Liver Mender by BioAnue

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Allergic rhinitis (hay fever). Oral agaricus mushroom has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research in people with IgE-positive birch pollen allergy shows that taking a specific agaricus mushroom product (Andosan, Immunopharma) containing 82% agaricus mushroom, 15% Hericium erinaceus mushroom, and 3% maitake mushroom extracts, 60 mL daily for 7 weeks starting before the pollen season, reduces symptoms of allergic rhinitis and allergic asthma and decreases use of anti-allergy medications when compared with placebo. During the allergy season, birch-specific IgE levels were reduced, and basophils were less sensitive to allergen activation (102919).
• Cancer. Although there is interest in using oral agaricus mushroom for the treatment of various types of cancer, there is insufficient reliable information about the clinical effects of agaricus mushroom for this purpose. Cardiovascular disease (CVD).Although there is interest in using oral agaricus mushroom for the management of CVD and CVD risk factors, there is insufficient reliable information about the clinical effects of agaricus mushroom for this purpose.
• Chemotherapy-induced adverse effects. It is unclear if oral agaricus mushroom is beneficial for reducing adverse effects in patients undergoing chemotherapy treatment. Details: Preliminary clinical research in females with gynecologic cancers shows that taking an agaricus mushroom extract three times daily while receiving chemotherapy for 6 weeks might improve some of the adverse effects of chemotherapy, such as generalized weakness, decreased appetite, and emotional instability, when compared with chemotherapy alone (15404).
• Crohn Disease. It is unclear if oral agaricus mushroom is beneficial for Crohn disease. Details: Preliminary clinical research in patients with Crohn disease shows that taking an oral agaricus mushroom extract (AndoSan, ACE Co. Ltd.) 30 mL twice daily for 21 days does not improve fatigue, quality of life, or symptom severity when compared with placebo (94721).
• Diabetes. It is unclear if oral agaricus mushroom is beneficial for type 2 diabetes. Details: Preliminary clinical research in patients with type 2 diabetes shows that taking an agaricus mushroom extract 500 mg orally three times daily for 12 weeks, in combination with metformin and the sulfonylurea gliclazide, decreases insulin resistance and lowers fasting insulin levels more than metformin and gliclazide alone (15421).
• Hepatitis B. It is unclear if oral agaricus mushroom is beneficial for hepatitis B. Details: Preliminary clinical research in adults with chronic hepatitis B infection shows that taking agaricus mushroom extract 500 mg three times daily for 12 months decreases aspartate aminotransferase (AST) from 246 IU/L to 61 IU/L and alanine aminotransferase (ALT) from 151 IU/L to 46 IU/L (94719). However, these results are limited by small study size and the lack of a comparator group.
• Hyperlipidemia. Although there is interest in using oral agaricus mushroom for hyperlipidemia, there is insufficient reliable information about the clinical effects of agaricus mushroom for this condition.
• Multiple myeloma. It is unclear if oral agaricus mushroom is beneficial for multiple myeloma. Details: Preliminary clinical research in patients with multiple myeloma undergoing stem cell transplantation with high-dose chemotherapy shows that taking an agaricus mushroom extract (AndoSan, ACE Co. Ltd.) 60 mL orally daily for about 7 weeks during chemotherapy does not improve treatment response or overall survival when compared with placebo (94716).
• Osteoporosis. Although there is interest in using oral agaricus mushroom for osteoporosis, there is insufficient reliable information about the clinical effects of agaricus mushroom for this condition.
• Peptic ulcers. Although there is interest in using oral agaricus mushroom for peptic ulcers, there is insufficient reliable information about the clinical effects of agaricus mushroom for this condition.
• Ulcerative colitis. It is unclear if oral agaricus mushroom is beneficial for ulcerative colitis. Details: Preliminary clinical research in patients with symptomatic ulcerative colitis shows that taking an agaricus mushroom extract (AndoSan, ACE Co. Ltd.) 30 mL orally twice daily for 21 days improves fatigue, quality of life, and overall symptom scores when compared with placebo (94715). More evidence is needed to rate agaricus mushroom for these uses.

(Read more about AGARICUS MUSHROOM)

POSSIBLY INEFFECTIVE

• Athletic performance. Taking cordyceps orally does not seem to improve athletic performance in adults. Details: One small clinical study in endurance-trained cyclists shows that taking a specific mycelial fermentation product of cordyceps (CordyMax Cs-4) 3.15 grams daily for 5 weeks does not improve endurance time trials or aerobic capacity when compared with placebo (12095). Another small study in healthy elderly adults shows that taking the same cordyceps preparation (CordyMax Cs-4) 3 grams daily for 12 weeks does not improve exercise performance when compared with placebo (46120). Research also shows that taking combination products containing cordyceps and other ingredients does not improve athletic performance when compared with control. These products have combined cordyceps (CordyMax Cs-4) 1000 mg with rhodiola 300 mg (46091) or cordyceps (CordyMax Cs-4) 2000 mg with roseroot 600 mg (Optygen, First Endurance) (15573); liquid and powdered cordyceps formulations with reishi mushroom, shiitake mushroom, bamboo, and honey (Fohow oral liquid and Fohow lingzhi capsules, FOHOW Technology Investment Group Co. Ltd.) (98686); and cordyceps (form unknown) 1.2 grams with a 930 mg mixture of extracts of ashwagandha root, green tea leaf, rhodiola root, and astragalus root (Shroom Tech Sport, Onnit Labs) (105079).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Arrhythmia. Although there is interest in using oral cordyceps for arrhythmia, there is insufficient reliable information about the clinical effects of cordyceps for this condition.
• Asthma. Oral cordyceps has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in children with asthma shows that a 619 mg capsule containing equal weights of the dried aqueous extracts of cordyceps, astragalus, skullcap, Radix stemonae, and Bulbus fritillariae daily for 6 months does not reduce the need for medication or improve symptoms when compared with placebo (32935).
• Chronic kidney disease (CKD). Small clinical studies suggest that oral cordyceps may modestly improve biomarkers in some patients with CKD. Details: A meta-analysis of clinical research in patients in China with CKD shows that taking cordyceps 0.6-2 grams orally three times daily, along with standard treatment, seems to decrease serum creatinine levels by 0.6 mg/dL and increase creatinine clearance by 9.2 mL/min when compared with standard treatment alone (92829). Another meta-analysis of clinical studies in patients in China with diabetic kidney disease shows that taking cordyceps 0.5-2 grams orally three times daily along with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) decreases blood urea nitrogen by 2 mg/dL and decreases serum creatinine levels by 0.1 mg/dL when compared with ACEI/ARB treatment alone (92830). Most individual studies in these analyses used Bailing (Cs-C-Q80) or Jinshuibao (Cs-4), fermented cordyceps mycelial products (92829,92830). Both of these analyses are limited by the low methodological quality and short duration (usually 1-6 months) of most of the included studies.
• Chronic obstructive pulmonary disease (COPD). Preliminary clinical studies suggest that oral cordyceps may modestly improve symptoms of COPD. Details: A meta-analysis of preliminary clinical research in patients with moderate or severe COPD shows that taking cordyceps alone or as part of a formulation containing other products for up to 12 months improves lung function and reduces the incidence of an acute exacerbation by a small amount. Also, the distance walked in 6 minutes is increased by about 45 meters, which was considered clinically meaningful. Most individual studies in this analysis used Bailing (Cs-C-Q80) or Jinshuibao (Cs-4), fermented cordyceps mycelial products, in combination with conventional treatments with conventional treatments alone (109705). This analysis is limited by the low methodological quality of the included studies.
• Contrast induced nephropathy. Small clinical studies suggest that oral cordyceps may modestly reduce contrast induced nephropathy. Details: A preliminary clinical study in patients with diabetic nephropathy shows that taking a specific cordyceps mycelial product (Corbrin; CS-C-Q80) 2-3 grams orally three times daily for 3 days before and after angiography reduces the risk of contrast induced nephropathy by about 48% to 66% when compared to standard treatment (92827). However, other preliminary clinical research in patients with stable angina pectoris shows that taking the same cordyceps product 3 grams orally three times daily for 3 days before and after angioplasty does not decrease the prevalence of contrast induced nephropathy when compared to standard therapy (92826). Reasons for these discrepancies are not clear but may relate to the small size and heterogenous populations in these studies.
• Diabetic nephropathy. Early research suggests that oral cordyceps may modestly improve kidney function in patients with diabetic kidney disease. Details: A meta-analysis of low to moderate quality clinical research in patients with diabetic kidney disease shows that taking cordyceps as adjunctive therapy to angiotensin-converting enzyme inhibitors or angiotensin receptor blockers for 2-24 weeks modestly improves kidney function when compared to these medications alone. Kidney function was based on markers such as blood creatinine and urea nitrogen, as well as urinary albumin and total protein. There were also modest improvements in systolic and diastolic blood pressure, triglycerides, and low-density lipoprotein (LDL) cholesterol. There was no effect on glycemic indices. The effect of cordyceps on disease progression or cardiovascular events is unclear (111903).
• Cough. Although there is interest in using oral cordyceps for cough, there is insufficient reliable information about the clinical effects of cordyceps for this purpose.
• Fatigue. Although there is interest in using oral cordyceps for fatigue, there is insufficient reliable information about the clinical effects of cordyceps for this purpose.
• Hepatitis B. Although there is interest in using oral cordyceps for hepatitis B, there is insufficient reliable information about the clinical effects of cordyceps for this condition.
• Hypercholesterolemia. Although there is interest in using oral cordyceps for hypercholesterolemia, there is insufficient reliable information about the clinical effects of cordyceps for this condition.
• Kidney failure. Small clinical studies suggest that oral cordyceps may improve inflammatory markers in patients on hemodialysis. Details: A meta-analysis of small clinical trials in patients in China on hemodialysis suggests that adding cordyceps to standard treatment does not seem to improve serum creatinine levels but may improve certain markers of inflammation, such as C-reactive protein, when compared with placebo. Most individual studies in this analysis used Bailing (Cs-C-Q80) or Jinshuibao (Cs-4), fermented cordyceps mycelial products (105076).
• Kidney transplant. Small clinical studies suggest that oral cordyceps is no better than standard treatment in patients with kidney transplant. Details: A meta-analysis of 4 heterogeneous clinical trials evaluating patients in China immediately post-kidney transplant or patients with complications post-kidney transplant suggests that adding cordyceps to standard therapy with cyclosporine and steroids is no better than adding azathioprine 50-150 mg for improving overall survival or graft survival or reducing rejection risk. However, there was a non-significant trend to reduced risk of graft rejection in the cordyceps group (95905). A higher quality systematic review, which determined the available studies were too heterogeneous to pool together in a meta-analysis, suggests that adding cordyceps 3-6 grams to standard therapy daily is no better than azathioprine or cyclosporine for improving organ rejection, kidney function, or survival in patients after kidney transplant (92828). All individual studies in these analyses used Bailing (Cs-C-Q80) fermented cordyceps mycelial product (95905,92828).
• Sexual dysfunction. It is unclear if oral cordyceps is beneficial in patients with sexual dysfunction. Details: Preliminary clinical research shows that taking a specific mycelial fermentation product of cordyceps (CordyMax Cs-4) approximately 3 grams daily for 40 days can improve symptoms of hyposexuality in 66% of patients, compared with 32% of patients taking natural cordyceps and 24% of patients taking placebo (46145).
• Tinnitus. Although there is interest in using oral cordyceps for tinnitus, there is insufficient reliable information about the clinical effects of cordyceps for this condition. More evidence is needed to rate cordyceps for these uses.

(Read more about CORDYCEPS)

POSSIBLY EFFECTIVE

• Cisplatin-induced neurotoxicity. Intravenous glutathione seems to reduce neurotoxicity from cisplatin. Details: Clinical studies in cancer patients receiving cisplatin shows that administering glutathione 1.5 grams/m2 by intravenous injection over 15 minutes seems to help prevent neurotoxicity and other toxicities from cisplatin when compared with control. Glutathione may also increase the highest dose of cisplatin that patients are able to tolerate (5373,5374,5377,5378,5380). In one study, this same dose of intravenous glutathione was administered, along with intramuscular glutathione 600 mg on days 2-5 (5374).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging. Although there is interest in using oral glutathione for aging, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Alcohol use disorder. Although there is interest in using oral glutathione for alcohol use disorder, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Athletic performance. Oral glutathione has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical trial in young, resistance-trained males shows that taking glutathione (Setria, Kyowa Hakko Bio) 200 mg in combination with L-citrulline 2 grams daily for 8 weeks in conjunction with resistance training has no effect on muscle strength, as measured by leg and bench presses, when compared with L-citrulline alone or with placebo (97394). The trial shows the increase in lean body mass with training to be significantly higher with glutathione and L-citrulline compared with placebo at 4 weeks. However, by 8 weeks of training lean body mass is not different between supplementation and placebo. An additional small, cross-over trial in young, endurance-trained males shows that taking glutathione 200 mg in combination with L-citrulline 2 grams (Setria Performance Blend, Kyowa Hakko Bio) daily for 8 days does not improve high speed running performance, as measured by time to exhaustion, when compared with placebo (112285).
• Angioplasty. It is unclear if intravenous glutathione is beneficial in patients recovering from angioplasty following myocardial infarction. Details: A small clinical trial in Italian adults undergoing primary percutaneous coronary intervention (PCI) for recent ST-elevation myocardial infarction (STEMI) shows that intravenous infusion of glutathione sodium salt 2500 mg/25 mL over 10 minutes before angioplasty and at 24, 48 and 72 hours after angioplasty reduces length of hospital stay by around 2 days; reduces markers of oxidative stress, inflammation, and cardiomyocyte damage; and improves measures of left ventricular function at 6-month's follow-up when compared with placebo (111417,111418).
• Alzheimer disease. Although there is interest in using oral glutathione for Alzheimer disease, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Cardiovascular disease (CVD). Although there is interest in using oral glutathione for preventing CVD, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Cataracts. Although there is interest in using oral glutathione for cataracts, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Chronic fatigue syndrome (CFS). Although there is interest in using oral glutathione for CFS, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Cirrhosis. It is unclear if oral glutathione is beneficial for improving cirrhosis severity. Details: A small clinical study in patients with cirrhosis shows that taking glutathione 500 mg daily with or without vitamin B6 50 mg daily for 12 weeks does not affect disease severity or reduce oxidative stress when compared with placebo (104392). These findings are limited because the study might not have been powered to detect a difference between groups, as 21 of the 61 participants were lost to follow-up.
• Cognitive function. Oral glutathione has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small cross-over trial in healthy adults shows that taking a product providing 20 mg/day of glutathione as part of a combination product containing probiotics (L. helveticus, Lactiplantibacillus plantarum, Bifidobacterium longum), inulin, zinc, potassium, magnesium and lactoferrin (Puraflor, GSK Consumer Healthcare) for 4 weeks does not affect cognitive performance during acute stress when compared with placebo (110923).
• Contrast induced nephropathy. It is unclear if intravenous glutathione is beneficial for preventing contrast induced nephropathy. Details: A small, non-blinded clinical study in patients aged 65 or older with diabetes undergoing percutaneous coronary intervention (PCI) shows that intravenous reduced glutathione 180 mg daily for 4 days, starting 6 hours prior to PCI, in conjunction with saline hydration, does not reduce the rate of contrast induced nephropathy when compared with saline hydration alone. Saline hydration was administered at a rate of 1 mL/kg/hr, starting 6 hours prior to PCI and continuing for 12 hours after PCI (107477). However, this study may have been inadequately powered to detect a difference between groups.
• Cystic fibrosis. It is unclear if oral glutathione is beneficial in children with this condition. Details: A small clinical study in children ages 2-10 years old with cystic fibrosis shows that taking glutathione powder 65 mg/kg daily in 3 divided doses for 6 months does not impact weight or inflammatory biomarkers when compared with placebo (104391).
• Glaucoma. Although there is interest in using oral glutathione for glaucoma, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Idiopathic interstitial pneumonia. Although there is interest in using inhaled glutathione for idiopathic pulmonary fibrosis, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Nonalcoholic fatty liver disease (NAFLD). It is unclear if oral glutathione is beneficial in patients with NAFLD. Details: Preliminary clinical research shows that taking glutathione 300 mg daily for 4 months reduces alanine aminotransferase (ALT) levels by around 13% and triglyceride levels by around 16%, but has no impact on aspartate aminotransferase (AST) levels or liver stiffness, when compared with baseline in patients with NAFLD (97397). The validity of these findings is limited by the lack of a comparator group.
• Osteoarthritis. Although there is interest in using oral glutathione for osteoarthritis, there is insufficient reliable information about the clinical effects of glutathione for this condition.
• Parkinson disease. It is unclear if intranasal glutathione is beneficial for improving Parkinson disease symptoms. Details: A small clinical study in patients with Parkinson disease shows that taking glutathione intranasally 100-200 mg three times daily for 3 months has no effect on symptoms when compared with placebo (97398). More evidence is needed to rate glutathione for these uses.

(Read more about GLUTATHIONE)

POSSIBLY INEFFECTIVE

• Hyperlipidemia. Preliminary clinical studies show that oral reishi mushroom does not improve lipid levels in patients with hyperlipidemia or type 2 diabetes. Details: Preliminary clinical research shows that taking reishi mushroom extract 1440 mg daily for 12 weeks does not significantly improve the lipid profile in patients with hyperlipidemia (70776). Also, a meta-analysis shows that taking reishi mushroom extract 1400-4000 mg daily for 12-16 weeks does not reduce total cholesterol or low-density lipoprotein (LDL) cholesterol in patients with type 2 diabetes (91435).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging. Although there has been interest in using oral reishi mushroom for aging, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose.
• Altitude sickness. Although there has been interest in using oral reishi mushroom for altitude sickness, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose.
• Alzheimer disease. A small clinical study suggests that oral reishi mushroom does not improve Alzheimer disease symptoms. Details: Preliminary clinical research in patients with Alzheimer disease shows that taking reishi mushroom powder 1000 mg three times daily for 6 weeks does not improve memory, language skills, or quality of life when compared with placebo (97942).
• Asthma. Although there has been interest in using oral reishi mushroom for asthma, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose.
• Benign prostatic hyperplasia (BPH). Preliminary clinical research suggests that oral reishi mushroom extract can help reduce some lower urinary tract symptoms in patients with BPH. Details: Clinical research in patients with mild to moderate lower urinary tract symptoms (LUTS) associated with BPH, urinary incontinence, overactive bladder, or other conditions, shows that taking reishi mushroom extract 6 mg orally once daily for up to 12 weeks moderately improves total symptom severity measured on the International Prostate Symptom Score (IPSS) scale, when compared with placebo (91436,91437). A higher dose of 60 mg daily is not more effective than the 6 mg dose, and a lower dose of 0.6 mg daily is not more effective than placebo (91437). Reishi mushroom extract does not improve peak urine flow rate, residual urine volume, prostate volume, or quality of life when compared with placebo (91436,91437). The relevance of these results is unclear since not all of the patients with LUTS had BPH.
• Bronchitis. Although there has been interest in using oral reishi mushroom for bronchitis, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose.
• Cancer. It is unclear if oral reishi mushroom is beneficial when used in conjunction with chemotherapy. Details: A meta-analysis of 9 clinical trials using various reishi mushroom products in combination with chemotherapy found that complete and partial responses increased by 30% with combination therapy when compared with chemotherapy alone. However, there was no difference in overall survival (102915). The reliability and applicability of these results are unclear since the trials looked at several different types of cancer, used varying doses and durations of therapy, and were all conducted in China or other Asian countries.
• Cancer-related fatigue. It is unclear if oral reishi mushroom is beneficial in patients with breast cancer and fatigue. Details: Results from a small clinical study in breast cancer patients show that taking reishi mushroom powder 1000 mg orally three times daily for 4 weeks can improve cancer-related fatigue when compared with placebo (91438). However, it is not clear if the improvement is clinically meaningful.
• Cardiovascular disease (CVD). It is unclear if oral reishi mushroom is beneficial for reducing CVD risk factors. Details: A meta-analysis of 5 low-quality studies in adults with diabetes shows that taking reishi mushroom 1400-3000 mg daily for 12-16 weeks does not reduce CVD risk factors, including total and low-density lipoprotein (LDL) cholesterol, triglycerides, blood pressure, and body mass index, when compared with placebo (91435).
• Chronic fatigue syndrome (CFS). Although there has been interest in using oral reishi mushroom for CFS, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose.
• Chronic kidney disease (CKD). Although there has been interest in using oral reishi mushroom for CKD, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose.
• Colorectal adenoma. Limited clinical research suggests that oral reishi mushroom extract may be beneficial for reducing colorectal adenoma size. Details: Preliminary clinical research in patients with colorectal adenomas shows that taking reishi mushroom extract 1500 mg orally in two divided doses daily for 12 months reduces the number and size of adenomas when compared with no treatment (70774).
• Coronary heart disease (CHD). It is unclear if oral reishi mushroom is beneficial for CHD. Details: Preliminary clinical research shows that taking a specific reishi mushroom extract (Ganopoly, Encore International Co.) 1800 mg orally three times daily for 12 weeks reduces symptoms of CHD, such as chest pain, palpitations, and shortness of breath, in a greater percentage of patients when compared with placebo (70800).
• Diabetes. Evidence on the use of oral reishi mushroom in patients with type 2 diabetes is conflicting. Details: A meta-analysis of clinical research in patients with type 2 diabetes shows that taking reishi mushroom extract 1400-4000 mg daily for 12-16 weeks does not reduce glycated hemoglobin (HbA1c) or plasma lipids (91435). However, one preliminary clinical study in patients with type 2 diabetes shows that taking a specific reishi mushroom extract (Ganopoly, Encore International Co.) 1800 mg three times daily for 12 weeks reduces HbA1c, but not fasting blood glucose, when compared with placebo (70801).
• Fibromyalgia. It is unclear if oral reishi mushroom is beneficial for fibromyalgia. Details: A small clinical trial in patients with fibromyalgia shows that taking reishi mushroom (MundoReishi Salud S.L.) powder 3 grams twice daily for 6 weeks does not improve mood, quality of life, anthropometric measures, blood pressure, or glycemic or lipid parameters when compared with placebo (108309,108310). However, the study may have been underpowered to detect any differences between groups.
• Genital herpes. Oral reishi mushroom has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research in adults with recurrent genital herpes shows that taking 4.4 grams of a mixture of hot water extracts of reishi mushroom, terminalia, Job's tears, Wisteria floribunda, Trapa natans, and Elfvingia applanata orally once daily for 2 days, then 2.2 grams daily thereafter until outbreak resolution, decreases the time to outbreak resolution by 6 days when compared with previous outbreaks (91434).
• Gulf war syndrome. It is unclear if oral reishi mushroom is beneficial for Gulf war syndrome. Details: A very small exploratory clinical trial in adults with Gulf war syndrome shows that taking reishi mushroom extract (JHS Natural Products, Mushroom Science) 1600 mg in two divided doses daily for 30 days does not improve symptoms when compared with placebo. Also, symptoms modestly worsened after an additional 30 days of treatment at a dose of 3200 mg daily (108311).
• Hepatitis B. One small clinical study suggests that a specific reishi mushroom extract may reduce hepatitis B activity and improve liver function. Details: Preliminary clinical research shows that taking a specific reishi mushroom extract (Ganopoly, Encore International Co.) 1800 mg orally three times daily for 12 weeks reduces levels of hepatitis B viral DNA and hepatitis B surface antigen, which are markers of hepatitis B activity, and normalizes aminotransferase levels in a greater percentage of patients when compared with placebo (70799).
• Herpes labialis (cold sores). Oral reishi mushroom has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research in adults with recurrent herpes labialis shows that taking 4.4 grams of a mixture of hot water extracts of reishi mushroom, terminalia, Job's tears, Wisteria floribunda, Trapa natans, and Elfvingia applanata orally once daily for 2 days, then 2.2 grams daily thereafter until outbreak resolution, decreases the time to outbreak resolution by almost 4 days when compared with previous outbreaks (91434).
• Herpes zoster (shingles). Although there has been interest in using oral reishi mushroom for herpes zoster, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose.
• Human papillomavirus (HPV). Oral reishi mushroom has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research in patients with oral HPV shows that taking a combination of reishi and coriolus mushroom powders, 400 mg orally daily for 2 months, clears HPV in 88% of patients when compared with baseline (91433). The validity of this finding is limited by the lack of a comparator group.
• Hypertension. Limited research suggests that oral reishi mushroom may be beneficial in some types of hypertension. Details: Preliminary clinical research shows that taking reishi mushroom extract 1440 mg daily for 12 weeks does not lower blood pressure in patients with hypertension (70776). However, in other clinical research, taking reishi mushroom extract 330-1440 mg daily for 1-6 months reduces blood pressure in patients with stage II or essential hypertension, but not in those with mild hypertension or diabetes (70786,70802,91435).
• Influenza. Although there has been interest in using reishi mushroom for influenza, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose.
• Insomnia. Although there has been interest in using reishi mushroom for insomnia, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose.
• Lung cancer. Small clinical studies suggest that oral reishi mushroom does not reduce the size of lung tumors. Details: A meta-analysis of preliminary clinical research shows that taking reishi mushroom does not reduce the size of lung tumors. However, it may stimulate immune function and improve quality of life in lung cancer patients when compared with control (70779).
• Peptic ulcers. Although there has been interest in using oral reishi mushroom for peptic ulcers, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose.
• Rheumatoid arthritis (RA). Oral reishi mushroom has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical trial in patients with active RA who are taking disease-modifying antirheumatic drugs shows that taking reishi mushroom extract 4 grams in combination with San Miao San (containing 2.4 grams each of atractylodes, phellodendron, and Achyranthes bidentata) daily for 24 weeks does not increase the percentage of patients achieving a 20% response based on the American College of Rheumatology (ACR) criteria or modify blood markers of disease and inflammation when compared with placebo (70767).
• Stress. Although there has been interest in using oral reishi mushroom for stress, there is insufficient reliable information about the clinical effects of reishi mushroom for this purpose. More evidence is needed to rate reishi mushroom for these uses.

(Read more about REISHI MUSHROOM)

POSSIBLY INEFFECTIVE

• Dental Plaque. A solution containing an extract of shiitake mushroom is less effective than fluoride mouthwash for reducing dental plaque. Details: Clinical research shows that rinsing the mouth with a solution containing shiitake mushroom extract does not reduce dental plaque when compared with placebo and appears to be less effective than fluoride mouth rinse (Meridol) (94250).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging. Although there has been interest in using oral shiitake mushroom for aging, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Atherosclerosis. Although there has been interest in using oral shiitake mushroom for atherosclerosis, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Breast cancer. Although there has been interest in using oral shiitake mushroom for breast cancer, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Cancer. It is unclear if oral shiitake mushroom is beneficial in patients with cancer. Details: Although some small clinical studies in patients with gastric or colon cancer have found that patients taking the shiitake mushroom extract AHCC 3-6 grams daily have better survival rates and quality of life when compared with historical population data, other observational research has not found a benefit for patients with head, neck, lung, or breast cancer when compared with baseline (30421,30425,30454). The validity of these studies is limited by lack of a comparator group.
• Chemotherapy-induced anemia. It is unclear if oral shiitake mushroom is beneficial in patients with chemotherapy-induced anemia. Details: A small clinical study in adults receiving chemotherapy for pancreatic cancer shows that taking the shiitake mushroom extract AHCC 6 grams daily for 8-12 weeks does not reduce the rate of grade 2 to 3 anemia when compared with placebo (110131).
• Chemotherapy-induced leukopenia. It is unclear if oral shiitake mushroom is beneficial in patients with chemotherapy-induced leukopenia. Details: Preliminary clinical research in patients with breast cancer receiving chemotherapy shows that taking the shiitake mushroom extract AHCC significantly reduces chemotherapy-related neutrophil events and lipid abnormalities when compared with standard care (94829).Observational research in patients with resectable pancreatic ductal adenocarcinoma has found that taking this product orally 3 grams daily throughout 2 cycles of neoadjuvant gemcitabine improves the neutrophil-to-lymphocyte ratio and nutritional scores when compared with standard of care (106783). In contrast, other clinical research in patients with pancreatic or biliary tract cancer receiving gemcitabine chemotherapy shows that taking AHCC 6 grams daily for two months does not seem to affect neutropenia, thrombocytopenia, or hepatic dysfunction when compared with standard of care. However, taking AHCC did reduce C-reactive protein and increase hemoglobin and albumin when compared to standard of care (30424).
• Chemotherapy-induced nausea and vomiting (CINV). It is unclear if oral shiitake mushroom is beneficial in patients with CINV. Details: Preliminary clinical research in patients being treated for head and neck cancers shows that taking the shiitake mushroom extract AHCC 3 grams daily, beginning 3 days prior to chemotherapy and continuing until one week after chemotherapy, reduces gastric side effects and the need for antiemetic therapy when compared with baseline (30425). The validity of these findings is limited by the lack of a comparator group.
• Chemotherapy-induced taste changes. It is unclear if oral shiitake mushroom is beneficial for the prevention of taste changes due to chemotherapy. Details: A small clinical study in adults receiving chemotherapy for pancreatic cancer shows that taking the shiitake mushroom extract AHCC 6 grams daily for 8-12 weeks reduces the rate of patient-reported taste disorders by 27% when compared with placebo (110131). Although patients in the AHCC group had modest improvements in some nutritional parameters when compared with the placebo group, it is unclear if any changes would be considered clinically significant.
• Common cold. Although there has been interest in using oral shiitake mushroom for the common cold, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Coronavirus disease 2019 (COVID-19). Although there has been interest in using oral shiitake mushroom for COVID-19, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Diabetes. Although there has been interest in using oral shiitake mushroom for diabetes, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Genital herpes. Although there has been interest in using oral shiitake mushroom for genital herpes, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Hepatitis C. It is unclear if oral shiitake mushroom is beneficial in patients with hepatitis C. Details: Preliminary clinical research in adults with chronic hepatitis C shows that taking the shiitake mushroom extract AHCC 6 grams daily for 6 months does not significantly reduce alanine aminotransferase (ALT) or hepatitis C virus RNA levels when compared with placebo (30419).
• HIV/AIDS. Although there has been interest in using oral shiitake mushroom for HIV/AIDS, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Human papillomavirus (HPV). It is unclear if oral shiitake mushroom is beneficial in patients with HPV. Details: A small clinical study in adult females with persistent high-risk HPV shows that taking the shiitake mushroom extract AHCC 3 grams daily leads to clearance of HPV RNA and DNA in 64% of patients after 6 months of treatment, compared to 11% of patients taking placebo (110129). The validity of these findings is limited by lack of statistical comparison between groups.
• Hypercholesterolemia. It is unclear whether oral shiitake mushroom is beneficial for lowering blood lipid levels. Details: Clinical research in adults with borderline high levels of cholesterol or triglycerides shows that consuming bars providing shiitake mushroom for 66 days modestly reduces triglyceride levels, but does not affect levels of low-density lipoprotein (LDL) cholesterol or high-density lipoprotein (HDL) cholesterol, when compared with placebo bars. Each bar provided dried shiitake mushroom 3.5 grams daily and the number of bars consumed daily was based on body mass index (108300). The effect of shiitake mushroom in patients with hypercholesterolemia, specifically, is unclear due to the heterogenous patient population.
• Hypertension. Although there has been interest in using oral shiitake mushroom for hypertension, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Impaired glucose tolerance (prediabetes). Oral shiitake mushroom has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Clinical research in adults with prediabetes shows that taking freeze-dried shiitake mushroom 0.96 grams in combination with chokeberry 1.36 grams, Panax ginseng 1.64 grams, and nattokinase 0.8 grams (Chakreis, YD Nutraceuticals Ltd.) twice daily for 12 weeks does not affect glycated hemoglobin, fasting blood glucose, or oral glucose tolerance test results when compared with placebo. However, there were some modest beneficial effects on insulin resistance and fasting insulin and liver transaminase levels (108301).
• Influenza. Although there has been interest in using oral shiitake mushroom for influenza, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Liver cancer. Small, low-quality clinical studies suggest that oral shiitake mushroom extract may improve overall survival in patients with liver cancer. Details: Preliminary clinical research in patients with advanced hepatic cancer shows that taking the shiitake mushroom extract AHCC orally 6 grams daily for a median of 3.5 months along with supportive care increases the median survival time by 2 months when compared with placebo. Taking AHCC also improved quality of life scores when compared with placebo (30359). Population research in patients with hepatocellular carcinoma has also found that taking AHCC 3 grams daily for up to 9 years after surgical resection reduces tumor recurrence and mortality by 48% and 56%, respectively, when compared with control (30353). In another small, open label clinical study of adults with advanced hepatocellular carcinoma, tumor recurrence occurred in 52% of patients who took AHCC 1 gram three times daily for 2 years after surgical resection (110130). The interpretation of these results is limited by the lack of a control group.
• Obesity. Although there has been interest in using oral shiitake mushroom for obesity, there is insufficient reliable information about the clinical effects of shiitake mushroom for this purpose.
• Prostate cancer. It is unclear whether shiitake mushroom has a role in preventing disease progression. Details: Preliminary clinical research shows that taking shiitake mushroom extract does not prevent disease progression, as determined by prostate-specific antigen (PSA) levels, when compared with baseline (10451). More evidence is needed to rate shiitake mushroom for these uses.

(Read more about SHIITAKE MUSHROOM)

POSSIBLY EFFECTIVE

• Dilated cardiomyopathy. Clinical research in adults with dilated cardiomyopathy, with or without myocarditis, shows that taking thymomodulin (calf thymus extract) in combination with conventional therapy improves exercise tolerance, left ventricular ejection fraction, clinical symptoms, and survival over a 7-year follow-up period when compared with conventional therapy alone. Thymomodulin seems to be similarly effective to treatment with interferon-alpha and conventional therapy (78542,78556,78558).
• Food allergies. Clinical research in children 7 months to 14 years of age with food allergies shows that taking thymomodulin (calf thymus extract) while on an elimination diet improves tolerance to allergenic foods after completion of the elimination diet when compared to an elimination diet alone (1175,1176).
• Respiratory tract infections. Clinical research shows that taking thymus extract orally may be beneficial for preventing recurrent respiratory infections in adults and children (938,6696,6697,6698,6699). Thymomodulin (calf thymus extract) treatment seems to reduce the number of infections or coughing attacks in patients with recurrent respiratory infections when compared to baseline or placebo (6697,6698,6699). It might also modestly reduce the use of antibiotics and the duration of infection (938).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Allergic rhinitis (hay fever). Preliminary clinical research shows that taking thymomodulin (calf thymus extract) 120 mg daily reduces the frequency of allergic episodes in patients with allergic rhinitis when compared to baseline (1010). The validity of these findings is limited by the lack of a comparator group.
• Asthma. Preliminary clinical research in children 2-12 years of age with asthma shows that taking thymomodulin (calf thymus extract) orally for 3 months reduces the frequency of acute asthma attacks when compared to baseline. Thymomodulin might also improve immune function (6694). The validity of these findings is limited by the lack of a comparator group. More evidence is needed to rate thymus extract for these uses.

(Read more about THYMUS EXTRACT)

POSSIBLY SAFE ...when used orally and appropriately. Agaricus mushroom extract has been safely used in doses up to 1500 mg daily for up to 12 months (15404,15421,94715,94716,94719,94721). A specific agaricus lyophilized powder product (Sen-Sei-Ro Powder Gold, Kyowa Wellness Co., Ltd.) has been safely used in doses up to 5.4 grams daily for 6 months (17185).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

(Read more about AGARICUS MUSHROOM)

POSSIBLY SAFE ...when used orally and appropriately. Cordyceps has been used with apparent safety in doses of 3-6 grams daily for up to 1 year (12,12095,92828,95905,105076,111903).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

(Read more about CORDYCEPS)

POSSIBLY SAFE ...when used orally in doses up to 500 mg daily for up to 2 months (5361,5362,97394,97396,97399,104392). ...when used by inhalation in doses of 600 mg twice daily for up to 3 days (5367,5368,5369). ...when used intramuscularly (5374,5375,5384). ...when used as an intravenous injection (5344,5354,5357,5358,5359,5360,5373,5374,5377,5378,5380).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

(Read more about GLUTATHIONE)

POSSIBLY SAFE ...when an extract of reishi mushroom is used orally and appropriately for up to one year (12,5485,70767,70774,70786,70799,70800,70801,70802). ...when whole powdered reishi mushroom is used orally and appropriately for up to 16 weeks (70776,70799,70800,70801,91433,91435,91436,91437,108309).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using

(Read more about REISHI MUSHROOM)

LIKELY SAFE ...when consumed in typical food amounts (6).

POSSIBLY SAFE .... ..when the shiitake mushroom extract AHCC is used orally and appropriately. AHCC 4.5-6 grams daily has been used with apparent safety in clinical trials lasting up to 6 months (22926,30419). Population research identified no safety concerns with the use of AHCC 3 grams daily for up to 9 years (30353,94830).

POSSIBLY UNSAFE ...when shiitake mushroom powder is used orally in medicinal amounts. Ingestion of shiitake mushroom powder 4 grams daily for 10 weeks can cause eosinophilia (1149). ...when uncooked shiitake mushroom is ingested. The lentinan component, which is broken down by heat, can cause toxic reactions, including shiitake dermatitis (94354).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid consuming greater than food amounts.

(Read more about SHIITAKE MUSHROOM)

POSSIBLY SAFE . .when used orally and appropriately. Purified thymus extract has been used with apparent safety in clinical trials (938,1010,1175,1176,1177,1178,6691,6694,6696,6697,6698,6699). There is some concern for contamination with diseased animal parts (1825). However, so far there are no reports of disease transmission to humans due to use of contaminated thymus extract. There is insufficient reliable information available about the safety of thymus extract when used parenterally.

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

(Read more about THYMUS EXTRACT)

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, taking agaricus mushroom with antidiabetes drugs might increase the risk of hypoglycemia.  Details In one clinical study in patients with type 2 diabetes who are stabilized on conventional oral hypoglycemic agents, 3 of 29 patients taking an agaricus mushroom extract 500 mg three times daily for 12 weeks reported hypoglycemia, compared to one of 29 patients in the placebo group (15421).

(Read more about AGARICUS MUSHROOM)

ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, cordyceps may increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.  Details In vitro and animal research suggests that cordyceps extract inhibits platelet aggregation and function (3429,46112). However, this interaction has not been reported in humans.

IMMUNOSUPPRESSANTS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = B Theoretically, concurrent use of cordyceps might interfere with immunosuppressive therapy.  Details Animal and in vitro research suggests that cordyceps stimulates the immune system (3403,3404,3414,3431,3432). However, limited clinical research suggests that taking cordyceps may lower the necessary therapeutic dose of the immunosuppressant cyclosporine (92828), which suggests that cordyceps may have an immunosuppressive effect.

TESTOSTERONE Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, concurrent use of cordyceps and testosterone might have additive effects.  Details Animal research suggests that cordyceps can increase testosterone levels (46087). The clinical significance of this finding is unclear.

(Read more about CORDYCEPS)

(Read more about GLUTATHIONE)

ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, high doses of reishi mushroom might increase the risk of bleeding.  Details A dose of 1.5 grams daily of reishi mushroom does not seem to decrease platelet aggregation, but a higher dose of 3 grams daily does (5476,13235).

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, reishi mushroom might have additive effects with antidiabetes drugs.  Details Animal research suggests that reishi mushroom decreases blood sugar (70769). However, in patients with type 2 diabetes, taking reishi mushroom does not reduce fasting glucose levels, and its effects on glycated hemoglobin are inconsistent (70801,91435).

ANTIHYPERTENSIVE DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.  Details Reishi mushroom has shown hypotensive activity in animal research (5488,70784). Clinical evidence suggests that reishi mushroom reduces blood pressure in some, but not all, patients with hypertension (70786,70802).

(Read more about REISHI MUSHROOM)

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, shiitake mushroom might increase levels of drugs metabolized by CYP2D6.  Details In vitro studies suggest that the shiitake mushroom extract AHCC might induce the CYP2D6 enzyme (30369,30420). This effect has not been reported in humans.

IMMUNOSUPPRESSANTS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, taking shiitake mushroom might decrease the effects of immunosuppressive therapy.  Details In vitro evidence suggests that shiitake mushroom extracts stimulate immune function (30351,30358,30360,30361,30366,30367,30368,30371,30376,30379,30381,30382,30416,30418) (74769,74783,74876,94245).

(Read more about SHIITAKE MUSHROOM)

(Read more about THYMUS EXTRACT)

General ...Orally, agaricus mushroom is generally well tolerated.
Most Common Adverse Effects:
Orally: Abdominal discomfort, diarrhea, and nausea.
Serious Adverse Effects (Rare):
Orally: Allergic reactions, hepatotoxicity, interstitial lung disease (ILD).

Gastrointestinal ...In one clinical trial, mild gastrointestinal side effects such as nausea, diarrhea, and abdominal discomfort were reported in 6 of 78 patients taking a specific agaricus powder product , Ltd.) 1.8-5.4 grams orally daily for 60 days. The causal relationship between this agaricus mushroom product and the associated gastrointestinal adverse effect was determined to be possible or probable in each case (17185).

Hepatic ...Three cases of severe hepatotoxicity have been reported in females with ovarian or breast cancer receiving chemotherapy who also took agaricus mushroom supplements. Two of the patients had increases in liver function tests a few days after starting agaricus mushroom, which then progressed rapidly to fatal, fulminant hepatitis. One of these patients was also an asymptomatic carrier of hepatitis B virus. In the third case, liver function improved when agaricus mushroom was stopped, worsened when it was restarted, and then recovered fully when the supplement was stopped permanently (16458).

Immunologic ...An allergic reaction has been reported in a female who took a specific agaricus powder product , Ltd.) 1.8 grams daily by mouth for 2 months. The patient developed an urticarial papular rash which resolved when the product was discontinued (17185). Allergic contact cheilitis was also reported in a patient taking a homemade agaricus mushroom extract orally. The reaction resolved upon discontinuation of agaricus mushroom (94720).

Pulmonary/Respiratory ...There is one case report of interstitial lung disease associated with the use of agaricus mushroom for approximately one month in a male with pancreatic ductal adenocarcinoma being treated with gemcitabine. Drug-induced lymphocyte stimulation test (DLST) was positive for agaricus mushroom extract and not gemcitabine. Pneumonitis improved upon discontinuation of agaricus mushroom (108313).

(Read more about AGARICUS MUSHROOM)

General ...Orally, cordyceps seems to be generally well tolerated when used for up to 1 year.
Most Common Adverse Effects:
Orally: Abdominal discomfort, constipation, diarrhea.

Gastrointestinal ...Orally, cordyceps has been associated with diarrhea, constipation, abdominal discomfort, dry mouth, and throat discomfort in clinical research. However, these events were uncommon, and in some cases symptoms could be reduced by taking cordyceps after eating (92829,105076,109705).

Hematologic ...Two cases of lead poisoning, characterized by loss of appetite and other symptoms, have been reported for patients taking cordyceps powder. After discontinuing cordyceps supplementation, both patients were treated with chelating agents (46135).

Hepatic ...There is a case report of acute cholestatic hepatitis probably associated with the use of a product containing cordyceps. The 64-year-old male was asymptomatic except for jaundice and laboratory markers and recovered once the supplement was stopped. However, it is unclear whether the hepatitis is associated with the cordyceps or with an unknown contaminant (109704).

Renal ...One case of a mild increase in serum creatinine level (< 30%) has been reported (95905).

(Read more about CORDYCEPS)

General ...Glutathione seems to be well tolerated; however, a thorough evaluation of safety outcomes has not been conducted.
Serious Adverse Effects (Rare):
Inhaled: Bronchoconstriction and shortness of breath.

Dermatologic ...Topically, glutathione has resulted in an intolerable rash and irritability in five children (90637).

Pulmonary/Respiratory ...Inhaled (nebulized) glutathione can cause airway narrowing and bronchoconstriction resulting in shortness of breath and cough in patients with asthma (5372).

(Read more about GLUTATHIONE)

General ...Orally, reishi mushroom is generally well tolerated.
Most Common Adverse Effects:
Orally: Dizziness, dry mouth, itching, nausea, rash, and stomach upset.

Dermatologic ...Orally, reishi mushroom can cause itching, rash, and other skin reactions (12,5479).

Gastrointestinal ...Orally, reishi mushroom can cause dryness of the mouth, throat, or nasal cavity, nausea, stomach upset, and, more rarely, diarrhea (12,70779,91438,108309).

Hematologic ...Orally, reishi mushroom can cause nosebleed and bloody stools (12,91438).

Hepatic ...One case of hepatotoxicity and one case of fatal fulminant hepatitis have been reported in patients who had used reishi mushroom powder for 1-2 months (70766). There is a case report of a 61-year-old male with hypereosinophilia associated with hepatic nodules following the use of reishi mushroom powder for about 2 months. Symptoms resolved after discontinuation of the product. Although these side effects were thought to be associated with the use of reishi mushroom powder, it is unclear if other factors played a role. The patient had been taking tegafur, gimeracil, and oteracil potassium for about 4 months following anterior resection for rectal adenocarcinoma but discontinued these agents and initiated reishi mushroom due to liver injury (108312).

Neurologic/CNS ...Orally, reishi mushroom can cause dizziness (91438). Other rare symptoms include insomnia and headache (70776,70779).

Pulmonary/Respiratory ...Respiratory allergy to reishi spores can occur (12,5479). Sore throat and runny nose have also been reported (70776,91438).

(Read more about REISHI MUSHROOM)

General ...Orally, shiitake mushroom is generally well tolerated when cooked and consumed as a food.
Most Common Adverse Effects:
Orally: Abdominal discomfort, bloating, diarrhea, nausea, and vomiting.
Serious Adverse Effects (Rare):
Orally: Consumption of raw shiitake mushroom can cause shiitake dermatitis, a skin eruption resembling whiplash marks which can be accompanied by systemic symptoms. Large pieces that have been inadequately chewed can cause intestinal blockage, occasionally requiring surgery.

Dermatologic ...Orally, shiitake mushrooms can cause shiitake dermatitis, a skin eruption that resembles whiplash marks, usually found on the trunk and limbs. This dermatitis is thought to be a toxic response to lentinan or other compounds found normally in uncooked or inadequately cooked shiitake mushroom. The rash can be made worse by scratching. Symptom onset is usually within hours to days and can persist for 3-4 weeks before resolving on its own. There is some evidence that treatment with steroids alone or with antihistamines might reduce the duration of the rash by a small amount in some people (1148,1152,74782,74806,94236,94237,94238,94240,94241,94243) (94244,94246,94247,94248,94249,94252,94253,94254,94255,94256)(94257,94259,94261,94262,108302,111909,111912,111913). The dermatitis may include small purple spots from broken capillaries, skin plaques, burning, blanching, and pustules (94256,108302). Rarely the rash may look like measles rather than whiplash (94256). Histologically, there may be evidence of dermal and epidermal edema, lymphocyte infiltration, and skin thickening (94256,94257). Other symptoms associated with the dermatitis include fever, aching, malaise, eosinophilia, diarrhea, prickling in the hands, trouble swallowing, conjunctivitis, and pustules with small ulcers in the mouth (94240,94246,94247,94249,94256,94257,108302). It is likely that the dermatitis and other symptoms are due to a delayed type hypersensitivity reaction (94244,94255). Cooking shiitake mushroom generally prevents shiitake dermatitis, although some cases have occurred in people who have consumed cooked sources (94242,94244). It appears that to inactivate lentinan, cooking temperatures of at least 130°C are needed (94243).
Less common is a photosensitivity reaction associated with oral ingestion, which involves rash and pruritus after sun exposure (1148,94241).
Orally, the shiitake mushroom extract AHCC has been reported to cause mild itching (30375).

Gastrointestinal ...Orally, shiitake mushrooms can cause abdominal discomfort, including bloating, nausea, pain, vomiting, and diarrhea (1149,30365,30375,30419,94241). Gastrointestinal symptoms, such as diarrhea, problems swallowing, or mouth ulcers have been associated with shiitake dermatitis (94241,94256). Consumption of large pieces of shiitake mushroom with inadequate chewing can cause abdominal obstruction that has resulted in death in one case and surgical intervention in two others. In another case, parenteral nutrition was used exclusively until the shiitake mushroom pieces were passed (1147,94260,103160,108303,108304).
Topically, an oral rinse containing shiitake mushroom extract has been associated with teeth sensitivity, teeth staining, and burning in the mouth (94250).

Hematologic ...Ingestion of shiitake mushroom powder 4 grams daily for 10 weeks caused eosinophilia in 5 of 10 healthy humans (1149). Eosinophilia, and leukocytosis or leukopenia have been reported with shiitake dermatitis (94254,94256,94257).

Immunologic ...Allergic contact dermatitis can occur by contact with shiitake hyphae (filaments) (1153,74785,111913). It appears to be more common in growers or others that handle shiitake mushrooms extensively (94241,94259). Contact or inhalation also results in other symptoms of allergy, such as asthma, rhinitis, conjunctivitis, and pneumonia (94241,94249,94258,94259).

Musculoskeletal ...Orally, the shiitake mushroom extract AHCC has been reported to cause foot cramps and difficulty moving hand joints (30365,30416).

Neurologic/CNS ...In patients experiencing shiitake dermatitis, other symptoms may include prickling in the hands (94256). Malaise has also been reported following oral intake or contact (1151,94240).
Orally, the shiitake mushroom extract AHCC has been reported to cause mild and transient headache (30365).

Ocular/Otic ...Conjunctivitis has been reported rarely in mushroom growers and handlers, or following oral intake in patients with shiitake dermatitis (94241,94256,94259).

Pulmonary/Respiratory ...In mushroom workers, hypersensitivity pneumonitis due to shiitake spore inhalation has occurred. Symptoms include difficulty breathing, chest pain, a dry cough, asthma, and rhinitis (1150,1151,74776,74813,94239,94241,94258,94259).

(Read more about SHIITAKE MUSHROOM)

General ...Orally, thymus extract seems to be well tolerated. No adverse effects have been reported in clinical trials (938,1010,1175,1176,1177,1178,6691,6694,6696,6697,6698,6699). However, there is some concern about potential contamination. Thymus extract is derived from raw bovine thymus glands gathered from slaughterhouses, possibly from sick or diseased animals (6620). Products made from contaminated or diseased organs might present a human health hazard. There is also concern that thymus extract produced from cows in countries where bovine spongiform encephalitis (BSE) has been reported might be unsafe (1825). However, there are no reports of disease transfer to humans from contaminated thymus extract.

Immunologic ...In one case report, severe anaphylactic reaction associated with thymostimulin administration occurred in a 36-year-old male being treated for a neck tumor (78453).

Other ...Thymus extract is derived from raw bovine thymus glands gathered from slaughterhouses, possibly from sick or diseased animals (6620). Products made from contaminated or diseased organs might present a human health hazard. However, there are no reports of disease transfer to humans from contaminated thymus extract.
There is also some concern that thymus extract that is obtained from cows in countries where bovine spongiform encephalitis (BSE) has been reported might be unsafe. However, there are no reports of BSE transfer to humans from contaminated thymus extract. Countries where BSE has been reported include Great Britain, France, The Netherlands, Portugal, Luxembourg, Ireland, Switzerland, Oman, and Belgium (1825). Until more is known, tell patients to avoid these products unless country of origin can be determined. Patients should avoid products that are produced in countries where BSE has been found.

(Read more about THYMUS EXTRACT)