Basidiomycota

Other Names

BasidiomycetesBasidiomycotinabasidiosclub fungiHeterobasidiomyceteshigher fungiHolobasidiomycetesHomobasidiomycetesPhragmobasidiomycetessubdivision Basidiomycotasubdivision BasidiomycotinaTeliomycetesUstomycetes

Synopsis

Basidiomycota: A Comprehensive Reference on Medicinal and Dietary Supplement Applications

1. Identity, Taxonomy, and Natural Sources

Basidiomycota (commonly called "club fungi" or "basidiomycetes") is one of the two major divisions of the fungal kingdom that, together with Ascomycota, constitutes the subkingdom Dikarya — often referred to as the "higher fungi." Basidiomycota forms one of two large divisions within the subkingdom Dikarya; its members are known as basidiomycetes and include agarics, puffballs, stinkhorns, bracket fungi, other polypores, jelly fungi, boletes, chanterelles, earth stars, smuts, bunts, rusts, mirror yeasts, and Cryptococcus, the human pathogenic yeast.

Basidiomycota constitutes a major phylum of the kingdom Fungi, distributed in 4 subphyla, 18 classes, 68 orders, and 241 families. Advances in molecular phylogeny over the past years have resulted in numerous changes to their classification at a rapid pace. A classification recognized by an alliance of 67 mycologists identifies three subphyla — Pucciniomycotina, Ustilaginomycotina, and Agaricomycotina — and two additional class-level taxa (Wallemiomycetes and Entorrhizomycetes) outside of these. Agaricomycotina consists of jelly fungi, yeasts, and mushrooms, while Ustilaginomycotina consists of smut fungi, and Pucciniomycotina includes rusts, yeasts, smut-like and jelly-like fungi.

Basidiomycota are filamentous fungi composed of hyphae (except for Basidiomycota-yeast) and reproduce sexually via the formation of specialized club-shaped end cells called basidia that normally bear external meiospores (usually four). These specialized spores are called basidiospores. Basidiomycota are also all dikaryons, meaning that each cell in the thallus contains two haploid nuclei. Another distinguishing feature of Basidiomycota are their clamp connections, or hyphal outgrowths that form from the division of cells in dikaryotic hyphae.

Global estimates indicate that Basidiomycota encompasses 1.4–4.2 million species, with the latest estimates suggesting 0.7 to 1 million species, representing about 28–40% of all fungal diversity. From a dietary supplement and nutraceutical perspective, medicinal interest is concentrated within the class Agaricomycetes (order Agaricales and related orders), encompassing the macroscopic fruiting-body-forming mushrooms. Medicinal mushrooms can be defined as macroscopic fungi, mostly higher Basidiomycetes, used in the form of extracts or powder for prevention, alleviation, or healing of diseases and/or for nutritional reasons.

Key species of medicinal and supplementary importance within Basidiomycota include:

Ganoderma lucidum — Reishi (Japan) / Ling Zhi (China)
Lentinula edodes — Shiitake
Trametes versicolor (syn. Coriolus versicolor) — Turkey Tail / Yun Zhi
Grifola frondosa — Maitake / Hen of the Woods
Hericium erinaceus — Lion's Mane
Agaricus blazei Murill (syn. Agaricus subrufescens) — Sun Mushroom / Himematsutake
Inonotus obliquus — Chaga
Auricularia auricula-judae — Wood Ear / Black Fungus
Pleurotus ostreatus — Oyster Mushroom
Wolfiporia extensa (syn. Poria cocos) — Fu Ling
Schizophyllum commune — Split Gill Mushroom

Common Forms and Preparations

Medicinal mushrooms are used in the form of extracts or powder for prevention, alleviation, or healing of diseases and/or for nutritional reasons, and are presently mainly used as dietary supplements or functional food. Medicinal mushrooms, which are macroscopic fungi belonging to the phylum Basidiomycota, can be consumed as food items and used as extracts or powders to treat diseases. Preparations commercially available include: whole dried fruiting bodies, water-extracted powders (hot-water extraction isolates polysaccharides), alcohol-based tinctures and extracts (which favor terpenoid and sterol extraction), dual-extraction preparations (combining water and alcohol steps), capsules, tablets, and myceliated grain products. Although numerous supplements and concentrated preparations of shiitake are available, fruit bodies or mushroom cord extracts or powders with higher concentrations of pharmacologically active compounds are more fitting for medicinal use.

2. Traditional and Historical Use

Mushrooms are macroscopic fungi estimated to number around 140,000 on Earth, yet only 10% are known. Since ancient time, they have played a diverse role in human history for mycolatry, mycophagy, and as medicine in folklore and religion. Mushrooms have been part of a diet for over 2,000 years. Traditional practices and scientific research have focused on mushrooms as a group of highly recommended dietary supplement and medicine due to their evidently nutritional values.

Traditional Chinese Medicine (TCM)

Mushrooms have featured in traditional Chinese medicine for centuries, and dried extracts from fruit bodies occupy a lucrative segment of the market for herbal medicines in Western countries. Some of the earliest written records of medicinal mushroom use come from China, where they were used as part of traditional Chinese medicine as far back as the Han Dynasty (202 BC – 220 AD). Since ancient times, mushrooms have been cultivated and utilized in Asian countries like China, Japan, and Korea.

The famous Ganoderma mushroom (Ganoderma lucidum, Chinese: lingzhi, Japanese: reishi or mannentake) was especially revered. Famous Taoist master and physician Tao Hongjing (456–536 AD) wrote the Bencao Jing Jinzhu, an extension of the Shennong Bencao Jing, in which even more medicinal mushroom species are reported for their healing ability. In TCM, Ganoderma lucidum (Ling Zhi) was considered a tonic for longevity, immunity, and vitality, and was referred to by classical texts as the "mushroom of immortality."

Japanese Kampo Medicine

Traditional Chinese medicine, introduced mostly during the 7th–9th century AD, greatly influenced Japanese traditional medicine (Kampo). Kampo is similar to traditional Chinese medicine with a stronger emphasis on using medicinal "herbs," including mushrooms, especially shiitake. Shiitake was a known medicinal mushroom; in the year 199 AD, the 14th Japanese Emperor Chuai received shiitake mushroom as a gift from a native tribe. Its usage dates back centuries, particularly in Japan and China, where traditional medicine referred to it as the "elixir of life," believed to enhance vitality and vigor.

South and Southeast Asian Traditions

Ayurveda — the Indian traditional medicinal system — believes in maintaining the balance between mind, body, soul and rectifying doshas (i.e., health issues), and mushrooms featured in its natural pharmacopeia. Similar are the views of the traditional Chinese medicinal system. Mushrooms and some plants have been used in indigenous traditional medicine since the beginning of civilizations. Mushroom species used differ among locations and cultures; nevertheless, in Asia, especially China and Japan, more species have been used than in European and American traditions.

Brazilian and South American Traditional Use

The basidiomycete Agaricus blazei Murill (AbM), popularly known as the "sun mushroom," is native to Brazil and widely grown in Japan and China because of its medicinal properties. It is widely used for non-prescription, medicinal purposes, both as an edible mushroom and in the form of extracts. AbM has traditionally been used for the prevention of a range of diseases, including cancer, hepatitis, atherosclerosis, hypercholesterolemia, diabetes, and dermatitis.

Traditional Preparations

Historically, Basidiomycota mushrooms were prepared as: decoctions (prolonged boiling in water), dried powdered fruiting bodies added to food, hot-water teas, and fermented preparations. They have also been used as Chinese herbal medicines for physiological function activating actions such as enhancement of immunocompetence, antimicrobial activity, control of biorhythm, and prevention of senescence, or as folk medicines for certain types of diseases. Studies of pharmacological ingredients have resulted in the discovery of ingredients showing antibacterial and antiviral actions, a cardiotonic action, a hypoglycemic action, a cholesterol-lowering action, an antithrombotic action, and an antihypertensive action.

3. Key Constituents and Active Compounds

Basidiomycetes mushrooms (phylum Basidiomycota), including agaric and bracket fungi, are producers of bioactive molecules and valuable enzymes with different therapeutic effects; they are therefore considered perspective organisms for developing different healthcare biotech-products. The main groups of bioactive molecules produced by different mushrooms are polysaccharides, terpenoids, phenolics, and lectins. They are producers of different groups of high- and low-molecular-weight bioactive compounds — including alkaloids, phenolics, polysaccharides, proteins, terpenoids, and vitamins — with around 130 therapeutic effects, including neuroprotective ones.

3.1 Polysaccharides (β-Glucans)

Many mushrooms, if not all Basidiomycetes, contain biologically and physiologically active polysaccharides. These polysaccharides differ in chemical structures but are composed chiefly of β-glucans. Structural features such as β-(1→3) linkages in the main chain of the glucan and additional β-(1→6) branch portions are necessary for antitumor and immunomodulatory action.

Lentinan, an antitumor polysaccharide, was isolated and purified from a hot-water extract of Lentinula edodes fruit bodies. The structure of lentinan was reported as a (1→3)-β-d-glucan having two (1→6)-β-glucopyranoside branches for every five (1→3)-β-glucopyranoside linear linkages.

β-Glucans are a heterogeneous group of glucose polymers with a common structure comprising a main chain of β-(1,3) and/or β-(1,4)-glucopyranosyl units along with side chains with various branches and lengths. β-Glucans initiate immune responses via immune cells, which become activated by the binding of the polymer to specific receptors. However, β-glucans from different sources also differ in their structure, conformation, physical properties, binding affinity to receptors, and thus biological functions. The mechanisms behind this are not fully understood.

Notable polysaccharide-derived preparations include:

Lentinan — β-(1,3)-glucan from Lentinula edodes (shiitake)
PSK (Polysaccharide Krestin) and PSP (Polysaccharide Peptide) — protein-bound polysaccharides from Trametes versicolor
D-fraction — proteoglycan from Grifola frondosa
Schizophyllan (SPG) — β-glucan from Schizophyllum commune

The biological activities of a β-(1,3)-glucan isolated from Grifola frondosa changed with its molecular weight, with the highest-MW glucan always showing the most potent immunomodulatory effect. The same applied to polysaccharide-K (Krestin, PSK), a protein-bound polysaccharide obtained from basidiomycetes, which showed the strongest immune-stimulating activities for PSK with the highest MW (>200 kDa).

3.2 Terpenoids and Triterpenoids

Substances detected in higher Basidiomycetes mushrooms include chemically highly diversified anti-inflammatory compounds such as polysaccharides, terpenoids, phenolic compounds, glycerides, and other low-molecular-weight molecules. Ganoderma lucidum is particularly notable for its triterpenoids (ganoderic acids), which have been studied for hepatoprotective, anti-inflammatory, and antitumor effects. Their molecular weight varies from a few kDa to several thousand kDa, and their biological effects vary with structure, molecular weight, and tertiary conformation. Agaricus blazei Murill also contains metabolic substances with cytotoxic effects, such as the steroid blazein, the lipid ergosterol, its derivative agarol, and the phenylhydrazine-containing compound agaritine.

3.3 Ergosterol and Vitamin D Precursors

Ergosterol is an important sterol commonly found in edible mushrooms, with important nutritional value and pharmacological activity. Ergosterol is a provitamin. It has been well established that edible mushrooms are an excellent food source of vitamin D2 because ergosterol is a precursor that is converted to vitamin D2 under ultraviolet radiation. The pharmacological effects of ergosterol include antimicrobial, antioxidant, anticancer, antidiabetic, and anti-neurodegenerative activities. After consumption, vitamin D2 is converted to 25-hydroxyvitamin D through hepatic metabolism. It is then transported to the kidney, where it is further transformed into 1,25-dihydroxyvitamin D (calcitriol), the active form that plays important roles in calcium homeostasis and bone health.

3.4 Phenolic Compounds and Antioxidants

Apart from vitamin D precursors, mushroom fruiting bodies contain other vitamins including tocopherol (vitamin E), β-carotene (provitamin A), and ascorbic acid (vitamin C). These compounds, along with polyphenols, determine the antioxidant properties of fungi. Mushrooms are rich in antioxidants and contain diverse secondary metabolites and phenolic compounds that help to combat free radicals. They are also a good source of essential minerals like iron and phosphorus, vitamins such as riboflavin, thiamine, and niacin, as well as dietary fiber.

3.5 Lectins, Glycoproteins, and Other Compounds

The most important new pharmaceutical products from medicinal mushrooms include polysaccharides, antioxidants, and lectins. In addition to glycoproteins and polysaccharides, Hericium erinaceus contains a number of metabolic substances, in particular the aromatic compounds hericerins and erinacines, which have been shown to have a function as nerve growth factor. The genus Gymnopilus biosynthesizes interesting bioactive compounds such as sesquiterpenoids, oligoisoprenoids, styrylpyrones, and lectins.

3.6 General Nutritional Profile

Mushrooms have gained attention as a favored and healthy food due to their flavor, high mineral, vitamin, and amino acid content, low fat and sodium contents, high dietary fibers, and digestible proteins with near-to-no calories. These species contain moderate quantities of good-quality protein and are good sources of dietary fiber, vitamin C, B vitamins, and minerals. Lipid levels are low, but unsaturated-to-saturated fatty acid ratios are high (about 2.0–4.5:1). Mushrooms are good dietary supplements to reduce hypertension since they have low sodium content and high potassium content (182–395 mg/100 g).

4. Established Mechanisms of Action

4.1 Immunomodulation via β-Glucan Receptor Binding

Bioactive components having potent effects on the immune system have been extracted from mushrooms and studied broadly, including polysaccharides, glycopeptides, β-d-glucan, protein complexes, terpenoids, and proteoglycans. The mechanism of action of mushroom polysaccharides is to stimulate T-cells, B-cells, natural killer cells, and macrophage-dependent immune responses via binding to receptors like toll-like receptor-2 (TLR-2) and Dectin-1. In addition, several reports suggest that lentinan and β-glucan stimulate the proliferation of lymphocytes, monocytes, and macrophages.

The antitumor activities of polysaccharides from mushrooms have been proven to act by affecting different immune responses in the host. A number of studies have proposed several antitumor mechanisms.

4.2 Antitumor Mechanisms

The extracts' constituents have anti-neoplastic qualities that are mediated by a number of mechanisms, including modulation of immune responses that target tumor cells, induction of apoptosis in cells, changes in oxidative balance, and anti-angiogenic mechanisms, among others. Preclinical studies have demonstrated that β-glucans such as lentinan from Lentinula edodes and D-fraction from Grifola frondosa, triterpenoids from Ganoderma lucidum, and cordycepin from Cordyceps militaris suppress tumor growth, enhance immune surveillance, and sensitize cancer cells to chemotherapy.

4.3 Anti-inflammatory and Antimicrobial Mechanisms

The Basidiomycota species Agaricus blazei Murill, Hericium erinaceus, and Grifola frondosa have been shown to exert antimicrobial activity against viral agents, Gram-positive and Gram-negative bacteria, and parasites in vitro and in vivo. Since the mechanism is immunomodulatory and not antibiotical, the mushrooms should be active against multi-drug resistant microbes as well.

4.4 Neuroprotective Mechanisms

Accumulating data demonstrate that ergosterol potentially serves as a neuroprotective agent by attenuating neuroinflammation and neuronal death. Ergosterol at a concentration of 10 μg/mL showed an anti-neuroinflammatory effect on LPS-induced BV2 microglial cell activation by reducing the production of NO, a pro-inflammatory agent. In Hericium erinaceus, aromatic compounds hericerins and erinacines have been shown to have a function as nerve growth factor.

5. Scientific Evidence by Area of Use

5.1 Oncology / Cancer Adjunct Therapy

Approximately 400 studies have been conducted worldwide with numerous published clinical trials on medicinal mushrooms. Several mushroom compounds have proceeded through Phase I, II, and III clinical studies, and are used extensively and successfully in Asia to treat various cancers and other diseases.

Clinically, polysaccharide preparations including lentinan and the protein-bound polysaccharides PSK and PSP from Trametes (Coriolus) versicolor have been used as chemotherapy adjuvants. Meta-analyses and randomized clinical trials report improved immune parameters and, in some cases, prolonged progression-free or overall survival.

Lentinan, a polysaccharide extracted from Lentinula edodes, is approved in Japan as an adjuvant in gastric cancer treatment.

The medicinal mushrooms investigated in a narrative oncology review included Agaricus sylvaticus (two trials), Agaricus blazei murill (two trials), Antrodia cinnamomea (one trial), Coriolus versicolor (one trial), and Ganoderma lucidum (three trials); all were compared to placebo and administered orally. Study results suggested beneficial effects of medicinal mushrooms, particularly quality of life and reduction of adverse effects of conventional therapies. Positive effects on antitumor activity and immunomodulation were also reported, including increased activity of natural killer cells. Results might also suggest a longer survival of cancer patients receiving mushroom preparations, although in most studies this was not significant when compared to placebo.

Limitations: The methodological quality of most studies was generally unsatisfying, and most results were insufficiently reported in several respects. Medicinal mushrooms may have a therapeutic potential for cancer patients during and after conventional oncological care with regards to quality of life, reduction of adverse effects, and possibly other surrogate parameters like immune function. There is an urgent need to investigate the safety and possible interactions of medicinal mushrooms. High-quality clinical research is warranted in order to clarify the potential of medicinal mushrooms in cancer therapy.

Eleven Phase I, II, and III clinical trials in stomach, colorectal, esophageal, and breast cancer patients found immunomodulatory benefits with Trametes versicolor treatment without significant adverse effects.

5.2 Immune System Modulation

Bioactive compounds in mushrooms could activate the innate and adaptive immune responses in pre-clinical studies, and react as bio-response modifiers. Polysaccharide complexes of mushrooms were capable of modulating the immune system and exerted antitumor activities.

In clinical research, the Andosan™ extract (an AbM-based preparation containing Agaricus blazei Murill, Hericium erinaceus, and Grifola frondosa) has been formally evaluated in several controlled trials: It has been used in three placebo-controlled randomized clinical trials as supplement to regular treatment for inflammatory bowel disease (IBD) — ulcerative colitis (50 patients) and Crohn's disease (50 patients) — multiple myeloma (40 patients), and pollen allergy and asthma (60 blood donors) without adverse effects. It reduced proinflammatory cytokines and improved symptoms and quality of life in IBD patients, reduced allergy and asthma symptoms, specific IgE, and basophil sensitivity in allergic patients, and increased IL-1 receptor antagonist, IL-7, T regulatory cells, dendritic cells, and expression of Ig, killer Ig receptors, and HLA genes in multiple myeloma patients.

Evidence characterization: Pre-clinical (in vitro and animal model) evidence for immunomodulation is robust. Human clinical trial evidence is more limited in scope and typically involves specific mushroom species and preparations, with small-to-moderate sample sizes. Broader generalization across Basidiomycota as a whole requires caution.

5.3 Cardiovascular and Lipid Health

Cholesterol-lowering, anti-diabetic, and immunomodulating compounds are ready for industrial trials and further commercialization, while others are in various stages of development. Ethnopharmacology studies indicate medicinal mushroom use in lowering cholesterol and the treatment of cardiovascular diseases such as arteriosclerosis and abnormal clotting.

For Ganoderma lucidum specifically, a systematic review and meta-analysis of 17 RCTs (971 participants) assessed the cardiovascular-relevant outcomes: Ganoderma lucidum supplementation demonstrated significant reductions in BMI, creatinine, glutathione peroxidase (GPx), and heart rate. No significant effects were observed on body fat, waist circumference, blood pressure, fasting glucose, lipid profile, inflammatory markers, or liver enzymes. Subgroup analyses indicated effects varied by health condition, dosage, duration, and age. The GRADE profile for Ganoderma supplementation indicated that the quality of evidence was very low across all outcomes. Ganoderma lucidum supplementation may have modest effects on certain health indices, but the evidence is limited by very low quality.

Evidence characterization: Pre-clinical evidence (animal and in vitro) for cholesterol-lowering and cardiovascular effects is moderately well-documented across multiple species; human clinical evidence remains sparse and of low quality by GRADE standards.

5.4 Metabolic and Glycemic Health

Several examples of medicinal mushroom species — including Ophiocordyceps sinensis, the velvety Phellinus linteus, several species of Pleurotus, the cauliflower mushroom Sparassis crispa, and Wolfiporia cocos — have been reported to be used for diabetes management. Ergosterol's pharmacological effects include antidiabetic activities. These compounds suggest potential in preventing and managing chronic diseases such as cancer, cardiovascular issues, diabetes, and neurodegenerative conditions.

Evidence characterization: The majority of antidiabetic data derives from animal models and in vitro studies. Clinical evidence in humans is preliminary and limited; no robust RCT evidence supports the use of Basidiomycota preparations as diabetes treatments.

5.5 Neuroprotection and Cognitive Health

In Hericium erinaceus, the aromatic compounds hericerins and erinacines have been shown to have a function as a nerve growth factor. Accumulating data demonstrate that ergosterol potentially serves as a neuroprotective agent by attenuating neuroinflammation and neuronal death. The common button mushroom (Agaricus bisporus) has been shown to have anti-aging, anti-inflammatory, immune-regulating, and anti-cancer properties, and may help prevent cognitive decline and other age-related diseases. Studies suggest that A. bisporus is able to reduce oxidative stress in the brain, which is a factor in neurodegenerative illnesses.

Evidence characterization: Neuroprotective evidence for Basidiomycota species is largely pre-clinical. Most human-relevant studies on cognitive effects — especially for Hericium erinaceus — are small and preliminary. Larger-scale RCTs are lacking.

5.6 Inflammatory Bowel Disease and Gut Health

The Andosan™ formulation (containing Agaricus blazei Murill, Hericium erinaceus, and Grifola frondosa) reduced proinflammatory cytokines and improved symptoms and quality of life in IBD patients. Additionally, the prebiotic advantages of medicinal mushrooms may improve quality of life before and after cancer therapy by reestablishing gut flora.

Evidence characterization: Some clinical trial data exist for specific multi-mushroom extracts in IBD, but most evidence is limited to small controlled studies with specific proprietary preparations. Findings cannot be broadly generalized to all Basidiomycota preparations.

5.7 Antimicrobial and Antiviral Activity

The Basidiomycota Agaricus blazei Murill, Hericium erinaceus, and Grifola frondosa have been shown to exert antimicrobial activity against viral agents, Gram-positive and Gram-negative bacteria, and parasites in vitro and in vivo. Changed forms of β-glucan appear to have a positive impact on viral replication suppression and might be used in future studies. COVID-19 antagonist compounds were found in concentrated form in terpenoids, lectins, glycoproteins, lentinan, galactomannan, and polysaccharides.

Evidence characterization: Antimicrobial and antiviral activity is well-documented in vitro. In vivo animal studies are supportive. Direct human clinical evidence for treating infections remains limited.

5.8 Hepatoprotection

Edible mushrooms show medicinal properties through anticancer, antiviral, hepatoprotective, anti-cardiovascular disease, immunopotentiating, antioxidative, and hypocholesterolemic effects. The immunostimulatory effects of the extracellular and intracellular polysaccharide fractions of Ganoderma lucidum were tested for the induction of interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) synthesis in primary cultures of human peripheral blood mononuclear cells. The TNF-α-inducing activity of G. lucidum fractions showed potential for use as supporting therapy in cancer patients receiving chemotherapy and/or radiotherapy.

Evidence characterization: Evidence for hepatoprotection is primarily from preclinical models. Human clinical evidence for specific hepatoprotective claims is weak.

6. Body Systems and Health Areas Associated with Basidiomycota

More than 126 therapeutic effects — including immunomodulating, antimicrobial, antiviral, antioxidant, and hypocholesterolemic activities — of bioactive molecules from Basidiomycetes mushrooms have been revealed. The principal organ systems and health areas associated with Basidiomycota use based on scientific literature include:

Immune System: T-cell, B-cell, natural killer cell, macrophage, and dendritic cell modulation via β-glucan receptor interactions (Dectin-1, TLR-2).
Oncology: Adjuvant role in cancer therapy; immune surveillance enhancement; apoptosis induction in tumor cells; reduced chemotherapy side effects.
Cardiovascular System: Lipid modulation, antithrombotic activity, antihypertensive potential, and cardioprotection (primarily preclinical).
Metabolic/Endocrine System: Antidiabetic activity, blood glucose modulation, anti-obesity effects (largely preclinical).
Nervous System: Neuroprotective and cognitive support activities, particularly nerve growth factor stimulation via erinacines and hericerins in Hericium erinaceus.
Gastrointestinal System: Anti-inflammatory activity in IBD; prebiotic effects and gut flora rebalancing.
Liver: Hepatoprotective effects studied in preclinical models.
Bone and Mineral Metabolism: Ergosterol as a vitamin D2 precursor supporting calcium homeostasis and bone health.
Antimicrobial Defense: Activity against bacterial, viral, and parasitic agents through immunomodulatory mechanisms.

7. Dosage Forms and Dosages Reported in Studies

Dosages used in the scientific literature vary considerably by species, preparation type, and indication. The following are reported directly from cited sources:

Ganoderma lucidum (Reishi): A systematic review assessed supplementation at 200–11,200 mg/day over 1–24 weeks in healthy, at-risk, and chronic disease populations. In vitro CYP3A4 inhibition was noted for triterpenoids, but human pharmacokinetic data did not show relevant interactions even at an oral dose of 3,000 mg of reishi mushroom.
Edible Basidiomycota species (immunomodulatory animal studies): In immunosuppressed Wistar albino rats, mushroom extracts from five Basidiomycota species were administered orally at low (200 mg/kg) and high (400 mg/kg) doses. At the higher doses (400 mg/kg), significant immunostimulatory effects were observed.
Agaricus blazei Murill — anti-inflammatory (animal model): Water-soluble polysaccharide of Agaricus blazei Murill (WSP-AbM) was administered orally to ovariectomized osteopenic rats at 200 mg/kg body weight for 8 weeks.
General supplement forms: Medicinal mushrooms are used in the form of extracts or powder and are presently mainly available as dietary supplements or functional food.

No single universally accepted standardized dosage exists for Basidiomycota preparations as a class. Dosages in human clinical trials vary widely depending on the species, preparation method, and target condition, and direct comparison across studies is limited by differences in standardization.

8. Safety Considerations and Drug Interactions

8.1 General Safety Profile

The overall tolerability of medicinal mushrooms in clinical settings has been documented by several research groups. Compared to most herbal products, safety research on mushroom products tends to be more robust, and many large-scale clinical trials of medicinal mushroom compounds have not revealed significant adverse events or drug-drug interactions.

Adverse events of treatment with medicinal mushrooms were poorly reported in reviewed oncology trials; gastrointestinal reactions and a decrease in platelet cell count occurred in some cases.

8.2 Hepatotoxicity

Reishi mushrooms are thought to generally lack toxicity, but reported adverse events include nausea and insomnia. Although one of the purported benefits of reishi mushrooms is their hepatoprotective effects, there have been 2 reports of hepatotoxicity and 1 report of hypereosinophilia with hepatic nodules attributed to their use. There are case reports in the published literature, documented in the NIH LiverTox database, of hepatotoxicity associated with high-dose extended reishi use. These appear to be uncommon events. At standard maintenance doses, liver toxicity risk from available evidence is low for adults without pre-existing liver conditions.

8.3 Interaction with Anticoagulants and Antiplatelets

Patients taking anticoagulants and antiplatelets should be monitored for increased risk of bleeding if they also are taking reishi mushrooms; concomitant use may cause decreased platelet aggregation. Documented interaction risks exist with specific medication classes: anticoagulants and antiplatelets (bleeding risk), antihypertensives (additive blood pressure effects), immunosuppressives (potential counter-effect), and diabetes medications (additive blood glucose effects).

8.4 Interaction with Immunosuppressive Medications

There is an urgent need to investigate the safety and possible interactions of medicinal mushrooms. Because Basidiomycota species act as immunomodulators, their use alongside immunosuppressive agents — such as those used after organ transplantation or in autoimmune disease management — presents a theoretical risk of counteracting the intended effect of the immunosuppressant.

8.5 Interaction with Antihypertensives and Glucose-Lowering Agents

Given their theoretical use in lowering blood glucose and blood pressure, concurrent use of reishi mushrooms may increase risk of hypotension and hypoglycemia.

8.6 CYP3A4 Enzyme Interaction

It has been reported that the triterpenoid component of reishi mushrooms has been shown to inhibit activity of CYP3A4 in vitro; however, human pharmacokinetic data have not shown relevant interactions even at high doses of reishi mushroom (oral dose of 3,000 mg), and therefore it does not seem to be clinically significant.

8.7 Heavy Metal Accumulation

Some species (e.g., shiitake) accumulate cadmium and selenium and other heavy metals, and some may contain toxic substances such as the heat-labile cardiotoxic proteins volvatoxin in the straw mushroom and flammutoxin in enokitake. Consumers of dietary supplements derived from wild-harvested or non-standardized mushroom sources should be aware of the potential for heavy metal contamination.

8.8 Limitation of Clinical Evidence on Safety

Despite the longstanding use of dried mushrooms and mushroom extracts in traditional Chinese medicine, there is no definitive scientific evidence to support the effectiveness of all these preparations in the treatment of human disease. The presence of potent toxins and neurotropic compounds in basidiomycete fruit bodies suggests that secondary metabolites with useful pharmacological properties are widespread in these fungi. Major investment in controlled experiments and objective clinical trials is necessary to fully develop this natural pharmacopeia.

References

Health Conditions

Health conditions that Basidiomycota may help support.

No conditions available.

Body Systems

Body systems that Basidiomycota may help support.

No body systems available.