Harnessing the power of medicinal mushrooms in patient practice

By Carolina Brooks, BA, IFMCP

My first foray in working with medicinal mushrooms was when I was still studying. I was looking for natural compounds to help me improve my focus and productivity and help to balance my stress response and study-induced anxiety. I wasn’t as far into my herbal studies at that point when I discovered the far-reaching benefits of reishi, cordyceps, and lion’s mane, which all became regular additions to my smoothies and hot drinks. It seems I had the power of foresight, given the commercial explosion of medicinal mushrooms today.

However, mushrooms have historically played a role in medicine. The Traditional Chinese Medicine pharmacopoeia uses 270 medicinal mushrooms, and most were already defined in the Pen Tsao Kang Mu of 1575. Otzi the Ice Man carried anti-parasitic, anti-inflammatory medicinal mushrooms on his person. In the 19th century, French and American doctors were using medicinal mushrooms to treat tuberculosis. Our modern-day antibiotics are isolated from molds, including penicillin and tetracycline. 

The last few years have also seen a reignition of interest in psychedelic or “magic” mushrooms, with millions being invested into research on the effects of psilocybin, the active ingredient in psychedelic mushrooms as a therapeutic tool against depression, anxiety, addiction, and post-traumatic stress disorder.  John Hopkins University researchers have recommended its reclassification to a Schedule IV drug. This month, Denver became the first city to decriminalize psychedelic mushrooms.

Medicinal mushrooms became one of 2018’s biggest health trends, with thousands of new products now available on the market, including mushroom powders, teas, coffees, chocolate, face creams, foods, grow kits, supplements, and more. According to a recent 2019 report, the global mushroom market, which includes medicinal mushrooms, is set to exceed $50 billion within the next seven years as the general public are becoming increasing aware of the health benefits of mushrooms and they become more readily available.  

Many mushrooms are saprotrophs, meaning  they feed on the dead and decaying matter of other organisms, usually trees. Their fruiting bodies sprout when they have absorbed the nutrients from a decaying tree, thus recycling plant life, redistributing nutrients, and playing an important role in forming the Earth’s atmosphere. Fungi  have the ability to extract minerals from rocks.  A 2014 review in AMB Express discusses the role of mushrooms in mycoremediation due to their ability to break down waste, including environmental toxins such as exhaust fume particulate, pesticides, industrial waste, plastics, and heavy metals. 

Nutritional and medicinal constituents of mushrooms

The main health benefits of mushrooms come from their polysaccharide content. Polysaccharides are complex carbohydrates which provide short-term energy and structure. These compounds are important because they act as immunomodulators.

Beta-glucans are a type of polysaccharide that helps to regulate the immune system. They are anti-viral, anti-microbial, bind to macrophages, natural killer cells, and other white blood cells to trigger a response. They stimulate the formation of immune stem cells and stimulate other white blood cells to release protective molecules against cancer and invading pathogens. Many mushrooms, including chaga, cordyceps, and lion’s mane also contain superoxide dismutase, which also helps to neutralize free radicals formed by toxins, thus supporting healthy detoxification and breakdown of hormones. I use mushrooms in various combinations with all my cancer patients.

Mushrooms, when grown outside, contain large amounts of vitamin D. They are a good source of amino acids, fiber, B vitamins, vitamin C, and are rich in minerals such as magnesium, calcium, zinc, and selenium. A 2017 study in Food Chemistry  found that mushrooms contain glutathione and high amounts of ergothioneine, a heat-stable, sulfur-rich antioxidant. Porcini mushrooms appear to have the highest levels of ergothioneine, but even common white button mushrooms contain some of this unique compound, which supports detoxification.

It has  been hypothesized that countries where large amounts of these mushrooms are eaten, such as Italy and France, have lower levels of neurodegenerative diseases. It’s easy to encourage patients to add mushrooms into the diet, particularly shiitake, enoki, maitake, crimini, and porcini, and mushrooms, which are all nutrient powerhouses. A 2016 review by Mendel Friedman PhD, research scientist at the U.S. Department of Agriculture, discussed the role of mushrooms polysaccharides in helping to enhance insulin sensitivity and regulate blood sugar, maintain satiety, and act as a prebiotic in the gut to support digestive health.

Cordyceps sinensis (Cordyceps)

The beta-glucans present in cordyceps boost ATP production and energy output, while the cordycepic acid and deoxyadenosine compounds support kidney and immune function, libido, and nitric acid production. This is a good choice for patients who are stressed, not able to perform effectively in their workouts, who lack endurance, or have erectile dysfunction issues.

Ganoderma Lucidum (Reishi)

Terpenoids or triterpenes are compounds that are also present in herbs such as thyme, eucalyptus, cilantro, and chamomile. Triterpenoids, present in reishi, are antimicrobial compounds that are anti-inflammatory, via downregulation of nuclear factor kappa B (NF-kb), anti-histaminic, and help to support healthy hormone balance by reducing the production of 5-alpha-reductase, the enzyme which facilitates the conversion of testosterone to the more potent dihydrotestosterone, linked with the development of polycystic ovarian syndrome (PCOS), benign prostatic hyperplasia (BPH), and prostate cancer. 

A 2003 study in Integrative Cancer Therapies discussed reishi’s ability to inhibit tumor invasiveness by reducing cell adhesion and migration in aggressive breast and prostate cancers . 

The triterpene ganoderic acid blocks 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase

 (HMG CoA-reductase) activity to block cholesterol absorption and reduce LDL cholesterol and triglyceride levels. The polypeptides in reishi act as neurotransmitter and endorphin precursors and the alkaline element has an anticholinergic effect, which relaxes the nervous system. Reishi also contains germanium, which enhances oxygen flow. I use reishi with stressed or anxious patients, who have hormone imbalance issues worsened by stress and insomnia, and those with estrogen dominance, dysmenorrhea, menorrhagia, or aggravated histamine issues.

Inonotus Obliquus (Chaga)

Chaga contains one of the highest antioxidant scores (ORAC) of any food, 53 times higher than that of blueberries and six times that of acai. It is renowned for its anti-cancer activity and is immunoprotective and antimicrobial. It also protects the skin from radiation, sun damage and contains melanin to encourage hair growth. I use chaga with my cancer patients, particularly if they have been going through radiotherapy.

Hericeum Erinaeus (Lion’s Mane)

Lion’s mane was used traditionally in China for digestive ailments and as a restorative adaptogen. Recent research has shown its compounds, hericenones, and diterpenoid erinacines to stimulate the synthesis of nerve growth factor, which has a protective effect on myelin sheath. A 2012 study from International Journal of Medicinal Mushrooms demonstrated the efficacy of lion’s mane in peripheral nerve injury, and I have found it an essential addition for my cognitive decline, multiple sclerosis, and Charcot-Marie-Tooth patients, who have noticed significant symptomatic improvement and reduced pain since they started taking a concentrated extract of this mushroom. Its eracine compounds have opioid receptor agonist activity and antimicrobial activity, which help to reduce symptoms of depression and anxiety, as well as supporting restoration of the gastrointestinal mucus membrane.

Tremella Fuciformis (Tremella)

A lesser known mushroom is Tremella, a traditional anti-ageing mushroom often used in skincare products for its hydrating properties that rival those of hyaluronic acid. It contains high levels of kojic acid, which has been shown to reduce skin pigmentation.  This mushroom is one of my favorites to use with patients suffering melasma. It is considered helpful in counteracting the harmful effects of radiation and radiotherapy, and I use it in combination with eleuthero, which does the same. I have also started to include this in formulas for Ehlers-Danlos patients, although thus far, we have not seen dramatic improvements.

Safety and Side Effects of Mushrooms

Safety studies are limited, so medicinal mushrooms are best avoided during pregnancy, lactation, and with children under six years old. The most common side effects include rashes, redness, nausea, and changes in bowel habit, which should last no longer than two to three days.

For safety, it is best to leave a three-hour window around medications, and there is also in vivo evidence that certain mushrooms taken alongside antibiotics may potentiate activity of medications. People taking antibiotics, anticoagulants, cholesterol, and diabetes medications must be monitored as they can have additive effects.

Oxalate issues may be exacerbated with chaga mushroom, lion’s mane may exacerbate allergic conditions, and if there is allergy to mushrooms, avoid all medicinal mushrooms completely. There are no known interactions with nutritional supplements, while some vitamins, such as vitamin C, may enhance absorption and activity.  

Considerations

Most medicinal mushrooms are edible, although I use concentrated double extractions of mushrooms as these are more potent, more bioavailable in the gut, and bring faster results. These supplement extracts are not cheap, which is why it is important to recommend a Good Manufacturing Practice (GMP)-certified provider and ask for a certificate of analysis which will indicate how much of the mushroom’s bioactive compounds are present.

Many cheaper products are often cut with starch powder to adulterate polysaccharide levels. Ensure mushrooms are certified organic, always find out what substrate mushrooms are being grown on, and where they are being grown. I avoid mushrooms grown in Eastern Europe due to radiation concerns, and I avoid mushrooms from China due to heavy metal contamination. Always store in an airtight dark glass container, away from heat, and, if it’s a dried formulation, recommend that the product is used within three to six months to ensure potency.

References

Freidman M. (2016) Mushroom Polysaccharides: Chemistry and Antiobesity, Antidiabetes, Anticancer, and Antibiotic Properties in Cells, Rodents, and Humans.  Foods, 2016, 5, 80. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5302426/pdf/foods-05-00080.pdf

Kalaras M.D., Richie J.P., Calcagnotto A. and Beelman R.B. (2017) Mushrooms: A rich source of the antioxidants ergothioneine and glutathione. Food Chemistry, Volume 223, 15 October 2017, Pages 429-433.  Retrieved from: https://doi.org/10.1016/j.foodchem.2017.04.109

Kulshreshta S., Mathur N. and Bhatnaga P. (2014) Mushroom as a product and their role in mycoremediation.  AMB Express, 2014, 4:29 Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4052754/pdf/s13568-014-0029-8.pdf

Silva D. (2003) Ganoderma Lucidum (Reishi) in Cancer Treatment. Integrative Cancer Therapies, Volume: 2 issue: 4, page(s): 358-364. Retrieved from: https://journals.sagepub.com/doi/abs/10.1177/1534735403259066

Wong K.H., Naidu M. David R.P., Bakar R. and Sabaratnam V. (2012) Neuroregenerative Potential of Lion’s Mane Mushroom, Hericium Erinaceus (Bull.: Fr.) Pers. (Higher Basidiomycetes), in the Treatment of Peripheral Nerve Injury (Review). International Journal of Medicinal Mushrooms, 2012;14(5):427-46. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23510212#