Ganoderma lucidum

Reishi/Drug Interactions:

  • AdenosineAdenosine: Reishi mushroom contains high levels of adenosine (28).
  • AnalgesicsAnalgesics: Reishi extract was shown to be effective in decreasing postherpetic pain in a case series (48). Reishi mushroom plus the traditional Chinese medicine (TCM) herbal combination formula San Miao San (SMS) was reported to reduce pain in patients with active rheumatoid arthritis when taken in combination with standard arthritis medications (52). However, these effects cannot be definitively attributed to reishi mushroom because other herbs were also taken.
  • AnestheticsAnesthetics: According to secondary sources, reishi mushroom may interact with anesthetics.
  • AntibioticsAntibiotics: In vitro, reishi had synergistic antibacterial effects with cefazolin against Bacillus subtilis and Klebsiella oxytoca (1); the combination of Ganoderma lucidum with ampicillin, cefazolin, oxytetracycline and chloramphenicol had additive, antagonistic, or synergistic antibacterial effects (1).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: According to laboratory research, reishi inhibited platelet aggregation (25; 26; 27). Reishi mushroom contains high levels of adenosine, which may be responsible for inhibition of platelet aggregation (28; 53), but there is controversy in this area. In human research, Ganoderma lucidum lacked negative antiplatelet effects (28), and in healthy volunteers, reishi lacked an effect on routine coagulation screen, fibrinogen concentration, von Willebrand ristocetin cofactor activity, platelet function analyzer PFA-100, and thrombelastography (29). PC-SPES, a combination of eight herbs, including reishi, caused venous thrombosis in one out of eight patients being treated for prostate cancer (40).The role of reishi alone is unclear.
  • Antidiabetic agentsAntidiabetic agents: In animal research, Ganoderma lucidum had hypoglycemic effects (19; 20; 21; 22). In human research, reishi reduced glycosylated hemoglobin (24). However, in other human research, reishi lacked an effect on glycemic profile (23).
  • Antihypertensive drugsAntihypertensive drugs: In animal research, reishi mycelium decreased diastolic and systolic blood pressure (30), and preliminary data suggest that reishi may exert a blood pressure-lowering effect (31; 32). In laboratory research, the 70% MeOH extract of Ganoderma lucidum demonstrated an inhibitory activity on angiotensin-converting enzyme (33). However, in human research, reishi lacked an effect on blood pressure (23).
  • Antilipemic agentsAntilipemic agents: In animal research, G. lucidum had antilipemic effects (54); however, in human research, reishi lacked an effect on lipid profile (23). In laboratory research, reishi inhibited the rate-limiting enzyme HMG-CoA in cholesterol biosynthesis (55).
  • Antineoplastic agentsAntineoplastic agents: In laboratory studies, reishi has been shown to have antineoplastic and immunomodulatory effects (56; 49; 57; 58; 59; 60; 61; 62; 38; 12; 13; 63; 64; 65; 66; 67; 14; 15; 68; 69; 70; 71; 72; 73; 74; 34). According to a systematic review and meta-analysis, reishi lacked an effect on tumor response in some studies; however, immunological effects occurred (37). In human trials conducted in advanced cancer patients using Ganopoly?, a Ganoderma lucidum polysaccharide extract (15; 39; 14), both randomized controlled trials (15) and case series suggested that patients treated with Ganopoly? showed improved quality of life and enhanced immune responses, which are typically reduced or damaged in cancer patients receiving chemotherapy or radiation therapy.
  • Antiretroviral agents Antiretroviral agents : In laboratory research, triterpenes isolated from Ganoderma lucidum inhibited HIV or HIV protease (3; 75).
  • Antiviral agentsAntiviral agents: A clinical trial using Ganopoly? or placebo was conducted in chronic hepatitis B patients (44). Ganopoly? treatment decreased the level of hepatitis B virus (HBV) DNA. Levels of HbeAg were also reported to have decreased, and since HbeAg is usually reported as either positive or negative, a decrease may suggest HBeAg changes from positive to negative. Substances from Ganoderma lucidum have been shown to inhibit herpes simplex virus types 1 and 2 (2) and Epstein-Barr Virus (76). In laboratory research, the acidic protein-bound polysaccharide (APBP) isolated from carpophores of Ganoderma lucidum had synergistic effects when administered with acyclovir (77).
  • Cardiovascular agentsCardiovascular agents: In human research, Ganopoly? improved primary symptoms (e.g., chest pain, palpitation, angina pectoris, shortness of breath), decreased abnormal ECG appearance, and decreased blood pressure and cholesterol levels in patients with coronary heart disease (24).
  • CNS stimulantsCNS stimulants: According to secondary sources, the use of reishi and amphetamines may result in an antagonistic effect.
  • Dermatologic agentsDermatologic agents: According to secondary sources, there have been reports that patients ingesting reishi mushroom have developed dermatitis, pruritus, and skin rash. Skin reactivity to spore and whole-body extracts of reishi mushroom has also been reported (43).
  • Gastrointestinal agentsGastrointestinal agents: Due to blood-thinning capabilities, gastric bleeding may be precipitated by the use of reishi (25). Mild gastrointestinal discomfort, including nausea and diarrhea, was found in a small percentage of cancer patients taking Ganoderma lucidum as Ganopoly? (39; 15; 37). According to secondary sources, reishi may also cause bloody stools.
  • Hepatotoxic agentsHepatotoxic agents: In 2004, Ganoderma lucidum (ling zhi) mushroom powder was first described to have hepatotoxic effects in a patient from Hong Kong (41). In 2005, a fatal case of fulminant hepatitis was linked to reishi mushroom powder. Both patients had taken other therapeutic agents and traditionally boiled ling zhi without any toxic effects. After switching to ling zhi in powder form for 1-2 months, the hepatotoxic episode occurred in both patients. However, another hepatoprotectant study performed in rats showed that extracts from reishi reduced free radicals that harm the liver (42).
  • Hormonal agentsHormonal agents: PC-SPES, a combination of eight herbs, including reishi, caused breast tenderness and loss of libido in eight patients being treated for prostate cancer (40). The role of reishi is unclear.
  • ImmunostimulantsImmunostimulants: In vitro and in animal research, reishi or its constituents had immunomodulatory, including immunosuppressive and immunopotentiating, effects (34; 35; 36; 37).
  • ImmunosuppressantsImmunosuppressants: In vitro and in animal research, reishi or its constituents had immunomodulatory, including immunosuppressive and immunopotentiating, effects (34; 35; 36; 37).
  • Musculoskeletal agentsMusculoskeletal agents: Bone pain has been anecdotally reported with use of reishi supplements.
  • Neurologic agentsNeurologic agents: Ganoderma lucidum spore preparations have been used in patients with atrophic myotonia (5). Adverse effects reported following reishi use have included dizziness and light-headedness (indicated as being likely due to the hypotensive properties of reishi) (38), insomnia (15; 37), and headache (23). According to secondary sources, the use of reishi and amphetamines may result in an antagonistic effect.
  • Respiratory agentsRespiratory agents: Sore throat, influenza, and runny nose have been reported with Ganoderma lucidum use (23). According to secondary sources, hypersensitivity reactions to reishi and its derivatives have included dry mouth, nosebleed, and nasal and throat dryness.
  • Thyroid hormonesThyroid hormones: According to secondary sources, reishi mushroom may interact with thyroid agents.

    • Reishi/Herb/Supplement Interactions:

  • AnalgesicsAnalgesics: Reishi extract was shown to be effective in decreasing postherpetic pain in a case series (48). Reishi mushroom plus the traditional Chinese medicine (TCM) herbal combination formula San Miao San (SMS) was reported to reduce pain in patients with active rheumatoid arthritis when taken in combination with standard arthritis medications (52). However, these effects cannot be definitively attributed to reishi mushroom because other herbs were also taken.
  • AnestheticsAnesthetics: According to secondary sources, reishi mushroom may interact with anesthetics.
  • AntibacterialsAntibacterials: In vitro, reishi had synergistic antibacterial effects with antibiotics against Bacillus subtilis and Klebsiella oxytoca (1); the combination of Ganoderma lucidum with antibiotics had additive, antagonistic, or synergistic antibacterial effects (1).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: According to laboratory research, reishi inhibited platelet aggregation (25; 26; 27). Reishi mushroom contains high levels of adenosine, which may be responsible for inhibition of platelet aggregation (28; 53), but there is controversy in this area. In human research, Ganoderma lucidum lacked negative antiplatelet effects (28), and in healthy volunteers, reishi lacked an effect on routine coagulation screen, fibrinogen concentration, von Willebrand ristocetin cofactor activity, platelet function analyzer PFA-100, and thrombelastography (29). PC-SPES, a combination of eight herbs, including reishi, caused venous thrombosis in one out of eight patients being treated for prostate cancer (40).The role of reishi alone is unclear.
  • AntilipemicsAntilipemics: In animal research, G. lucidum had antilipemic effects (54); however, in human research, reishi lacked an effect on lipid profile (23). In laboratory research, reishi inhibited the rate-limiting enzyme HMG-CoA in cholesterol biosynthesis (55).
  • AntineoplasticsAntineoplastics: In laboratory studies, reishi has been shown to have antineoplastic and immunomodulatory effects (56; 49; 57; 58; 59; 60; 61; 62; 38; 12; 13; 63; 64; 65; 66; 67; 14; 15; 68; 69; 70; 71; 72; 73; 74; 34). According to a systematic review and meta-analysis, reishi lacked an effect on tumor response in some studies; however, immunological effects occurred (37). In human trials conducted in advanced cancer patients using Ganopoly?, a Ganoderma lucidum polysaccharide extract (15; 39; 14), both randomized controlled trials (15) and case series suggested that patients treated with Ganopoly? showed improved quality of life and enhanced immune responses, which are typically reduced or damaged in cancer patients receiving chemotherapy and/or radiation therapy.
  • AntiviralsAntivirals: A clinical trial using Ganopoly? or placebo was conducted in chronic hepatitis B patients (44). Ganopoly? treatment decreased the level of hepatitis B virus (HBV) DNA. Levels of HbeAg were also reported to have decreased, and since HbeAg is usually reported as either positive or negative, a decrease may suggest HBeAg changes from positive to negative. Substances from Ganoderma lucidum have been shown to inhibit herpes simplex virus types 1 and 2 (2) and Epstein-Barr Virus (76). In laboratory research, the acidic protein bound polysaccharide (APBP) isolated from carpophores of Ganoderma lucidum had synergistic effects when administered with acyclovir (77). In laboratory research, triterpenes isolated from Ganoderma lucidum inhibited HIV or HIV protease (3; 75).
  • Cardiovascular herbs and supplementsCardiovascular herbs and supplements: In human research, Ganopoly? improved primary symptoms (e.g., chest pain, palpitation, angina pectoris, shortness of breath), decreased abnormal ECG appearance, and decreased blood pressure and cholesterol levels in patients with coronary heart disease (24).
  • Dermatologic agentsDermatologic agents: According to secondary sources, there have been reports that patients ingesting reishi mushroom have developed dermatitis, pruritus, and skin rash. Skin reactivity to spore and whole-body extracts of reishi mushroom has also been reported (43).
  • Gastrointestinal agentsGastrointestinal agents: Due to blood-thinning capabilities, gastric bleeding may be precipitated by the use of reishi (25). Mild gastrointestinal discomfort, including nausea and diarrhea, was found in a small percentage of cancer patients taking Ganoderma lucidum as Ganopoly? (39; 15; 37). According to secondary sources, reishi may also cause bloody stools.
  • Hepatotoxic agentsHepatotoxic agents: In 2004, Ganoderma lucidum (ling zhi) mushroom powder was first described to have hepatotoxic effects in a patient from Hong Kong (41). In 2005, a fatal case of fulminant hepatitis was linked to reishi mushroom powder. Both patients had taken other therapeutic agents and traditionally boiled ling zhi without any toxic effects. After switching to ling zhi in powder form for 1-2 months, the hepatotoxic episode occurred in both patients. However, another hepatoprotectant study performed in rats showed that extracts from reishi reduced free radicals that harm the liver (42).
  • Hormonal agentsHormonal agents: PC-SPES, a combination of eight herbs, including reishi, caused breast tenderness and loss of libido in eight patients being treated for prostate cancer (40). The role of reishi is unclear.
  • HypoglycemicsHypoglycemics: In animal research, Ganoderma lucidum had hypoglycemic effects (19; 20; 21; 22). In human research, reishi reduced glycosylated hemoglobin (24). However, in other human research, reishi lacked an effect on glycemic profile (23).
  • HypotensivesHypotensives: In animal research, reishi mycelium decreased diastolic and systolic blood pressure (30), and preliminary data suggest that reishi may exert a blood pressure-lowering effect (31; 32). In laboratory research, the 70% MeOH extract of Ganoderma lucidum demonstrated an inhibitory activity on angiotensin-converting enzyme (33). However, in human research, reishi lacked an effect on blood pressure (23).
  • ImmunomodulatorsImmunomodulators: In vitro and in animal research, reishi or its constituents had immunomodulatory, including immunosuppressive and immunopotentiating, effects (34; 35; 36; 37).
  • Musculoskeletal agentsMusculoskeletal agents: Bone pain has been anecdotally reported with use of reishi supplements.
  • Neurologic herbs and supplementsNeurologic herbs and supplements: Ganoderma lucidum spore preparations have been used in patients with atrophic myotonia (5). Adverse effects reported following reishi use have included dizziness and light-headedness (indicated as being likely due to the hypotensive properties of reishi) (38), insomnia (15; 37), and headache (23). According to secondary sources, the use of reishi and amphetamines may result in an antagonistic effect.
  • Respiratory agentsRespiratory agents: Sore throat, influenza, and runny nose have been reported with Ganoderma lucidum use (23). According to secondary sources, hypersensitivity reactions to reishi and its derivatives have included dry mouth, nosebleed, and nasal and throat dryness.
  • SeleniumSelenium: Reishi may contain up to 72mcg of selenium per gram (dry weight) (78).
  • StimulantsStimulants: According to secondary sources, the use of reishi and amphetamines may result in an antagonistic effect.
  • Thyroid agentsThyroid agents: According to secondary sources, reishi mushroom may interact with thyroid agents.

    • Reishi/Food Interactions:

  • Insufficient available evidence.

    • Reishi/Lab Interactions:

  • Blood cell countBlood cell count: In human research, G. lucidum attenuated leukocyte depletion vs. control (37). Also, there were benefits on T cell counts (CD3, CD4, CD8, and the CD4:CD8 ratio). According to a review, immune-modulating effects of G. lucidum polysaccharides may include effects on B lymphocytes, T lymphocytes, dendritic cells, macrophages, and natural killer cells (79).
  • Blood glucoseBlood glucose: In animal research, Ganoderma lucidum had hypoglycemic effects (19; 20; 21; 22). In human research, reishi reduced glycosylated hemoglobin (24). However, in other human research, reishi lacked an effect on glycemic profile (23).
  • Blood lipidsBlood lipids: In animal research, G. lucidum had antilipemic effects (54); however, in human research, reishi lacked an effect on lipid profile (23).
  • Blood pressureBlood pressure: In animal research, reishi mycelium decreased diastolic and systolic blood pressure (30), and preliminary data suggest that reishi may exert a blood pressure-lowering effect (31; 32); however, in human research, reishi lacked an effect on blood pressure (23).
  • Coagulation panelCoagulation panel: According to laboratory research, reishi inhibited platelet aggregation (25; 26; 27). Reishi mushroom contains high levels of adenosine, which may be responsible for inhibition of platelet aggregation (28; 53), but there is controversy in this area. In human research, Ganoderma lucidum lacked negative antiplatelet effects (28), and in healthy volunteers, reishi lacked an effect on routine coagulation screen, fibrinogen concentration, von Willebrand ristocetin cofactor activity, platelet function analyzer PFA-100, and thrombelastography (29).
  • InsulinInsulin: Results from a study on glycan ganoderan B of Ganoderma lucidum fruit bodies indicated that ganoderan B increased the plasma insulin level in normal and glucose-loaded mice but lacked an effect on insulin binding to isolated adipocytes (21).