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While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
Synonyms
Chi zhi, Enhanvol®, fungus, fu zhen herb, Ganoderma tsugae extract, Ganopoly®, he ling zhi, holy mushroom, hong ling zhi, ling chi, ling chih, ling zhi (Chinese), ling zhi-8, Linzhi extract, Mannentake, mushroom, mushroom of immortality, mushroom of spiritual potency, polysaccharides peptide, rei-shi, shiitake, spirit plant, Sunrecome®, triterpene, varnished polypore, young ji, zi zhi.
Background
Reishi mushroom (Ganoderma lucidum), also known as ling zhi in China, grows wild on decaying logs and tree stumps. Reishi occurs in six different colors, but the red variety is most commonly used and commercially cultivated in East Asia and North America.
The reishi mushroom is a derivative of the Far East with its usage dating back to ancient China. Royalty would utilize this precious mushroom in the hopes of obtaining immortality and promoting calmness and thought. Chinese medicine now includes therapy with reishi for fatigue, asthma, insomnia, and cough.
Ganoderma lucidum has been used in traditional Chinese medicine for more than 4,000 years to treat liver disorders, high blood pressure, arthritis, and other ailments. In modern times, the available data from human trials together with evidence from animal studies suggest thatGanoderma lucidum may have some positive benefits for cancer and liver disease patients. However, the number and quality of trials is very limited. Other promising uses for which there is still inconclusive evidence include diabetes, heart disease, pain, Russula subnigricans poisoning, and proteinuria (protein in the urine). Reishi is also believed to reduce cholesterol levels and has an anticoagulant ("blood-thinning") effect, which may make it useful in coronary heart disease prevention.
Some experts believe that Ganoderma lucidum promotes longevity and maintains vitality of the human body. Reishi's major benefit appears to be its immunomodulating action, improvement of liver function, and improvement and restoration of the normal functions of the respiratory system. Antioxidant effects, which contribute to the overall well-being of patients, have been proposed. In the 16th Century pharmacopeia Ben Cao Gang Mu, reishi was described as being able to affect the life energy, or qi, of the heart, repair the chest area, increase intellectual capacity, and banish forgetfulness.
Reishi is currently regulated in the United States as a dietary supplement. It is also included in the 2,000 Pharmacopoeia of the People's Republic of China as an agent approved for the treatment of dizziness, insomnia, palpitations, shortness of breath, cough, and asthma. At this time, high quality clinical trials supporting the use of reishi mushroom are lacking. More proven therapies are recommended at this time.
Evidence Table
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Condition: Arthritis
Description: A combination of reishi mushroom and San Miao San (a mixture of several Chinese herbs) may help reduce the pain of rheumatoid arthritis. These herbs did not reduce swelling. More research with reishi mushroom alone is needed.
Grade: C
Condition: Cancer
Description: Reishi has been shown to have antineoplastic and immunomodulatory effects in animal studies. One clinical trial and two case reports exist on advanced cancer patients using Ganopoly®, a Ganoderma lucidum polysaccharide extract. Results show improved quality of life and enhanced immune responses, which are typically reduced or damaged in cancer patients receiving chemotherapy and/or radiation therapy. It is important to note that these data were published by the same group of authors who are affiliated with the manufacturer of Ganopoly®. Well-designed long-term studies are needed to confirm these results and potential side effects.
Grade: C
Condition: Chronic hepatitis B
Description: Based on positive laboratory evidence, a clinical trial using Ganopoly® or placebo was conducted in chronic hepatitis B patients. Ganopoly® treatment decreased the level of hepatitis B virus (HBV) DNA. This virus is notoriously hard to clear from the body and recurrence after treatment is common. Again, the affiliation of authors to the manufacturer of the drug is noteworthy. Further well-designed research is needed before a strong recommendation can be made.
Grade: C
Condition: Coronary heart disease
Description: A clinical trial was conducted to evaluate the effect of Ganopoly® on coronary heart disease in human. Ganopoly® treatment improved the major symptoms (e.g., angina (chest pain), palpitations, and shortness of breath), decreased abnormal ECG appearance, and decreased blood pressure as well as cholesterol levels in these patients. Long-term study is needed to evaluate the efficacy and safety of Ganopoly® before it may be recommended for CHD. The authors are closely related to the manufacturer of Ganopoly®.
Grade: C
Condition: Diabetes mellitus type 2
Description: Based on animal studies that demonstrated the blood sugar and lipid-lowering activities of Ganoderma lucidum (ling zhi, reishi mushroom), a clinical study was conducted to evaluate the effect of Ganopoly® versus placebo in diabetic patients. The treatment of Ganopoly® slightly decreased the levels of plasma glucose and glycosylated hemoglobin and improved other markers for diabetes. Long-term studies with larger sample size are needed to evaluate the efficacy and safety of Ganopoly® in treating diabetic patients. The authors are closely related to the manufacturer of Ganopoly®.
Grade: C
Condition: High blood pressure
Description: Ancient Chinese monks utilized the reishi mushroom to calm their minds for meditation. Theory would lead one to believe that the physiological effects of decreasing blood pressure may have lead to the calming effect precipitated by the ingested reishi. Preliminary data suggest that reishi may exert a blood pressure-lowering effect; however, the currently available evidence in this area is weak. Future studies are warranted to validate the results of these small studies and to provide clinical usefulness of reishi as a possible treatment for high blood pressure.
Grade: C
Condition: Pain (postherpetic)
Description: Reishi extract was effective in decreasing postherpetic pain (pain after herpes lesions heal) in one case series. Further research is needed to confirm these results.
Grade: C
Condition: Poisoning (Russula subnigricans)
Description: Ganoderma lucidum has shown a beneficial effect in treating RSP in one small trial. Further well-designed clinical trials are needed to confirm these results.
Grade: C
Condition: Proteinuria (protein in the urine)
Description: One clinical trial was conducted to evaluate the effect of Ganoderma lucidum in treating kidney disorder patients with persistent proteinuria resistant to steroids with or without immunosuppressants. Ganoderma lucidum treatment decreased proteinuria in the small number of patients in this study. This trial provides good preliminary data, but long-term studies with a larger amount of patients are needed to evaluate the effects of Ganoderma lucidum on proteinuria.
Grade: C
Dosing
2-6 grams per day of reishi as raw fungus or an equivalent dosage of concentrated extract has been taken with meals. In clinical trials studying cancer, chronic hepatitis B, coronary heart disease, or diabetes, doses of 600-1,800 milligrams have been taken three times daily. For high blood pressure, Linzhi extract (reishi) has been used in doses of 55 milligrams a day for four weeks. For pain management in herpes zoster, 36-72 grams of dry weight per day for up to 10 days have been studied. Other doses used are 500-1,125 milligrams per day for the treatment of proteinuria (excess protein in the urine) or 100 grams of reishi boiled in 600 milliliters water per dose for poisoning.
Insufficient available evidence to recommend.
Safety
Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
Avoid in individuals with a known allergy/hypersensitivity to any constituents of Ganoderma lucidum or any member of its family. Skin reactivity to spore and whole body extracts have been reported. Hypersensitivity reactions to reishi and its derivatives may occur including dry mouth, nosebleed, and nasal and throat dryness
Acute and long-term studies have found Ganoderma lucidum to be generally well-tolerated in recommended doses for up to 16 months. The most common adverse events reported are skin rash, dizziness, and headache.
Use cautiously in patients who are taking diabetes/hypoglycemic drugs because reishi may lower blood sugar.
Low blood pressure may occur upon the utilization of reishi and its derivatives.
Due to "blood thinning" capabilities, gastric bleeding could result from the use of reishi. Reishi may prolong bleeding time and caution is advised in those patients with bleeding disorders (ulcers, hemophilia) or taking anticoagulants. Diarrhea and bloody stools may occur with supplemental doses. Mild gastrointestinal discomfort including nausea and diarrhea has been found in a small percentage of cancer patients taking Ganoderma lucidum as Ganopoly®.
Severe liver inflammation that led to death has been linked to reishi mushroom powder.
Not recommended due to lack of sufficient data.
Interactions
Reports have suggested that reishi may antagonize the effects of amphetamines.
Reishi therapy may increase or decrease the activity of certain antibiotics such as ampicillin, cefazolin, oxytetracycline, and chloramphenical.
A study conducted on the antiherpetic activity of the acidic protein bound polysaccharide (APBP) that was isolated from capophores of Ganoderma lucidum had synergistic effects when administered with the prescription antiviral drug acyclovir.
Reishi and anticoagulants or NSAIDs may theoretically lead to additive effects or an increased risk of bleeding. Reishi may cause bleeding due to prolongation of prothrombin time.Ganoderma lucidum inhibits platelet aggregation.
Ganoderma lucidum may cause additive blood pressure-lowering effects.
Based on animal study, Ganoderma lucidum may cause an additive blood sugar-lowering effect.
Reishi with HMG-CoA reductase inhibitor drugs ("statins") may result in additive effects.
Theoretically, the use of reishi and protease inhibitors may result in additive effects.
The risk of liver damage may increase when reishi mushroom powder is taken with drugs that are known to damage the liver.
Reishi and anticoagulant herbs and supplements may theoretically lead to additive effects, increasing bleeding risk.
Ganoderma lucidum may cause additive blood pressure-lowering effects with herbs and supplements such as fish oil, coenzyme Q10, and ginseng.
Ganoderma lucidum may cause additive blood sugar-lowering effects with herbs and supplements such as beta-glucan, bitter melon, ginseng, gymnema, and chromium.
Theoretically, reishi may result in additive effects when taken with herbs and supplements like guggul, red rice yeast, or garlic.
The risk of liver damage may increase when reishi mushroom powder is taken with herbs or supplements that are known to damage the liver.
Attribution
This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Rae Abrams, PharmD (University of Rhode Island); Stephen Bent, MD (University of California, San Francisco); Heather Boon, BScPhm, PhD (University of Toronto); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Cynthia Dacey, PharmD (Natural Standard Research Collaboration); Jacquelyn Guilford, PhD, MBA (Natural Standard Research Collaboration); Nicole Giese, MS (Natural Standard Research Collaboration); Dana A. Hackman, BS (Northeastern University); Lisa Scully, PharmD (Massachusetts College of Pharmacy); Erica Seamon, PharmD (Nova Southeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Nazhiyath Vijarian, MD (Natural Standard Research Collaboration); Wendy Weissner, BA (Natural Standard Research Collaboration); Shannon Welch, PharmD (Northeastern University); Denise Wong, PharmD (Northeastern University); Jen Woods, BS (Natural Standard Research Collaboration); Kui Xu, PhD (Northeastern University).
Bibliography
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to
www.naturalstandard.com. Selected references are listed below.
Cheuk W, Chan JK, Nuovo G, et al. Regression of gastric large B-Cell lymphoma accompanied by a florid lymphoma-like T-cell reaction: immunomodulatory effect of Ganoderma lucidum (Lingzhi)? Int J Surg Pathol 2007 Apr;15(2):180-6. [View Abstract]
Eo SK, Kim YS, Lee CK, et al. Possible mode of antiviral activity of acidic protein bound polysaccharide isolated from Ganoderma lucidum on herpes simplex viruses. J.Ethnopharmacol 2000;72(3):475-481. [View Abstract]
Futrakul N, Panichakul T, Butthep P, et al. Ganoderma lucidum suppresses endothelial cell cytotoxicity and proteinuria in persistent proteinuric focal segmental glomerulosclerosis (FSGS) nephrosis. Clin Hemorheol Microcirc 2004;31(4):267-272. [View Abstract]
Gao Y, Dai X, Chen G, et al. A Randomized, Placebo-Controlled, Multicenter Study of Ganoderma lucidum (W.Curt: Fr.) Lloyd (Aphyllophoromycetideae) Polysaccharides (Ganopoly®) in Patients with Advanced Lung Cancer. International Journal of Medicinal Mushrooms 2003;5.
Gao Y, Zhou S, Jiang W, et al. Effects of ganopoly (a Ganoderma lucidum polysaccharide extract) on the immune functions in advanced-stage cancer patients. Immunol Invest 2003;32(3):201-215. [View Abstract]
Gao Y, Zhou S, Wen J, et al. Mechanism of the antiulcerogenic effect of Ganoderma lucidum polysaccharides on indomethacin-induced lesions in the rat. Life Sci 12-27-2002;72(6):731-745.[View Abstract]
Hijikata Y, Yamada S. Effect of Ganoderma lucidum on postherpetic neuralgia. Am J Chin Med 1998;26(3-4):375-381. [View Abstract]
Li EK, Tam LS, Wong CK et al. Safety and efficacy of Ganoderma lucidum (lingzhi) and San Miao San supplementation in patients with rheumatoid arthritis: a double-blind, randomized, placebo-controlled pilot trial. Arthritis Rheum 2007 Oct 15;57(7):1143-50. [View Abstract]
Lin ZB. Cellular and molecular mechanisms of immuno-modulation by Ganoderma lucidum. J Pharmacol Sci 2005 Oct;99(2):144-53. [View Abstract]
Tao J, Feng KY. Experimental and clinical studies on inhibitory effect of ganoderma lucidum on platelet aggregation. J.Tongji Med Univ 1990;10(4):240-243. [View Abstract]
Wanachiwanawin D, Piankijagum A, Chaiprasert A, et al. Ganoderma lucidum: a cause of pseudoparasitosis. Southeast Asian J Trop Med Public Health 2006 Nov;37(6):1099-102. [View Abstract]
Wanmuang H, Leopairut J, Kositchaiwat C, et al. Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder. J Med Assoc Thai 2007 Jan;90(1):179-81. [View Abstract]
Wicks SM, Tong R, Wang CZ, et al. Safety and tolerability of Ganoderma lucidum in healthy subjects: a double-blind randomized placebo-controlled trial. Am J Chin Med 2007;35(3):407-14.[View Abstract]
Xiao GL, Liu FY, Chen ZH. [Clinical observation on treatment of Russula subnigricans poisoning patients by Ganoderma lucidum decoction]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2003;23(4):278-280. [View Abstract]
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
