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Updated 18 February 2013

Cordyceps (Cordyceps sinensis)

Cordyceps sinensis, the Cordyceps species most widely used as a dietary supplement, naturally grows on the back of the larvae of a caterpillar from the moth Hepialus armoricanus Oberthur found mainly in China, Nepal, and Tibet. The mycelium invades the caterpillar and eventually replaces the host tissue. The stroma (fungal fruit body) grows out of the top of the caterpillar. The remaining structures of the caterpillar along with the fungus are dried and sold as the dietary supplement cordyceps.

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RELATED TERMS

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BACKGROUND

Cordyceps sinensis, the Cordyceps species most widely used as a dietary supplement, naturally grows on the back of the larvae of a caterpillar from the moth Hepialus armoricanus Oberthur found mainly in China, Nepal, and Tibet. The mycelium invades the caterpillar and eventually replaces the host tissue. The stroma (fungal fruit body) grows out of the top of the caterpillar. The remaining structures of the caterpillar along with the fungus are dried and sold as the dietary supplement cordyceps.

Commonly known as "dong chong xia cao" (summer-plant, winter-worm) in Chinese, cordyceps has been used as a tonic food in China and Tibet and has been used as a food supplement and tonic beverage among the rich because of its short supply due to over harvesting. It is also an ingredient in soups and other foods used traditionally in Chinese medicine for thousands of years helping debilitated patients recover from illness.

Cordyceps is used therapeutically for asthma, bronchitis, chemoprotection, exercise performance, hepatitis B, hepatic cirrhosis, hyperlipidemia (high cholesterol), as an immunosuppressive agent, and in chronic renal failure.

The fungus became popular in 1993 when two female Chinese athletes, who admitted using cordyceps supplements, beat the world records in the track and field competition at the Stuttgart World Championships for the 1,500-, 3,000-, and 10,000-meter runs. The women were drug tested for any banned substances such as steroids and were negative. Their coach attributed the performance to the cordyceps supplementation.

EVIDENCE TABLE

Conditions

Uses
disclaimer: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Grade*

Hepatitis B

Cordyceps may stimulate the immune system and improve serum gamma globulin levels in hepatitis B patients. Currently, there is insufficient evidence to recommend for or against the use of cordyceps for chronic hepatitis B. However, the results are promising. Additional study of cordyceps and current hepatitis treatments is needed.

B

Hyperlipidemia (high cholesterol)

Cordyceps may lower total cholesterol and triglyceride levels, although these changes may not be permanent or long lasting. Longer studies with follow up are needed to determine the long-term effects of cordyceps on hyperlipidemia.

B

Anti-aging

Cordyceps may improve various symptoms related to aging. However, higher quality studies testing specific symptoms of aging are needed before the effects of cordyceps can be described. Currently, there is insufficient evidence to recommend for or against the use of cordyceps for anti-aging.

C

Asthma

Cordyceps may reduce some asthma symptoms. Additional studies are needed to make a firm recommendation.

C

Bronchitis

There is insufficient evidence from controlled clinical trials to recommend for or against the use of cordyceps for bronchitis. Most studies using cordyceps have found improved symptoms with cordyceps more than the control drugs. Although results are promising, more studies should be performed before a firm recommendation can be made.

C

Chemoprotective

There is insufficient evidence to recommend for or against the use of cordyceps as a chemoprotective agent in aminoglycoside toxicity. However, the results are promising.

C

Exercise performance enhancement

In 1993, two female Chinese athletes, who admitted using cordyceps supplements, beat the world records in the track and field competition at the Stuttgart World Championships for the 1,500-, 3,000-, and 10,000-meter runs. However, there is insufficient evidence from conflicting controlled clinical trials to recommend for or against the use of cordyceps for improving exercise performance. More studies are needed in this area.

C

Immunosuppression

Two studies using combination herbal treatments that included cordyceps indicate that these combinations suppressed the immune system in kidney transplant and lupus nephritis patients. However, as these treatments used combination products, the effect of cordyceps cannot be defined. More studies with cordyceps as a monotherapy are needed.

C

Renal failure (chronic)

In traditional Chinese medicine, cordyceps is used to strengthen kidney function. Two studies indicate that cordyceps may improve renal function in patients with chronic renal failure. More studies are needed to confirm these findings.

C

Sexual dysfunction

There is not enough available scientific evidence in this area.

C

*Key to grades: A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

TRADITION

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below. Addiction (opiates), Alzheimer's disease, anemia, anti-inflammatory, antioxidant, arrhythmia (irregular heartbeat), atherosclerosis (hardening of the arteries), bone marrow production, cancer, cardiovascular disease, cough, diabetes, fatigue, fertility, hematopoiesis (formation of blood cells), hemorrhage, hypertension (high blood pressure), longevity, lower backache, memory, menstruation irregularities, mucilage, muscle weakness, nephritis (inflammation of kidneys), neurodegeneration, night sweats, radiation protection, respiratory disease, senility (weakness), systemic lupus erythematosus (SLE), tinnitus, tonic, tranquilizer, tuberculosis, urinary incontinence (nocturia).

DOSING

disclaimer: The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

Typical doses of cordyceps are 3-9 grams daily of fermented cordyceps (eg. Cs-4 extract, CordyMax©), which have been given for up to 4-8 weeks. These doses have been used for antiaging, chronic renal failure, hepatitis, and as a chemoprotective or performance enhancer. Lower doses of 999 milligrams taken in three 333-milligram capsules have been studied for hyperlipidemia (high cholesterol).

Children (younger than 18 years)

There is no proven safe or effective dose for cordyceps in children, and use is not recommended.

SAFETY

disclaimer: The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to cordyceps, mold, or fungi.

Side Effects and Warnings

Minimal side effects have been reported with the use of cordyceps in humans. Cordyceps is likely safe when used in patients with asthma, bronchitis, hepatitis B, hepatic cirrhosis, hyperlipidemia (high cholesterol), immunosuppression, and chronic renal (kidney) failure. It is also likely safe when used as a chemoprotective agent or an exercise performance enhancer, although more study is needed to confirm these findings.

Cordyceps may cause dry mouth, nausea, loss of appetite, diarrhea, or dizziness. Due to the increasing popularity of Cordyceps sinesis, some supplements have been adulterated; some manufacturers substitute other species of cordyceps. The safety of these supplements is not known.

When taken by mouth, cordyceps (jin shiubao capsules) may cause tightness in the chest, wheezing or palpitations. The symptoms may be alleviated after administration of an antihistamine. Skin rashes have also been observed.

Although not well studied in humans, cordyceps's polysaccharides may increase corticosteroid production. Cordyceps may also increase 17beta-estradiol and stimulate progesterone production. It may also inhibit platelet aggregation, and increase the risk of bleeding.

Use cautiously in patients with prostate conditions or in individuals taking immunosuppressive medications, hormonal replacement therapy or birth control. Avoid in patients with myelogenous-type cancers based on reports of cordyceps causing proliferation of progenitor red blood cells.

Pregnancy and Breastfeeding

Cordyceps is not recommended in pregnant or breastfeeding women due to lack of available scientific evidence. Cordyceps may be possibly unsafe in pregnant women, as it may affect steroid hormone levels.

INTERACTIONS

disclaimer: Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Concomitant administration of cordyceps and aminoglycosides may reduce amikacin-induced nephrotoxicity (kidney damage) in older people.

Cordyceps may reduce heart rate. Caution is advised in patients with heart disease or those taking antiarrhythmic agents.

Although not well studied in humans, cordyceps may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin©) or heparin, anti-platelet drugs such as clopidogrel (Plavix©), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin©, Advil©) or naproxen (Naprosyn©, Aleve©).

Cordyceps may induce sex steroid-like effects. Patients taking hormonal replacement therapy or birth control pills should use cordyceps with caution.

Cordyceps may stimulate the immune system and may decrease the efficacy of immunosuppressants, such as prednisolone or cyclophosphamide.

Use of cordyceps with cyclosporin may reduce nephrotoxicity (kidney damage) in kidney-transplanted patients. Furthermore, administration of cordyceps and gentamycin may return blood urea nitrogen (BUN), serum creatinine (SCr), sodium excretion, and urinary NAGase to more normal ranges during drug-induced nephrotoxicity (kidney toxicity). Concomitant administration of cordyceps with kidney-damaging drugs may reduce amikacin-induced kidney damage in older people.

Cordyceps may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.

Cordyceps may lower blood pressure. Caution is advised when using medications that may also lower blood pressure. Patients taking drugs for blood pressure, such as ACE inhibitors, should be monitored closely by a qualified healthcare professional, including a pharmacist.

Preliminary evidence suggests that cordyceps may have additive effects when used with medications that lower cholesterol. Caution is advised.

Cordyceps mycelium extracts may inhibit monoamine oxidase type B. Patients taking MAOIs (monoamine oxidase inhibitors, a class of antidepressants) such as isocarboxazid (Marplan©), phenelzine (Nardil©), tranylcypromine (Parnate©) should consult with a qualified healthcare professional, including a pharmacist, before combining therapies.

Interactions with Herbs and Dietary Supplements

Cordyceps may reduce heart rate. Caution is advised in patients with heart disease or those taking antiarrhythmic agents.

Although not well studied in humans, cordyceps may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Cordyceps may induce sex steroid-like effects. Patients taking herbs and supplements with potential hormonal effects, such as black cohosh or St. John's wort, should use cordyceps with caution.

Cordyceps may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Cordyceps may lower blood pressure. Caution is advised when using herbs or supplements that may also lower blood pressure.

Cordyceps may stimulate the immune system and may decrease the efficacy of immunosuppressants.

Preliminary evidence suggests that cordyceps may have additive effects when used with herbs or supplements that lower cholesterol, such as red yeast rice. Caution is advised.

Cordyceps mycelium extracts may inhibit monoamine oxidase type B. Caution is advised in patients taking herbs and supplements with potential MAOI (monoamine oxidase inhibitor, anti-depressant) activity. Consult with a qualified healthcare professional, including a pharmacist, before combining therapies.

ATTRIBUTION

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

  • Chen J, Zhang W, Lu T, et al. Morphological and genetic characterization of a cultivated Cordyceps sinensis fungus and its polysaccharide component possessing antioxidant property in H22 tumor-bearing mice. Life Sci 5-1-2006;78(23):2742-2748. View abstract
  • Kim HG, Shrestha B, Lim SY, et al. Cordycepin inhibits lipopolysaccharide-induced inflammation by the suppression of NF-kappaB through Akt and p38 inhibition in RAW 264.7 macrophage cells. Eur J Pharmacol 9-18-2006;545(2-3):192-199. View abstract
  • Kunwar RM, Nepal BK, Kshhetri HB, et al. Ethnomedicine in Himalaya: a case study from Dolpa, Humla, Jumla and Mustang districts of Nepal. J Ethnobiol Ethnomedicine 2006;2:27. View abstract
  • Lee H, Kim YJ, Kim HW, et al. Induction of apoptosis by Cordyceps militaris through activation of caspase-3 in leukemia HL-60 cells. Biol Pharm Bull. 2006;29(4):670-674. View abstract
  • Li FH, Liu P, Xiong WG, Xu GF. [Effects of Cordyceps sinensis on dimethylnitrosamine-induced liver fibrosis in rats]. Zhong Xi Yi Jie He Xue Bao 2006;4(5):514-517. View abstract
  • Li SP, Yang FQ, Tsim KW. Quality control of Cordyceps sinensis, a valued traditional Chinese medicine. J Pharm Biomed Anal 8-28-2006;41(5):1571-1584. View abstract
  • Li SP, Zhang GH, Zeng Q, et al. Hypoglycemic activity of polysaccharide, with antioxidation, isolated from cultured Cordyceps mycelia. Phytomedicine 2006;13(6):428-433. View abstract
  • Liu WC, Wang SC, Tsai ML, et al. Protection against radiation-induced bone marrow and intestinal injuries by Cordyceps sinensis, a Chinese herbal medicine. Radiat Res 2006;166(6):900-907. View abstract
  • Rukachaisirikul V, Chantaruk S, Tansakul C, et al. A cyclopeptide from the Insect pathogenic fungus Cordyceps sp. BCC 1788. J Nat Prod 2006;69(2):305-307. View abstract
  • Wang NQ, Jiang LD, Zhang XM, et al. [Effect of dongchong xiacao capsule on airway inflammation of asthmatic patients]. Zhongguo Zhong Yao Za Zhi 2007;32(15):1566-1568. View abstract
  • Wu WC, Hsiao JR, Lian YY, et al. The apoptotic effect of cordycepin on human OEC-M1 oral cancer cell line. Cancer Chemother Pharmacol 10-10-2006. View abstract
  • Wu WC, Hsiao JR, Lian YY, et al. The apoptotic effect of cordycepin on human OEC-M1 oral cancer cell line. Cancer Chemother Pharmacol 2007;60(1):103-111. View abstract
  • Yoo O, Lee DH. Inhibition of sodium glucose cotransporter-I expressed in Xenopus laevis oocytes by 4-acetoxyscirpendiol from Cordyceps takaomantana (anamorph = Paecilomyces tenuipes). Med Mycol 2006;44(1):79-85. View abstract
  • Yu HM, Wang BS, Huang SC, Duh PD. Comparison of protective effects between cultured Cordyceps militaris and natural Cordyceps sinensis against oxidative damage. J Agric Food Chem 4-19-2006;54(8):3132-3138. View abstract
  • Zhang G, Huang Y, Bian Y, et al. Hypoglycemic activity of the fungi Cordyceps militaris, Cordyceps sinensis, Tricholoma mongolicum, and Omphalia lapidescens in streptozotocin-induced diabetic rats. Appl Microbiol Biotechnol 2006;72(6):1152-1156. View abstract
disclaimer: Natural Standard Bottom Line Monograph, Copyright © 2011 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions. disclaimer: While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy. disclaimer: The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Copyright © 2011 Natural Standard (www.naturalstandard.com)



Copyright © 2011 Natural Standard (www.naturalstandard.com)
 
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