Focus

Medicinal Mushrooms in Western and Chinese Herbal Medicine


Date: February 18, 2014 Posted by: Dafydd Monks

Introduction


Traditional Chinese Medicine is one of the oldest medical traditions currently practiced. It has a very large materia medica and formulary, which includes many herbal, mycological, mineral and animal products. In recent years, Western Herbal Medicine has borrowed many herbs from the Chinese materia medica, and certain classes of herbs (most notably the adaptogens) have become cornerstones of Western Herbalists’ treatment strategies for many conditions. However, much lesser used are the non plant based medicines: Mineral and Animal drugs are not considered for use by Western Herbalists, although dietary supplementation could be said to be a use of minerals/trace elements. The exception to this rule is mycological drugs - ‘mushrooms’ or fungi, which, though originally categorised as plants, and thus covered in the scope of botanical or herbal medicine, are actually an entirely different kingdom of life.

Rock paintings found in the Sahara desert attest to a 9000 year history of using mushrooms as an ‘ethnogen’ – as a medicine, for shamanic or religious ceremonies, as a food and as a psychoactive substance.

The use of extracts of microscopic fungi in Western Medicine is widespread: indeed, many of the most widely used and profitable drugs of the 20th Century have been derived from microscopic fungi: the list includes antibiotics, such as penicillin, hypocholesterolaemics such as statins, and immunosuppressant drugs such as cyclosporine.

However, macroscopic fungi have seen little western medicinal use. Due to the wider scope of Chinese and oriental medicine, and the use of many substances which are considered to be foodstuffs in the west, the line between medicine and food is blurred in a western viewpoint, and many fungi would fall under the category of medicinal food. One exception to this is two tincture-extracts used extensively in Western Herbal Medicine: Cordyceps spp. and Ganoderma lucidum. As both are fungi, with differences in biochemistry compared to botanical drugs, and there has been great interest in their use with research conducted into the mechanism of action and clinical efficacy, both of these drugs make an interesting topic.

The common theme between medicinal fungi is that they are adaptogenic: both to adreno cortical stress and to the immune system. This has given medicinal fungi an association with anticancer and anti-tumour activity. In oriental medicine, all three fungi discussed have an association with longevity and good health in senescence. Cordyceps has even been compared to ginseng. But are these potentially valuable therapeutic agents undervalued in the armoury of herbs available to practitioners of western herbal medicine?

Cordyceps


Cordyceps sinensisCordyceps is a genus of about 400 fungi that are endemic to Eastern China and Tibet. They grow in the woods of the cool, forested mountains and hills. The Cordyceps fruiting body grows from the mummified corpse of a previously infected invertebrate: usually a caterpillar which lives underground and is vulnerable to attack by the fungal spores when it sheds its skin in late summer. The fungus grows on the corpse of the caterpillar until the next summer when the fruiting body emerges from the soil as a stalk-like growth (Cordyceps means ‘club headed’ in Latin).

The principle active constituents of Cordyceps are immune stimulating polysaccharides (galactomannins, cordycepic acid), also present are amino acids, fatty acids, polyamines and ecdysterones.


In Chinese Medicine

Cordyceps has a 2000 year history of usage in traditional Tibetan medicine, and was introduced to the Chinese material medica in the 1600s.

It is primarily a relaxing restorative with some degree of astringency: It has a affinities with the respiratory, endocrine, immune, reproductive, musculoskeletal and digestive systems (in western terminology), or lung and kidney Ying or Yang deficiency with stagnation of the air and fluid bodies (In Chinese terminology).

It is primarily used in Chinese medicine for Lung and Kidney Yang deficiency with a symptom picture of ‘wheezing, fatigue, and loss of stamina’. This symptom picture is analogous to adrenocortical deficiency in Western Terminology:  this is an adaptogenic adrenal tonic use in Western terminology.

It is indicated in Lung Yin Deficiency: this is a symptom pattern of coughing with blood tinged sputum and a fatigued state. It is also used in cases of ‘genitourinary cold with Yin deficiency’ – a symptom pattern of weakness, fatigue, night sweats, seminal incontinence and impotence.

From these symptom patterns, it is clear that Cordyceps is a strongly restorative drug, possibly with tonifying properties. Holmes states that it is comparable to Ginseng for its life extending abilities. This suggests that it has a profound effect on building and maintaining foundation energy.


In Western Herbal Medicine

In the university herbal medicine clinic, Cordyceps is used as an immune-stimulating adaptogen. Its western usage is not well established, with TCM informing the Western use. However, compounds from Cordyceps have been the subject of research and much interest in therapeutic use. It is interesting to note that Cyclosporines, the immunosuppressant drugs often used to inhibit organ rejection were discovered in, and originated from Cordyceps subsessilis a European variety of Cordyceps found in Norway. Given that C. sinensis is used as an immune tonic, and that C. subsessilis is used in an inhibitory way, one could extrapolate an amphoteric, balancing effect on the immune system, rather than a purely stimulatory effect.

In addition to adaptogenic properties, Cordyceps is described as having anti asthmatic, antileukemic, antioxidant, hepatoprotective, hypocholesterolaemic, and sedative properties.

Two small studies have been conducted on the reno-protective effects of Cordyceps. In the first study, 54 patients were given aminoglycoside, and a random sample was given a placebo and the other random sample were given an extract of Cordyceps. The group given the Cordyceps extract developed less prominent nephrotoxicity than the placebo group; this was determined by lower levels of NAGase and ?_2-microglobulin in the urine of the Cordyceps group.

In a similar trial of 21 patients who were given amikacin sulphate for 6 days, a random sample were given a Cordyceps, and the remainder were given a placebo. As in Feng’s study, the group which took the Cordyceps had lower levels of NAGase and ?_2-microglobulin, indicating lower kidney toxicity.
The above two studies make the same conclusion: that Cordyceps reduces toxicity to the kidneys and thus can be described as renoprotective.
Cordyceps has been shown to improve the TH1 immune response leading to a reduction in the reaccurrance of genital warts in a study by Gao, Wu, and He.

In an interesting study of 28 patients with chronic renal failure, 3 to 5 grams per day of Cordyceps was shown to improve both renal function and potentially raise immune function which is diminished in chronic renal failure: Thus it could be said that through a supportive action on the tissues of the urinary system the traditional Chinese affinities with toning the kidneys (either as an energetic/constitutional system or the physical organs/tissues) are valid and translatable into the western medical paradigm.

Ganoderma


Ganoderma Lucidum imageGanoderma lucidum is fungus with a large, polypore fruiting body. It grows in China’s coastal regions, and in the northern Forests of North America, though it’s morphology there may be different. It grows on rotting tree stumps and fallen branches.

The principle active constituents of Ganoderma are triterpenes, notably ganoderic and ganoderenic acids, which have a structure similar to steroids. Also present are immune stimulating polysaccharides known as beta glucans, and proteins, specifically a protein known as ling zhi-9.


In Chinese Medicine

Ganoderma has been used as a medicine in China for at least 2000 years: It was first collected in the ‘warring states’ period (3rd Century BCE onwards) and was so rare that it was collected exclusively for monarchs.  It was held in such regard in Japan that it is still referred to as the ’10,000 year mushroom’ or mannentake.

Since the earliest days of its use, Ganoderma has been associated with long life and good health, to the extent of being classed as an ‘elixir of life’. It is also strongly associated with psycho-spiritual wisdom and potency, it’s Chinese name, Ling Zhi actually means ‘Spirit Plant’.

Ganoderma is bitter in taste and has restoring, calming, relaxing and dispersive actions. It has affinities with the nervous, immune, endocrine, digestive, respiratory and circulatory systems; it tones the lung, spleen, liver, heart, and kidney organ systems and moderates the yin/yang balance in those systems
.
It is specific for liver and adrenal Yin deficiency, functionally manifested as a blood and Qi deficiency. This presents as a pattern of chronic, or frequent acute infections, asthenic constitution, fatigue, loss of motivation and low stamina, and exhaustion. It also is indicated in Qi stagnation and constraint – symptom patterns that include fatigue, tight chest, coughing, allergies and a stress response; possibly with circulatory constriction and cold extremities.

The effect on the ‘Chinese’ heart is important here; it stores Shen. This is a balance of psycho spiritual function that includes consciousness, memory, dreams, emotions and subconscious function which combine to form a person’s psychological function. When this balance is disturbed, symptoms such as anxiety, insomnia, listlessness and night-terrors occur. Ganoderma is often prescribed for these conditions alongside other nervine, sedative or adaptogenic herbs as required for the individual case.


In Western Herbal Medicine

Aside from Adaptogenic properties, Ganoderma is hypocholesterolaemic, anti-inflammatory, antioxidant, antiviral, cardiotonic, hepatoprotective, and nervine.

In western herbal medicine, Ganoderma tends to be used for conditions where immune function needs improving or stimulating. The Chinese constitutional use however could inform a western constitutional application for cases of centrally congested immunological heat: This fits with the diffusive action of the herb which could be said to act as an immunological diaphoretic. Bartram lists Ganoderma as being hypotensive; this supports the dispelling of congestion via relaxing the circulatory system; as such one can deduce an amphoteric action on the parasympathetic nervous system through via a reduction in visceral tone. Holmes states that Ganoderma balances immune function and improves the efficiency with which the immune response occurs: this is a rationale for the anticancer effects seen in animal studies. As such it could be seen as an immune-system adaptogen in addition to an immune system stimulant.


Research

Ganoderma has caused interest and excitement due to its apparent anti-cancer and anti-tumour properties. One study examined the effect of Ganoderma on epithelial ovarian cancer cells: an interesting target for evaluation due to that type of cancer being the most fatal gynecological malignancy. The results were encouraging: there was a strong dose-dependant reduction in the number of malignant cells, and importantly, the tendency of those cells to form into a colony was greatly reduced. This effect applied to both chemosensitive and chemoresistant strains of cancer cells. The study indicated that Ganoderma induced cell cycle arrest, and induced apoptosis by activating caspase 3 – suggesting that the antitumour effects of ganoderma work through several different vectors.

A review of Ganoderma suggested that though evidence for clinical use in humans is currently inconclusive, it should certainly not be underestimated and could become a valuable future treatment. The authors concluded that not only does Ganoderma improve immune function, but also has some degree of in vivo anti-tumour activity. In one of the quoted studies, 65% of patients with lung cancer reported an improvement in their quality of life, they were also found to have a raised cellular immune response to the cancer cells.

The adaptogenic qualities of Ganoderma were demonstrated in a trial by Tang in which a Ganoderma extract was given to 132 patients suffering with fatigue, depression, and chronic fatigue immune deficiency syndrome. The reduction in fatigue on the group receiving Ganoderma was 28% less than baseline after 8 weeks of treatment, with wellbeing increasing by 37%.


Discussion

Shiitake GrowingIt is interesting to compare Cordyceps and Ganoderma with the more widely known Japanese culinary mushroom ‘Shiitake’ (Lentinus edodes), which has also shown almost ‘miraculous’ health giving properties. Lentinus has been found to be antibiotic, anti-carcinogenic and antiviral.

Various compounds have been isolated intracellularly (fruiting body and mycelia) and extracellularly (culture media) from Lentinus; some of these substances were lentinan, lectins and eritadenine. Comparing both the actions and the constituents of Lentinus with Cordyceps and Ganoderma is interesting: in Lentinus it is a polysaccharide (Lentinan) which has been attributed with inducing the immune stimulating action and anti-tumour action. Cordyceps also has an immune stimulant polysaccharide component. This makes an interesting connection to the botanical immune stimulants, as it is a similar polysaccharide, inulin, that is found in the roots of Inula helenium which gives it immune stimulating properties! By comparison, despite having similar effects to Lentinus, Ganoderma principally produces triterpenes which have been attributed with exerting the therapeutic effects, although polysaccharides are also produced.

Wild ShiitakeGiven the regard in which Cordyceps, Ganoderma, and Lentinus, are held by practitioners of Oriental medicine especially for strengthening and maintaining vitality, perhaps these medicinal ‘mushrooms’ deserve more attention. Since the term ‘Adaptogen’ entered the vocabulary of the western herbal medicine practitioner a generation ago, and the widespread adoption of oriental herbs such as Panax ginseng, Eleuthrococcus senticosus and Schisandra chinensis, and their subsequent inclusion in many western herbal prescriptions, the mind set of western herbalists has changed somewhat. Although Cordyceps and Ganoderma are expensive in tincture form, there are undoubtedly cases in which they are very strongly indicated. Evaluating cases in which adaptogens and immune supportive herbs have been used in the clinic, at least half of them could benefit from the inclusion of one of the aforementioned medicinal fungi. Cases in which cancer or long term immune deficiency are present immediately spring to mind.  

Further Reading.


This article was written as an essay which can be downloaded as a PDF here. The PDF contains all citations and a full reference list.