Cordyceps: benefits, dosage, contraindications

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Cordyceps is a unique blade-shaped fungus that grows on caterpillars in high mountain regions (5000 m) in China and Tibet. Cordyceps parasitizes the larva, gradually feeding on it to endure the winter and replacing all its tissues, leaving only the shell. In spring, it emerges through the host’s mouth cavity, forming a visible reddish stalk.

Given the limited quantity of natural Cordyceps, various cultured and fermented mycelial products with similarly pharmacologically active components (strain Cs-4 for example) are now used in clinical practice.

A standardized fermentation product, Cs-4® has been produced from the Paecilomyces hepiali Chen at Dai mycelial strain isolated from wild Cordyceps sinensis. A close similarity has been demonstrated between this fermentation product and natural Cordyceps regarding their chemical constituents.

The active constituents of Cordyceps are polysaccharides, adenosine, cordycepin, cordycepaccid, and ergosterol (a sterol unique to mushrooms and an important precursor of vitamin D2).

Cordyceps is used as a tonic herb in traditional Chinese medicine (TCM) to treat a wide range of disorders, such as respiratory diseases, kidney, liver, and cardiovascular diseases, as well as to enhance libido and physical performance. In Tibetan tradition, Cordyceps is considered a kidney tonic, the seat of vital energy, earning its reputation as an anti-fatigue remedy.

Other name(s) 

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Scientific name(s)

Cordyceps sinensis

Family or group: 

Mushrooms

Active ingredients:

Polysaccharides

Adenosine

Sterols


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


Renal insufficiency
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A meta-analysis of clinical studies on patients with chronic kidney disease shows that taking 0.6 to 2 g of cordyceps orally three times a day, in addition to standard treatment, seems to decrease serum creatinine levels and increase its clearance compared to standard treatment alone. Another meta-analysis of clinical studies on patients with diabetic nephropathy shows that taking 0.5 to 2 g of cordyceps orally three times a day along with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) reduces blood urea nitrogen and lowers serum creatinine levels compared to ACEI/ARB treatment alone. A meta-analysis of small clinical trials on hemodialysis patients suggests that adding cordyceps to standard treatment does not seem to improve serum creatinine levels, but may improve certain inflammation markers like C-reactive protein, compared to placebo. These studies confirm the traditional use of cordyceps as a kidney tonic.

Posologie

posologieOral

posologie1.5 - 6 g

formulationstandardized extract, dry extract


Diabetic nephropathy
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Cordyceps has been widely used as a tonic for patients in poor health in China. As a fermentation product of cordyceps, jinshuibao has been used in clinical practice for a long time, particularly in the treatment of diabetic kidney disease and nephropathy. A meta-analysis of clinical studies on patients with diabetic nephropathy shows that taking 0.5 to 2 g of cordyceps orally three times a day along with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) reduces blood urea nitrogen by 2 mg/dL and lowers serum creatinine levels by 0.1 mg/dL compared to ACEI/ARB treatment alone. Furthermore, Cordyceps might benefit patients undergoing angiography to reduce the risk of contrast-induced nephropathy, a form of kidney damage that can occur after certain medical procedures. A preliminary clinical study on patients with diabetic nephropathy shows that taking 2 to 3 g of cordyceps orally three times a day for 3 days before and after angiography reduces the risk of contrast-induced nephropathy by approximately 48% to 66% compared to standard treatment.

Posologie

posologieOral

posologie6 - 9 g

formulationstandardized extract, dry extract


Sexual disorders
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In men, studies suggest that cordyceps might increase testosterone levels, which are essential for various aspects of male reproductive health, including sperm production and sexual function. In women, cordyceps might increase libido. Preliminary clinical research shows that taking a specific preparation of cordyceps (Cs-4) at about 3 g per day for 40 days may improve symptoms of sexual asthenia in 66% of patients, versus 32% of patients taking natural cordyceps and 24% of patients taking a placebo.

Posologie

posologieOral

posologie3 g

formulationstandardized extract, dry extract


Sports Performance
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Taking 1g of Cordyceps (Cs-4) per day for 12 weeks (divided into a 333mg dose three times a day) increased lactate and ventilatory threshold in older individuals but did not affect VO2 max (the maximum measure of a person's oxygen consumption during intense exercise). This suggests that Cordyceps likely enhanced the body's ability to generate energy in anaerobic (oxygen-free) conditions. In another study, a 3g dose of a Cordyceps-based product over 5 weeks did not increase aerobic cycling performance or VO2 max. One reason for these mixed results may be that the cordyceps ingestion scheme was insufficient to prompt positive changes in humans. An attack phase of one week followed by a maintenance phase of at least 2 to 4 weeks may be necessary to achieve improved aerobic capacity and fatigue resistance. Another reason could be that, since these experiments were conducted on healthy individuals, there was less room for improvement in physiology, health, and performance than in sick or elderly people.

Posologie

posologieOral

posologie1 g

formulationCS-4


Synergies


Fatigue
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In TCM, cordyceps has been used for treating fatigue, cough, hypo-sexual dysfunction, asthenia after serious illness, kidney dysfunction, and kidney insufficiency. Cordyceps extracts may act in several ways, according to studies conducted on mice: - In ATP (adenosine triphosphate) production which improved hepatic energy metabolism and blood flow in iron-deficient anemic mice but also significantly increased the ATP/inorganic phosphate ratio in the liver of normal mice - Treatment with cordyceps extracts increased the ATP-generation capacity of the myocardium ex vivo in mice, which could be mediated by the enhancement of mitochondrial electron transport. - Cordyceps has a strong antioxidant effect, which can eliminate ROS (reactive oxygen species) produced in working muscles during exercise and help relieve fatigue - Cordyceps induces more efficient oxygen use and consumption, leading to a higher survival rate in a hypoxic environment in mice. These results indicate a more effective utilization of O2 by cordyceps to support essential physiological activities of tissues and improve tolerance to hypoxia-induced acidosis. However, few human trials have been conducted on the antifatigue effect of cordyceps; this indication is based on long traditional use.

Posologie

posologieOral

posologie3 g

formulationstandardized extract, dry extract


Properties


Anticancer

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Studies conducted on animals with cancer suggest that Cordyceps may enhance immune response, reduce tumor size, and extend survival.

Several mechanisms contribute to Cordyceps' antitumor effect, such as direct cytotoxicity, immunopotentiation, apoptosis, selective inhibition of ribonucleic acid (RNA) and protein synthesis, as well as its antioxidant, antiangiogenic, antimutagenic, antimetastatic, and antiviral activities.

One of the functional components is cordycepin, whose anticancer effects on various tumors, including breast cancer, have been reported. Its structural similarity to cellular nucleosides and adenosine (constituents of DNA and RNA, playing important roles in many biological processes including genetic information transmission and cell activity regulation) allows it to interfere with the ability of cancer cells to properly produce genetic messages (mRNA), thus contributing to their destruction.


Immunomodulator

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Preliminary studies suggest that Cordyceps may boost immune function by increasing the number of T-helper cells; enhancing natural killer cell activity; stimulating blood mononuclear cells; raising interferon-gamma, tumor necrosis factor-alpha, and interleukin-1 levels; and prolonging lymphocyte survival.

Interestingly, Cordyceps has immunomodulatory effects, mainly attributed to its polysaccharides and cordycepin.

Polysaccharides may stimulate macrophage and T-cell activity, increasing pro-inflammatory cytokine production and phagocytosis, mechanisms useful for tackling tumors and viral infections.

Cordycepin, on the other hand, seems more suitable for autoimmune diseases as it can act as an immunosuppressant. The combination helps balance immune response, making Cordyceps an appealing remedy for immunity.


Nephroprotective

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The use of Cordyceps in Chinese medicine reinforces the kidneys. Studies have shown much of Cordyceps' kidney-strengthening potential comes from its ability to increase 17-hydroxycorticosteroids and 17-ketosteroids levels in the body. Their dosage provides insights into adrenal function.

Renal protection effects are mainly presented in three aspects:

- Protection against chronic renal functional insufficiency;

- Therapeutic effect on toxic renal lesions;

- Reversal of glomerulonephritis effect in an animal model.

All these aspects have been proven by a series of experiments with Cordyceps.

Usages associés

Renal Insufficiency, Diabetic Nephropathy

Hypoglycemic

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Studies on Cordyceps have revealed its hypoglycemic potential. A compound extracted from this mushroom, called CS-F30, was effective in reducing blood glucose levels in diabetic mice. Another compound, CS-F10, also showed positive effects by lowering glucose in diabetic mice and those with induced high glucose levels.

But there's more: Cordyceps also seems to positively influence cholesterol. It has been found to lower total cholesterol and LDL (bad cholesterol) while increasing HDL (good cholesterol) in mice fed a high-cholesterol diet. These findings suggest that Cordyceps could be a natural ally for managing both diabetes and cholesterol issues.


Hepatoprotective

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Animal tests and clinical research data have shown Cordyceps has a protective effect on patients suffering from liver conditions, particularly those with viral hepatitis A, chronic hepatitis B, chronic hepatitis C, and liver fibrosis. The bioactive components of Cordyceps for liver protection are primarily Cordyceps polysaccharides. Although the content and efficacy of Cordyceps polysaccharides vary by species, they can improve the immunological functions of organic cells, eliminate harmful components, and thereby reduce hepatic cell damage. The effects include:

- Protective effect on liver immune lesions;

- Effect on cirrhosis patients post-hepatitis;

- Effect on patients with chronic hepatitis B;

- Protective effect on liver fibrosis.


Bioenergizer

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A recent study explored the effects of Cordyceps Sinensis, a medicinal mushroom, on stress and endurance. Researchers administered hot water extract of Cordyceps to rats at a dose of 150 mg/kg for a week.

A notable reduction in biochemical stress markers was observed. Among them, total cholesterol decreased, returning to levels comparable with non-stressed rats. This cholesterol normalization is an important indicator of the body's effective stress management, as stress has been shown to contribute to increased LDL cholesterol, also known as 'bad cholesterol.'

Furthermore, the extract had an impact on the weight of certain vital organs. The spleen, adrenal glands, and liver of the rats showed a less significant weight reduction - respectively 24%, 91%, and 37% - compared to what's generally observed under stress. These organs play a crucial role in immune response, hormonal regulation, and metabolism, and maintaining them in good health is essential.

Finally, the study also highlighted the effects on endurance. With doses of 150 to 300 mg/kg of extract, rats were able to swim longer before tiring. The time before fatigue set in increased by about 12.5%, suggesting that Cordyceps could be beneficial for improving physical endurance.

Usages associés

Fatigue, Athletic Performance

Fertility Effect

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Cordyceps is traditionally used to enhance sexual function in men.

Evidence shows that Cordyceps sinensis and Cordyceps militaris can improve reproductive activity and restore impaired reproductive function. Administration of Cordyceps sinensis increased libido and sexual activity, and restored impaired reproductive function in men. These effects are linked to increased testosterone release in plasma via the cAMP (cyclic adenosine monophosphate)-protein kinase A signaling pathway.

A protein in Cordyceps contributed to the hypotensive and vasorelaxing properties observed, enhancing NO (nitric oxide) production, which could support erection, thus improving sexual function.

Usages associés

Sexual Disorders


Safety dosage

Adults: 1 g - 3 g

Cordyceps has been used in clinical trials at doses ranging from 1,000 to 3,000 mg per day in multiple doses with meals.


Interactions

Médicaments

Immunosuppressant: moderate interaction

Animal and in vitro research suggests that Cordyceps stimulates the immune system. However, limited clinical research suggests that taking Cordyceps may reduce the therapeutic dose required for the immunosuppressant cyclosporine, which suggests that Cordyceps may have an immunosuppressive effect.


Precautions

Autoimmune diseases: avoid

In theory, Cordyceps could interfere with the management of autoimmune diseases by stimulating or suppressing immune function. It is recommended to consult a qualified healthcare professional before starting any treatment with Cordyceps.

Pregnant women: avoid

Avoid due to lack of data

Breastfeeding women: avoid

Avoid due to lack of data