Mycotherapy: Medicinal Mushroom Therapy

Introduction to Mycotherapy

Mycotherapy, from the Greek mykes (mushroom) and therapeia (care), constitutes one of humanity's oldest therapeutic disciplines. This approach relies on the reasoned use of medicinal mushrooms — also referred to as functional mushrooms — to prevent, support, or treat various pathologies. Far from being a recent trend, mycotherapy draws its roots from over two millennia of documented practice, primarily in Traditional Chinese Medicine (TCM), Indian Ayurvedic medicine, and traditional Japanese and Korean pharmacopeias.

Medicinal mushrooms distinguish themselves from ordinary culinary mushrooms through their exceptional richness in bioactive compounds: beta-glucans, triterpenes, polysaccharides, lectins, ergosterol, and phenolic compounds. These molecules exert documented pharmacological actions on the immune system, metabolism, nervous system, and inflammatory mechanisms. Modern scientific research, particularly since the 1960s in Japan with work on shiitake lentinan, has considerably strengthened the credibility of this approach by identifying the molecular and cellular mechanisms of action involved.

Today, mycotherapy is experiencing remarkable growth in the West, driven by the convergence between ancestral traditional knowledge and advances in modern mycology. University research centers in Europe, the United States, and Asia actively continue studying the therapeutic properties of medicinal mushrooms, with promising results in the fields of integrative oncology, neurology, and chronic stress management.

Fundamental Principles and History

The history of mycotherapy dates back over 2,000 years in Traditional Chinese Medicine. The Shennong Bencao Jing (Classic of the Divine Farmer's Materia Medica), written between the first and second centuries CE, already mentions reishi (Ganoderma lucidum) as a superior substance capable of prolonging life and harmonizing vital functions. The mushroom is classified among the noblest remedies — those that can be consumed over long periods without adverse effects.

In Japan, the mycotherapeutic tradition developed in parallel, with particular attention given to shiitake (Lentinula edodes), cultivated since the 12th century on wooden logs. The physician Wu Rui, during the Ming Dynasty (14th century), documented the use of shiitake to stimulate qi (vital energy) and strengthen disease resistance. In Russia and Siberia, chaga (Inonotus obliquus) had been used since the 16th century as a general tonic and folk remedy against tumors.

The major scientific turning point occurred in the 1960s when Dr. Chihara and his team at the National Cancer Center Research Institute in Tokyo isolated lentinan, a beta-glucan from shiitake, and demonstrated its antitumor properties in animal models. This discovery paved the way for a series of clinical studies that led to the approval of lentinan as an adjuvant medication in oncology in Japan in 1985. Simultaneously, PSK (polysaccharide-K) extracted from turkey tail (Trametes versicolor) was approved as an immunostimulant in oncology in Japan as early as 1977.

The fundamental principles of mycotherapy rest on several key concepts. First, the principle of synergy: medicinal mushrooms contain hundreds of bioactive compounds that act in concert, and the total extract often exhibits greater activity than isolated molecules. Second, the principle of bidirectional immunomodulation: unlike conventional immunostimulants, medicinal mushrooms can both stimulate deficient immunity and modulate an excessive immune response. Third, the principle of adaptogenicity: many medicinal mushrooms help the body adapt to different forms of stress (physical, chemical, biological, psychological) by normalizing disrupted physiological functions.

Technical Aspects and Bioactive Compounds

Medicinal mushrooms owe their therapeutic activity to a remarkable diversity of bioactive compounds. Beta-glucans constitute the most studied class. These are polysaccharides composed of glucose chains linked in beta-1,3 with beta-1,6 branches. This particular three-dimensional structure is recognized by innate immunity receptors, notably Dectin-1 receptors and complement receptor 3 (CR3) located on macrophages, dendritic cells, and NK (Natural Killer) cells.

When beta-glucans bind to these receptors, they trigger an intracellular signaling cascade that leads to immune cell activation, production of pro-inflammatory cytokines (TNF-alpha, IL-1, IL-6), and stimulation of phagocytosis. Remarkably, this stimulation is physiological and regulated, which distinguishes beta-glucans from conventional immune stimulants that can cause deleterious overactivation of the immune system.

Triterpenes, abundant in reishi and chaga, constitute another major class of bioactive compounds. The ganoderic acids of reishi, numbering over 130 identified to date, exert anti-inflammatory activities by inhibiting histamine release, hepatoprotective activities by protecting hepatocytes against oxidative stress, and antitumor activities by inducing apoptosis in cancer cells and inhibiting tumor angiogenesis.

High molecular weight polysaccharides, beyond beta-glucans, include heteropolysaccharides, glycoproteins, and proteoglycans. PSK and PSP from turkey tail, lentinan from shiitake, and ganoderan from reishi are examples of polysaccharides that have undergone extensive clinical studies. Their mechanism of action involves not only direct stimulation of immune cells but also modulation of the intestinal microbiota, as non-digestible polysaccharides serve as prebiotics for beneficial bacteria in the colon.

Other compounds of interest include ergothioneine, a sulfur amino acid with exceptional antioxidant properties found in many medicinal mushrooms; natural statins (such as lovastatin from oyster mushroom) that contribute to cholesterol regulation; cordycepin (3'-deoxyadenosine) from cordyceps, a nucleoside analog with antiviral, anti-inflammatory, and antitumor properties; and hericenones and erinacines from lion's mane (Hericium erinaceus), which cross the blood-brain barrier and stimulate nerve growth factor (NGF) synthesis.

The quality of mycotherapy products depends on several crucial technical factors. The growth substrate directly influences the composition of active principles: mushrooms grown on wood or enriched substrates generally present bioactive profiles closer to their wild counterparts than those grown on cereal grain. The part of the mushroom used is also determinant: the mycelium (vegetative part) and the carpophore (fruiting body) do not contain the same proportions of active compounds. The type of extraction (hydroalcoholic, aqueous, supercritical CO2) determines which compounds will be present in the final extract, with beta-glucans being water-soluble while triterpenes require alcoholic extraction.

Indications and Clinical Applications

The indications for mycotherapy are vast and supported by a growing body of scientific data. Immunomodulation represents the best-documented field of application. Medicinal mushrooms are used as adjuncts to conventional oncological treatments to reduce the side effects of chemotherapy and radiotherapy, improve patient quality of life, and potentiate the effects of anticancer treatments. In Japan and China, lentinan, PSK, and PSP are officially approved as oncology adjuvants, with clinical studies involving thousands of patients with gastric, colorectal, and lung cancers.

Recurrent infections represent another major indication. Beta-glucans from medicinal mushrooms strengthen both mucosal and systemic immunity, resulting in reduced frequency and severity of respiratory, urinary, and ENT infections. Randomized clinical studies have shown that supplementation with yeast or mushroom beta-glucans significantly reduces the number of respiratory infection days in adults and children during winter periods.

Chronic stress and exhaustion represent a domain where the adaptogenic properties of medicinal mushrooms are particularly relevant. Reishi, cordyceps, and lion's mane have demonstrated anxiolytic, antidepressant, and neuroprotective effects in preclinical models and pilot studies in humans. Cordyceps improves aerobic capacity and reduces subjective fatigue, while lion's mane improves cognitive functions and reduces anxiety and depressive symptoms.

Metabolic disorders also benefit from mycotherapeutic support. Maitake (Grifola frondosa) contains polysaccharide fractions (D-fraction and SX-fraction) that improve insulin sensitivity and contribute to glycemic regulation. Shiitake and oyster mushroom, through their natural statins and eritadenine, participate in cholesterol regulation. Chaga, rich in phenolic compounds, exerts antioxidant and anti-inflammatory activity that may contribute to cardiovascular protection.

Digestive health constitutes an emerging domain in mycotherapy. Non-digestible polysaccharides from medicinal mushrooms exert a documented prebiotic effect, promoting the growth of bifidobacteria and lactobacilli at the expense of pathogenic species. Lion's mane presents particular interest for gastrointestinal health, with studies showing improvement in chronic gastritis symptoms and protection of gastric mucosa against lesions induced by Helicobacter pylori and non-steroidal anti-inflammatory drugs.

Course of a Mycotherapy Consultation

The mycotherapy consultation begins with a thorough assessment of the patient's health status. The practitioner collects the complete medical history, including personal and family medical background, current treatments, dietary supplements already in use, and lifestyle habits. A specific questionnaire evaluates various physiological functions: immunity, digestion, sleep, energy, cognitive functions, emotional state, pain, and inflammation.

Terrain assessment constitutes a fundamental step. The practitioner identifies underlying functional imbalances contributing to the patient's symptoms. This holistic approach allows selection of the most suitable medicinal mushrooms for the individual patient profile rather than limiting to a symptomatic approach. For example, a patient presenting with chronic fatigue, recurrent infections, and digestive disorders may benefit from a combination of reishi (immune modulation and stress management), cordyceps (cellular energy), and lion's mane (gut-brain axis).

The practitioner then develops a personalized protocol specifying the selected mushrooms, recommended galenic forms (whole mushroom powder, standardized extract, mother tincture), daily dosages, and protocol duration. Mycotherapy protocols generally span three to six months, with regular symptom reassessment and prescription adjustments.

The initial consultation typically lasts between 60 and 90 minutes. Follow-up consultations, scheduled every four to six weeks, last between 30 and 45 minutes and allow evaluation of symptom progression, protocol tolerance, and the need for adjustments. The practitioner ensures the compatibility of medicinal mushrooms with current drug treatments, as certain interactions are documented, particularly with anticoagulants, immunosuppressants, and oral antidiabetics.

Patient education is an integral part of the care pathway. The practitioner explains to the patient the mechanisms of action of the selected mushrooms, the quality criteria to verify when purchasing supplements, and the rules for proper use. They emphasize that mycotherapy is part of a global health approach including nutrition, physical activity, stress management, and sleep.

Variants and Complementary Approaches

Mycotherapy comes in several approaches reflecting different traditions and scientific advances. The traditional Chinese approach integrates medicinal mushrooms within the TCM conceptual framework, classifying them according to their flavor, thermal nature, and organ tropisms. Reishi, neutral in nature and bitter in flavor, is directed toward the heart, liver, and lung; cordyceps, warm in nature and sweet in flavor, is oriented toward the kidney and lung. This classification enables individualized prescriptions based on the patient's energetic assessment.

The modern Western mycotherapeutic approach relies more heavily on pharmacological and clinical data. It favors extracts standardized for active principles (beta-glucans, triterpenes) and fits within an evidence-based integrative medicine framework. Protocols are established according to validated clinical indications and available levels of evidence for each mushroom and each condition.

Combinatorial mycotherapy represents a growing trend. It combines several medicinal mushrooms with complementary properties in synergistic formulations. For example, the reishi-maitake-shiitake combination is frequently used as oncological support for its complementary immunomodulatory effects, while the cordyceps-lion's mane-reishi association is proposed for cognitive performance optimization and stress management.

Integration with other natural health disciplines enriches mycotherapeutic practice. Association with phytotherapy allows combining the immunomodulatory polysaccharides of mushrooms with the antioxidant polyphenols of plants. Association with micronutrition optimizes the bioavailability of active compounds and corrects nutritional deficiencies that may limit the effectiveness of the mycotherapeutic protocol. Association with aromatherapy adds a direct anti-infectious dimension through essential oils.

Veterinary mycotherapy constitutes a rapidly expanding field of application. Beta-glucans and medicinal mushroom extracts are increasingly used in companion animals and horses for immune support, tumor management, and overall vitality improvement, with encouraging clinical outcomes.

Contraindications and Precautions

Although medicinal mushrooms generally present a favorable safety profile, several contraindications and precautions must be observed. Patients undergoing immunosuppressive treatment (organ transplantation, severe autoimmune diseases treated with biotherapy) should avoid mushrooms with strong immunostimulatory activity, as they could interfere with the effectiveness of immunosuppressive treatment or trigger graft rejection.

Patients on oral anticoagulants (warfarin, acenocoumarol) or antiplatelet agents should use reishi with caution, as the triterpenes of this mushroom possess antiplatelet properties that could potentiate the anticoagulant effect and increase bleeding risk. Close biological monitoring of INR is recommended when combining these treatments.

Individuals allergic to culinary mushrooms carry a theoretical risk of cross-reaction with medicinal mushrooms. A tolerance test with a minimal dose is recommended before initiating a complete protocol. Documented allergic reactions include cutaneous manifestations (urticaria, eczema), digestive disorders, and, exceptionally, anaphylactic reactions.

Pregnant and breastfeeding women should refrain from consuming medicinal mushrooms in the absence of sufficient safety data for these populations. Although reproductive toxicity has not been demonstrated for most medicinal mushrooms, the precautionary principle applies, and available clinical data are insufficient to guarantee safety during pregnancy and lactation.

Diabetic patients on hypoglycemic treatment should be informed that certain medicinal mushrooms (maitake, coprinus, reishi) possess hypoglycemic properties that could potentiate the effect of antidiabetic medications and lead to hypoglycemic episodes. Enhanced glycemic monitoring and medication dosage adjustment may be necessary.

Finally, the quality of mycotherapy products constitutes a major concern. Mushrooms are bioaccumulators that concentrate heavy metals, pesticides, and pollutants present in their growth environment. It is imperative to choose certified organic products, analyzed for contaminants, and produced according to good manufacturing practices. Extracts standardized for beta-glucans with an independent certificate of analysis offer the best guarantee of quality and efficacy.