Scientific Name(s): Ganoderma lucidum (Leysser ex Fr.) Karst
Common Name(s): Ganopoly, Ling chih, Ling zhi, Lingzhi, Reishi, Spirit plant
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
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
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
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 enhancement3, 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 system3, 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 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. 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
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 Inhibition of cholesterol biosynthesis, enhanced antioxidase activity, decreased platelet aggregation2, 3, 40 and reduced lipid peroxidation have been demonstrated in animal and in vitro experiments.2, 3, 10 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
In animal experiments, ganopoly affected carbohydrate metabolism and promoted insulin secretion. In a clinical trial of patients with type 2 diabetes, ganopoly 1,800 mg 3 times daily reduced postprandial glucose values. The glucans ganoderan A and B (glucans) inhibited hypoglycemia in clinical studies.3
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 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
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 Two clinical trials have been conducted involving patients with rheumatoid arthritis. Both trials used a combination of lingzhi plus San-Miao-San, therefore making it difficult to attribute the positive outcomes to the individual agents.5, 45
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
An antiasthma herbal formula containing 62.5% lingzhi, 28.1% ku shen, and 9.4% gan cao was found to be safe and well-tolerated by nonsmoking adults with asthma during a 1-week, phase 1 dose-escalation study (n = 20).53
Chronic fatigue syndrome
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
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
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
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.
None well documented.
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 among 8 US centers in the Drug-induced Liver Injury Network revealed 15.5% (130) of hepatotoxicity cases was caused by herbals and dietary supplements whereas 85% (709) were related to medications. Of the 130 related cases of liver injury related to supplements, 65% were from non-bodybuilding supplements and occurred most often in Hispanic/Latinos compared to 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 number of severe liver injury cases was significantly higher from supplements than conventional medications (P=0.02). Of the 217 supplement products implicated in liver injury, reishi mushroom was among the 22% (116) of the single-ingredient products.56
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
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