IngredientsThe term medicinal fungi, as used in the dietary supplement context, refers to a diverse group of macroscopic fungi — predominantly from the phylum Basidiomycota and, to a lesser extent, Ascomycota — whose fruiting bodies, mycelia, or spores are consumed for their purported health-promoting properties. Mushrooms, both edible and medicinal, can produce a wide range of physiologically active chemicals, making them a distinct class of nutraceuticals; although mushrooms, their extracts, and separated metabolites are not medications, they are a significant type of nutritional supplement, such as nutraceuticals or functional food.
Medicinal mushrooms have become an important component of modern dietary supplementation and functional nutrition due to their diverse biological activities and long-standing use in traditional medicine. Among the most widely studied and utilized species are Ganoderma lucidum, Lentinula edodes, Grifola frondosa, Cordyceps militaris, Cordyceps sinensis, Trametes versicolor, and Inonotus obliquus. More than 100 species of medicinal mushrooms are used in Asia.
The principal species covered in this article, with their accepted binomial names and common names, include:
Ganoderma lucidum products are available in various forms, such as powders, dietary supplements, and tea, produced from different parts of the mushroom, including mycelia, spores, and fruit body. While traditional preparation methods such as decoctions, teas, and coffee remain available, Western markets increasingly favor standardized extracts in tablet and capsule formations.
Hericium erinaceus has been increasingly incorporated into dietary supplements and functional foods, and this mushroom is available in several forms, including capsules and tablets, powdered form, liquid extracts, functional beverages, and protein bars.
A fundamental challenge in the field remains the lack of extract standardization; studies utilize vastly different substrates, ranging from spore oils and pure mycelium extracts to fermented rice bran, making it difficult to establish universal dosage protocols. This is further complicated by the frequent failure to distinguish between mycelium-based biomass and pure fruiting bodies, each possessing distinct pharmacological profiles.
Because dietary supplements are not formally reviewed for manufacturing consistency every year, ingredients may vary considerably from lot to lot and there is no guarantee that ingredients claimed on product labels are present in the specified amounts.
The earliest documented use of medicinal mushrooms in written records takes us to East Asia, where Chinese medicine practitioners were already utilizing species like Ganoderma lucidum (reishi) and Ophiocordyceps sinensis (cordyceps) over 2,000 years ago. The revered "Divine Farmer's Materia Medica," written around 200 CE, featured detailed descriptions of medicinal mushrooms and their applications.
Lingzhi (Ganoderma lucidum) has been recognized as a medicinal mushroom for over 2,000 years, and its powerful effects have been documented in ancient scripts. Reishi is a type of mushroom that grows on live trees; scientists may call it either Ganoderma lucidum or Ganoderma sinense. In traditional Chinese medicine, this group of mushrooms is known as Ling Zhi, and in Japan they are known as Reishi. Ganoderma lucidum, the reishi mushroom, was revered in ancient China and Japan as a way to increase longevity, and to treat asthma, bronchitis, nephritis, and hypertension.
In ancient Chinese writings, particularly in the "Shennong Ben Cao Jing," a classic herbal medicine book dating back to around 200 BC, medicinal mushrooms such as Reishi (Ganoderma lucidum), Cordyceps, and Maitake are mentioned.
Medicinal mushrooms have been used for hundreds of years, mainly in Asian countries, for the treatment of infections. More recently, they have also been used in the treatment of pulmonary diseases and cancer. Medicinal mushrooms have been approved adjuncts to standard cancer treatments in Japan and China for more than 30 years and have an extensive clinical history of safe use as single agents or combined with radiation therapy or chemotherapy.
Hericium erinaceus is extensively found in East Asian countries including Japan and China. The mature mushroom is easily identifiable, consisting of a number of single, long, dangling fleshy spines which are white in colour. H. erinaceus has traditionally been used as a herbal medicine in East Asian countries with well-documented health-promoting effects.
The birch polypore (Fomitopsis betulina) was used as an antimicrobial agent and was famously found in the possession of Ötzi the Iceman, a 5,300-year-old mummy discovered in the Alps. Ötzi the Iceman, whose mummy was preserved in glacial ice in the Austrian Alps, was carrying the tinder polypore, Fomes fomentarius, and Fomitopsis betulina, the birch polypore. It is likely he was carrying the tinder polypore as a fire starter, but scientists speculate that he carried the birch polypore to treat a bad case of intestinal parasites.
Chaga mushrooms have been used in traditional medicine in Siberia, Scandinavia, and by the indigenous population of North America since at least the 12th century. The ancient Siberians and Scandinavians believed that Chaga mushrooms could help heal ailments of internal diseases, and they used Chaga mushrooms in teas, tinctures, and poultices to treat a range of conditions, including headaches and stomachache. Traditional use of chaga has been widespread in Russia, Poland, and other Baltic countries as folk medicine for gastric problems, cancer, tuberculosis, and heart and liver issues.
The Jewish Talmud references the use of Chamka, a concoction of moldy corn mash soaked in date wine to heal wounds. Ancient Egyptians recorded the use of moldy bread to prevent infections in burns.
Traditional preparations of medicinal fungi were typically aqueous (water-based), most often long-simmered decoctions or teas. As a folk remedy, Chaga was ingested by the local people of the Siberian mountain regions in tea or powder form, inhaled from smoke, and applied to the skin. Reishi was traditionally prepared as a decoction of the dried fruiting body sliced and boiled in water, sometimes for several hours, to extract both water-soluble polysaccharides and some triterpenes.
The therapeutic potential of medicinal fungi is associated with a wide range of biologically active constituents, including polysaccharides, triterpenoids, phenolic compounds, and other secondary metabolites. The important immunomodulatory compounds found in medicinal mushrooms are terpenes, flavonoids, terpenoids, lectins, polysaccharides (particularly D-glucans), and fungal immunomodulatory proteins.
One well-known compound is β-glucan, a natural polysaccharide found in the cell walls of many fungi, yeasts, and some microorganisms, as well as in plants such as barley and wheat. The beta-glucans in mushrooms mostly contain a linear (1→3) backbone with (1→6)-linked glucose branches attached. These differences in the shape, structure, and molecular weight of beta-glucans determine their biological activity.
Named β-glucan polysaccharide isolates of pharmacological importance include:
G. lucidum is clearly rich in triterpenes, and it is this class of compounds that gives the herb its bitter taste and, it is believed, confers on it various health benefits, such as lipid-lowering and antioxidant effects. However, the triterpene content is different in different parts and growing stages of the mushroom. Hundreds of compounds have been isolated and identified from G. lucidum, such as triterpenoids, meroterpenoids, steroids, polysaccharides, and peptides; among them, water-soluble polysaccharides and triterpenoids are the main active components.
Triterpenes exhibit potential antihypertensive effects through inhibition of ACE activity and reduction of oxidative stress via upregulation of antioxidant enzymes such as superoxide dismutase (SOD) and catalase, thereby contributing to improved lipid profiles and vascular function.
The chemical structures of the main constituents of H. erinaceus include hericenones, erinacines, and other relevant molecules. Animal studies have suggested that Lion's Mane mushroom [Hericium erinaceus (Bull.) Pers.] can enhance cognitive function and mood due to its bioactive metabolites, including erinacines and hericenones. Erinacine-A-enriched H. erinaceus appears to demonstrate the highest bioactive potency of all H. erinaceus extracted compounds, providing the greatest effects while also showing transportability ease across biological barriers.
H. erinaceus is also a rich source of essential nutrients, including proteins, dietary fiber, vitamins like complex B (B1, B2, B3, B5, B6) and vitamin D precursors, and minerals, which contribute to several physiological processes, including antioxidant defense and nerve function.
Scientists have identified a number of compounds found in Chaga mushrooms, including betulinic acid, which has been found to have potential anti-inflammatory and even anti-cancer properties.
β-Glucans are widely recognized for their ability to lower cholesterol and blood glucose levels, thereby reducing the risk of cardiovascular disease and diabetes. In addition to their effects on lipid levels and glucose metabolism, these molecules exhibit antioxidant properties by eliminating reactive oxygen species.
Beta-glucan particles bind with macrophages with the help of dectin-1, the primary receptor for most insoluble beta-glucans. Subsequently, dectin-1 induces the secretion of pro-inflammatory cytokines via nuclear factor kappa-B (NF-κB) and various interconnected inflammatory and immunoregulatory processes such as chemokinesis and chemotaxis.
Studies have examined the effects of mushrooms on immune response pathways and on direct antitumor mechanisms. The immune effects are mediated through the mushroom's stimulation of innate immune cells, such as monocytes, natural killer cells, and dendritic cells. The activity is generally considered to be caused by the presence of high-molecular-weight polysaccharides (beta-glucans) in the mushrooms, although other constituents may also be involved.
The polysaccharide fraction, mainly β-glucans, is responsible for much of the immunomodulatory and antitumor activity. β-(1→3)-Glucans trigger different immune responses, and these polysaccharides have been shown to be effective immunostimulatory agents. Fungal β-glucans interact with mononuclear phagocytes during fungal infections; different fungal β-glucans exhibit antitumor and antimicrobial activities by modulating the biological responses of mononuclear phagocytes, making them potential candidates as therapeutic agents.
The problem with many direct antitumor cell studies is that none of them were ever independently repeated, and they all differ in type of β-glucan and in experimental conditions. Therefore, the possible direct effects of β-glucan on cancer cells remain a side note.
G. lucidum displayed broad inhibitory effects on cytochrome P450 (CYP) enzymes, with triterpenoids as the main bioactive constituents, which may induce potential drug-drug interactions.
Medicinal mushrooms have important health benefits and exhibit a broad spectrum of pharmacological activities, including antiallergic, antibacterial, antifungal, anti-inflammatory, antioxidative, antiviral, cytotoxic, immunomodulating, antidepressive, antihyperlipidemic, antidiabetic, digestive, hepatoprotective, neuroprotective, nephroprotective, osteoprotective, and hypotensive activities.
Mushrooms are recognized for their immune-boosting properties, influencing dendritic cells (DCs), lymphocytes, macrophages, T cells, hematopoietic stem cells, and natural killer (NK) cells. However, the strength of this evidence in humans varies considerably by species. β-Glucans have been reported to possess immune-boosting and antitumor effects; by binding to specific receptors on the surface of immune cells, they stimulate immune activity.
The success of PSP from Coriolus versicolor in preclinical models prompted many to investigate CV-derived products as potentially adjunctive therapy to standard chemotherapy or radiotherapy regimens for various malignancies. To confirm whether its immunostimulatory effects carry forth from animal models to humans in homeostatic conditions, a double-blind, crossover study recruited healthy volunteers for a 10-month study period.
Evidence strength: Moderate (human clinical data exists for specific polysaccharide extracts; mechanistic data is robust; whole-mushroom supplement immune effects in healthy humans are supported but not conclusive).
Clinical evidence investigating medicinal mushrooms in oncology suggests beneficial effects primarily in immune modulation, improvement of quality of life, mitigation of chemotherapy-related adverse effects, and, in selected contexts, improved survival outcomes.
The strongest clinical evidence originates from protein-bound polysaccharides such as PSK and PSP from Trametes versicolor, lentinan from Lentinula edodes, and polysaccharide fractions from Grifola frondosa, which have been evaluated in randomized trials and meta-analyses as adjuncts to conventional cancer therapies.
A systematic review of 28 studies, including 17 preclinical, 6 RCTs, and 5 non-randomized clinical trials, suggests that Trametes versicolor, particularly PSK, exerts beneficial immunomodulatory effects in the context of lung cancer. In the RCTs, which primarily used PSK at a dose of 3 g/day, PSK treatment was associated with improvements in immune and hematological function, including shortened chemotherapy-induced bone marrow suppression, as well as increased white blood cell counts, hemoglobin, platelets, neutrophils, IgG and IgM antibodies, NK cell activity, and CD4+ T cell counts.
A third RCT conducted in Japan evaluated the efficacy of Krestin (PSK) as an adjunctive immune therapy in addition to combination chemotherapy in 227 operable breast cancer patients with vascular invasion in the tumor and/or metastatic lymph node involvement. Patients were randomized to receive chemotherapy of 5-fluorouracil, cyclophosphamide, mitomycin C, and prednisolone (FEMP) alone, FEMP + levamisole, or FEMP + Krestin (PSK). Krestin (PSK) was orally administered at 3,000 mg/d for 28 days. The 5- and 10-year survival curves for the FEMP + Krestin (PSK) group were superior to either FEMP alone or FEMP + levamisole.
A Phase I dose-escalation trial in the United States tested a preparation of Trametes versicolor in women with breast cancer (n=11) up to 9 g of Trametes versicolor per day for 6 weeks following radiotherapy (NCT00680667). There were trends in increased lymphocyte counts at 6 and 9 g/day, and increased functional activity for NK cells at 6 g/day.
Among fungi-derived β-glucans, several compounds such as lentinan were proven to have considerable anticarcinogenic and immunostimulatory effects. Lentinan, a β-1,3/1,6-glucan isolated from Lentinula edodes mushrooms, has been evaluated in multiple Japanese clinical trials, primarily as an intravenous or intratumoral adjunct in gastrointestinal cancers.
Clinical trials in cancer patients have demonstrated that G. lucidum products are generally well tolerated. Previous trials on Ganoderma lucidum have been limited by small sample sizes, inconsistent methodologies, and variable supplement formulations, necessitating a comprehensive synthesis of the evidence.
The majority of clinical studies were carried out with just 3 species: Lentinula edodes (22.2%), Coriolus versicolor, and Ganoderma lucidum (both 13.9%), followed by two other species: Agaricus bisporus and Grifola frondosa (both 11.1%). Although 32 species of mushrooms show at least some promise for the treatment of cancer, only 11 species have been tested clinically. Moreover, most clinical studies have investigated small numbers of patients. Therefore, despite the promising preclinical and clinical data, more solid scientific efforts are required to clarify the therapeutic value of mushrooms in oncology.
Evidence strength: Moderate for PSK/PSP from Trametes versicolor and lentinan from Lentinula edodes (multiple RCTs, primarily Japanese); weak-to-moderate for Ganoderma lucidum and other species in oncology; largely preliminary for most other species.
Hericium erinaceus, commonly known as lion's mane mushroom, has gained increasing scientific interest due to its rich composition of bioactive compounds and diverse health-promoting properties. The medicinal properties of H. erinaceus include antioxidant, antimicrobial, and anticancer effects. Recently, interest has been placed on the potential neuroprotective and neuroregenerative properties of H. erinaceus.
A seminal double-blind placebo-controlled clinical trial (referenced in the NIH LiverTox database) enrolled 30 Japanese adults aged 50 to 80 years with mild cognitive impairment, who were treated with powdered Yamabushitake (Hericium erinaceus: 3 grams daily) or placebo for 16 weeks, and dementia symptom scales improved with the H. erinaceus treatment.
A 2023 randomized, double-blind, placebo-controlled, parallel-groups pilot study investigated the acute and chronic (28-day) cognitive and mood-enhancing effects of Hericium erinaceus in a healthy, young adult cohort. The study investigated the acute and chronic effects of 1.8 g Hericium erinaceus in 41 healthy adults aged 18–45 years. Analysis revealed that following a single dose, participants performed quicker on the Stroop task (p = 0.005) at 60 minutes post-dose. A trend towards reduced subjective stress was observed following 28-day supplementation (p = 0.051). Given the small sample size, these findings should be interpreted with caution.
A further 2025 acute crossover study tested an acute dose of H. erinaceus fruiting body extract (3g of 10:1 extract) on cognitive performance and mood in 18 healthy participants aged 18 to 35 years. The results showed no significant effect of the H. erinaceus fruiting body extract for composite measures of global cognitive function and mood. However, when analysing individual tests, participants exhibited improved performance on the pegboard test at 90 minutes following a single dose. In conclusion, acute consumption of H. erinaceus fruiting body did not demonstrate a significant overall improvement in cognitive performance and mood compared to the placebo, and any benefits may be task or domain specific.
The use of Hericium erinaceus demonstrated positive significant differences in results obtained from behavioural, histological, and biochemical assessments from both human clinical trials and animal model studies, accentuating its utility for the improvement of cognitive function. Evidence suggests that intake of H. erinaceus may be an appropriate and relevant future therapeutic treatment for the prevention and delayed progression of Alzheimer's disease; however, continued research is necessary to provide further significant evidence, through an increased quantity of human clinical trials.
Evidence strength: Weak-to-moderate (preliminary human evidence is positive for specific cognitive domains and mild cognitive impairment; most studies are small; acute effects in healthy adults are mixed; animal and in vitro mechanistic evidence is stronger).
G. lucidum has shown clinical capacity to lower blood pressure, cholesterol, and glucose levels. Triterpenes exhibit potential antihypertensive effects through inhibition of ACE activity and reduction of oxidative stress via upregulation of antioxidant enzymes such as superoxide dismutase (SOD) and catalase, thereby contributing to improved lipid profiles and vascular function.
β-Glucans are widely recognized for their ability to lower cholesterol and blood glucose levels, thereby reducing the risk of cardiovascular disease and diabetes. They help lower the risk of conditions such as atherosclerosis, cardiovascular disease, neurological disorders, diabetes, and cancer.
Evidence strength: Weak-to-moderate. Clinical evidence in humans exists for G. lucidum on blood pressure, cholesterol, and glucose, but studies are limited by small sample sizes and variable methodologies. β-Glucan lipid-lowering effects are better established for oat/barley sources than for fungal sources specifically.
β-Glucans belong to a group of probiotics that promote the growth and activity of beneficial gut microbiota, preventing the proliferation of harmful pathogens. They play a vital role in maintaining gastrointestinal health, reducing inflammation, and lowering the risk of colon cancer.
Evidence strength: Preliminary (primarily preclinical; limited dedicated human clinical trials on gut microbiota effects of fungal β-glucans specifically).
Synergistic effects of β-glucans as antioxidant, antigenotoxic, and antimutagenic activities have been reported by scientists. In addition to their effects on lipid levels and glucose metabolism, these molecules exhibit antioxidant properties by eliminating reactive oxygen species.
Evidence strength: Preclinical. Antioxidant activity is consistently demonstrated in cell and animal studies, but whether oral supplementation produces clinically meaningful antioxidant effects in humans has not been robustly established.
Ganoderma lucidum is traditionally used to prevent and treat diseases such as liver disorders, hypertension, insomnia, diabetes, and cancer. The specific applications and attributed health benefits of lingzhi include control of blood glucose levels, modulation of the immune system, and hepatoprotection.
Review of the purported biological effects of lion's mane mushrooms as shown in animal models or in vitro includes antioxidant, antineoplastic, antihypertensive, antidiabetic, hepatoprotective, neuroprotective, cardioprotective, immunomodulatory, wound healing, and lipid lowering properties.
Evidence strength: Mostly preclinical (in vivo animal and in vitro). Human clinical evidence for hepatoprotection of medicinal mushrooms is limited and largely indirect.
Based on the published scientific evidence, medicinal fungi have been associated with the following body systems:
Strong evidence from scientific and clinical research shows that edible fungus polysaccharides can modulate body metabolism through a variety of pathways and mechanisms, thereby reducing the incidence and progression of diseases related to humans.
Dosages vary widely across species, preparation type, and indication. The following represent dosages reported in clinical studies and referenced sources — not recommendations:
Most existing literature is based on pilot or Phase I/II trials with small cohorts, which limits statistical power and the generalizability of findings to broader populations. A fundamental challenge remains the lack of extract standardization; studies utilize vastly different substrates, making it difficult to establish universal dosage protocols.
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. 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.
Studies reported no adverse effects on hepatic or renal function markers, and participants experienced no significant adverse reactions.
Several studies have demonstrated that Ganoderma lucidum can compromise hemostasis because of its antithrombotic and anticoagulant activity. A published clinical case report documented a 41-year-old man with heart disease and hypertension on hemodialysis, who was receiving ongoing anticoagulant therapy with warfarin. Two consecutive markedly increased INR values (6.92 and 8.22) were confirmed, with anamnesis revealing a recent ingestion of two 500 mg tablets of Ganoderma lucidum extracts on each of these two occasions.
Reishi might slow blood clotting, so combining reishi with medications that slow clotting (for example, clopidogrel, ibuprofen, naproxen, heparin, and warfarin) might increase the chance of bleeding and bruises.
Since reishi can stimulate immune activity, it may counteract immunosuppressive medications used after organ transplants or for autoimmune diseases (e.g., cyclosporine, tacrolimus). This could reduce drug efficacy and increase the risk of organ rejection or flare-ups.
In vitro research suggests that PSP from Trametes versicolor inhibits cytochrome P450 2C9 (CYP2C9) enzymes in a dose-dependent manner. Theoretically, taking PSP with other drugs metabolized by CYP2C9 could increase drug levels and the risk of adverse effects. Even though this interaction has not been reported in humans, watchfulness is warranted when turkey tail mushroom is combined with CYP2C9 substrates.
G. lucidum displayed broad inhibitory effects on CYPs, with triterpenoids as the main bioactive constituents, which may induce potential drug-drug interactions.
Despite growing popularity in dietary supplements, many medicinal mushrooms have not been evaluated for their safe human consumption using modern techniques. The FDA does not regularly review the way that supplements are made, so all batches and brands of mushroom supplements may not be the same.
A multifaceted approach for evaluating safety relies on five key principles: identification by sequencing the nuclear ribosomal internal transcribed spacer (ITS) region (ITS barcoding), screening an extract against a database of known fungal metabolites, comparison of extracts to those from culinary mushrooms using analytical methods, review of the toxicological and chemical literature, and evaluation of data establishing presence in-market.
Despite the promising clinical evidence regarding the therapeutic potential of medicinal mushrooms — specifically Ganoderma lucidum, Trametes versicolor, Lentinula edodes, and Cordyceps spp. — several critical methodological and technical limitations persist. Most existing literature is based on pilot or Phase I/II trials with small cohorts, which limits statistical power and the generalizability of findings to broader populations.
The variety of studies using crude extracts of fungal cell wall rather than purified β-glucans renders data difficult to interpret. A better understanding of the mechanisms of purified fungal β-glucan recognition, downstream signaling pathways, and subsequent immune regulation is, therefore, essential not only to develop new antifungal therapy but also to evaluate β-glucan as a putative anti-infective and antitumor mediator.
The growing interest in mycotherapy requires a strong commitment from the scientific community to expand clinical trials and to propose supplements of safe origin and genetic purity.
Health conditions that Fungus may help support.
Body systems that Fungus may help support.
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