focused on the stimulatory effects of the higher molecular weight polysaccharides (eg, ganopoly, beta-d-glucan, GL-1) on the immune system(3, 7, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29) and the suppressive effect of the triterpenes (eg, ganoderic acid) on the growth and invasive behavior of cancer cells.(15, 16, 18, 30, 31, 32, 33, 34) An ethanol soluble compound ganoderol B binds to androgen receptors and inhibits the sterol enzyme 5-alpha-reductase in experiments in rats.(1)

Clinical data

Clinical trials have been conducted in patients with advanced cancer.(15, 16, 35) Not all published trials are randomized and blinded. Ganopoly in doses up to 5.4 g daily (equivalent to 81 g of the fruiting body) for 12 weeks were used. Increased cellular immunity indices were reported in 80% of cancer patients in one trial.(36) Quality of life improved in 65% of patients in another trial.(16) In a further trial, varying results were obtained. It was proposed that ganopoly could reverse the immunosuppressive effects of chemotherapy and radiotherapy.(36, 37) A 2011 systematic review and meta-analysis evaluated the effects of G. lucidum, regardless of preparation, in Chinese cancer patients. A total of 5 randomized controlled trials met inclusion criteria, all of which had unsatisfactory methodological quality. The analysis showed a positive treatment response was more likely to occur in patients who received G. lucidum in combination with chemo-/radiotherapy than with either G. lucidum or chemo-/radiotherapy alone. The data are insufficient to justify use of G. lucidum as a first-line treatment for cancer. Data also suggested improved immune function via increases in CD3, CD4, and CD8.(51)

In a case report of the effect of lingzhi on gastric large B-cell lymphoma, the patient consumed 3 times the recommended dose for 5 days (60 capsules daily). Histological changes were recorded 11 days later, showing only a dense infiltrate of T lymphocytes remaining.(38)

Cardiovascular effects

The effect of reishi on the cardiovascular system has been investigated. Decreases in high blood pressure were reported to be attributed to the ganoderic acids.(2) Angiotensin-converting enzyme-inhibiting triterpenes from reishi have been described.(3, 39)

Animal and experimental data

Inhibition of cholesterol biosynthesis, enhanced antioxidase activity, decreased platelet aggregation(2, 3, 40) and reduced lipid peroxidation have been demonstrated in animal and in vitro experiments.(2, 3, 10)

Clinical data

A randomized, double-blind, crossover trial (n = 23) reported no significant changes in body mass index, blood pressure, glycemic indices, antioxidant capacity, lymphocytes, urine catecholamines, cortisol, or cortisone when 1.44 g/day of lingzhi (equivalent to 13.2 g of fresh mushroom) or placebo was administered to patients with borderline elevated blood pressure and/or cholesterol. The only significant change in lipid profile was apo-B, which increased significantly in the placebo group.(52)

Chronic fatigue syndrome

Clinical data

A multicenter, double-blind, randomized, placebo-controlled trial was conducted in China. Ganopoly 5.4 g daily was administered for 8 weeks, resulting in a reduced sense of fatigue and lower Clinical Global Impression severity scores.(31)

Diabetes/Metabolic syndrome

Animal data

In animal experiments, ganopoly affected carbohydrate metabolism and promoted insulin secretion.(3)

Clinical data

A randomized, multi-blind, placebo-controlled clinical trial enrolled 84 adults with metabolic syndrome and high fasting blood glucose to investigate the safety and efficacy of 3 g/day G. lucidum (with and without Cordyceps sinensis) on hyperglycemia and cardiovascular risk factors. However, because they failed to recruit the sample size needed to assess the 3 groups separately, they combined data for both G. lucidum treatment groups into a single "intervention group.” Compared to placebo, none of the primary (HbA1c, fasting plasma glucose) or secondary outcomes (ie, lipid parameters, blood pressure, anthropomorphic measurements) were significantly affected by the interventions after 16 weeks. All of the participants had type 2 diabetes.(53) In a review, ganopoly 1,800 mg 3 times daily reduced postprandial glucose values in patients with type 2 diabetes in a clinical trial. The glucans ganoderan A and B (glucans) inhibited hypoglycemia.(3)

Hepatitis

Animal and experimental data

In in vitro and in vivo animal experiments, hepatoprotection by extracts of ganoderma against induced liver damage has been demonstrated.(3, 26, 41, 42, 43)

Clinical data

A review documented that polysaccharide ganopoly therapy for 6 months resulted in normalization of aminotransferase levels in 33% and cleared serum hepatitis B surface antigen in 13% of trial participants compared with control.(3)

Immunological effects

Clinical data

Because high-altitude training can cause immunosuppression, the effect of G. lucidum on T-lymphocyte subsets in young male football players (n=40) undergoing simulated high-altitude training (living high-training low; LHTL) was evaluated in a 6-week randomized controlled trial. A 20 g/day dose of G. lucidum significantly increased CD3+ from baseline on day 21 and tended to increase CD4+/CD8+ ratios, but differences were not significant over time for either measurement.(50)

Prostate

Clinical data

G. lucidum 6 mg once daily for 12 weeks was well tolerated and significantly decreased the International Prostate Symptom Score, compared with placebo, in men older than 49 years with lower urinary tract symptoms. No significant changes were noted in quality of life or for any of the secondary outcome measures (ie, prostate size, residual volume after voiding, peak urinary flow, serum prostate-specific antigen, testosterone levels).(54) The dose was based on a previously conducted dose-ranging study.(55)

Rheumatoid arthritis

Experimental data

The effect of reishi on the immune system has been studied in in vitro experiments. In an experiment using synovial fluid from patients with rheumatoid arthritis, researchers demonstrated an inhibitory effect of a polysaccharide extract on the proliferation of synovial fibroblasts, possibly via the nuclear factor-kappa B transcription pathway.(44)

Dosing

Traditional practitioners recommend 0.5 to 1 g daily, 2 to 5 g daily for chronic illness, and up to G. lucidum 15 g extract daily for serious illness.5 The Chinese pharmacopoeia recommends 6 to 12 g extract daily.5 Doses up to Ganopoly 5.4 g daily (equivalent to 81 g of the fruiting body) for 12 weeks have been used in clinical trials.35

Pregnancy / Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

Agents with antiplatelet properties: Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of agents with antiplatelet properties. Bleeding may occur. Consider therapy modification.57, 58, 59, 60

Anticoagulants: Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of anticoagulants. Bleeding may occur. Consider therapy modification.57, 58, 59, 60

Herbs (anticoagulants/antiplatelet properties): Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of other herbs (anticoagulant/antiplatelet properties). Bleeding may occur. Consider therapy modification.57, 58, 59, 60

NSAIDs: Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of nonsteroidal anti-Inflammatory agents. Bleeding may occur. Consider therapy modification.57, 58, 59, 60

Salicylates: Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of salicylates. Bleeding may occur. Consider therapy modification.57, 58, 59, 60

Thrombolytic agents: Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of thrombolytic agents. Bleeding may occur. Consider therapy modification.57, 58, 59, 60

Adverse Reactions

Reported adverse reactions from reishi include dizziness, dry mouth, stomach upset, nosebleed, bone pain, skin irritation, diarrhea, and constipation.2, 31

In a small, placebo-controlled trial designed to determine adverse reactions related to reishi use, 4 g of extract daily for 10 days taken by healthy adults resulted in no differences between participants receiving reishi and those taking placebo.48 No changes in blood CD4, CD8, or CD19 were observed, and insignificant increases in CD56 were noted.48

Ganodermic acid S and adenosine-related compounds found in reishi are thought to cause platelet inhibition, and a protease compound has been demonstrated to competitively inhibit thrombin-fibrinogen binding in in vitro experiments. However, another placebo-controlled trial using 1.5 g of extract daily for 4 weeks did not result in any changes in platelet or hemostatic function.49

Data collected between 2004 and 2013 from 8 US centers in the Drug-induced Liver Injury Network revealed that 15.5% (130) of hepatotoxicity cases were caused by herbals and dietary supplements, whereas 85% (709) of cases were related to prescription medications. Of the 130 cases of liver injury related to supplements, 65% were from non-bodybuilding supplements and occurred most often in Hispanics/Latinos compared with non-Hispanic whites and non-Hispanic blacks. Liver transplant was also more frequent with toxicity from non-bodybuilding supplements (13%) than with conventional medications (3%) (P<0.001). Overall, the proportion of severe liver injury cases was significantly higher for supplements than for conventional medications (P=0.02). Of the 217 supplement products implicated in liver injury, 175 had identifiable ingredients, of which reishi mushroom was among the 32 (18%) single-ingredient products.56 The European Association for the Study of the Liver (EASL) clinical practice guideline for drug-induced liver injury (2019) recommends physicians consider herbal and dietary supplements as potential causative agents associated with liver injury (Level 4; Grade C), including reishi mushrooms (G. lucidum).45

Toxicology

Research reveals little information regarding toxicity with the use of reishi mushroom. A mean lethal dose has been estimated to be 10 to 21 g per kg body weight. Animal experiments have tested dosages up to 38 g/kg.5

Index Terms

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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