Reishi – Ganoderma lucidum

Japanese name – Reishi or Mannetake (10,000 year mushroom)
Chinese name – Ling Zhi (spirit mushroom – mushroom of spritual potency)

The most famous of all the medicinal mushrooms with annual sales of over US$2billion, G. lucidum’s wide-ranging health benefits are due to its combination of high polysaccharide content (Stamets reports the fruiting body to contain 41% beta-glucan) and triterpenoid compounds^1-4. Over 130 of these have been identified, belonging primarily to two families: ganoderic and lucidenic acids with functions including:

Levels of triterpenes are particularly high in G. lucidum spores, typically >2.0% in shellbroken spore powder and >30% in the spore oil and recent studies report promise for the spores and spore oil as anti-cancer and neuroprotective agents^5-8.
G. lucidum shows exceptionally high tyrosinase inhibition with the highest activity in the aqueous extract. This has led to its inclusion in many commercial skin whitening products and has medical implications, especially in relation to Parkinson’s Disease (see discussion under Parkinson’s Disease)^9-11.
A number of related species have also been investigated with polysaccharides and triterpenes from both Ganoderma tsugae and Ganoderma applanatum showing similar anti-tumour, anti-inflammatory, immune-modulatory and hepatoprotective activity to those from G. lucidum and Ganoderma japonicum showing neuroprotective properties^12-21.

CANCER – G. lucidum has a long history of traditional use in the treatment of cancer and is credited with many cases of spontaneous remission^{22, 23}. As well as the immune modulating effect of its high polysaccharide content, its triterpenes show significant cytotoxic activity against different cancer cell lines, as well as inhibitory effects against Epstein-Barr virus, known to be associated with some cancers^24-35. In addition triterpenes from G. lucidum show inhibition of the nuclear transcription factor, NF-kappaB (NF-kB), which is overexpressed in various cancer cell lines, and also theAP-1 signalling pathway³⁶.
Inhibition of NF-kB is of particular importance in the activity of G. lucidum against breast and prostate cancers as it is considered to play an essential role in the hormone independent growth and spread of these cancers^37,38. In addition G. lucidum triterpenes have been shown to block the androgen receptor on prostate cancer cells, supporting G.lucidum’s use in the treatment of prostate cancer.
Clinical studies with G. lucidum polysaccharide extract confirm its ability to enhance immune status in cancer patients with increases in NK cell activity and Th1 cytokine levels and decreases in Th2 cytokine levels in advanced lung cancer patients, and reduction in side effects when given alongside chemotherapy and radiotherapy^39-41.
In vitro and in vivo studies also indicate significant anti-tumour activity for the triterpenerich G. lucidum spore powder and spore oil^5,42-46. A randomized controlled trial of 48 breast cancer patients reported reductions in fatigue, anxiety and depression in the treatment group (3g/day G. lucidum spore powder), together with improvements in immune parameters⁴⁷.

ALLERGIES – As well as immunomodulatory activity, G. lucidum demonstrates strong anti-inflammatory activity with suppression of tumour necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), the inflammatory mediator nitric oxide (NO) and prostaglandin E2, mediated through inhibition of the NF-kB andAP-1 signaling pathways. This combination of immunomodulatory and anti-inflammatory activity contributes to its efficacy in the treatment of allergies and other inflammatory conditions^48-51. G. lucidum is a component of FAHF-2, a Chinese herbal formula that has been reported to completely block anaphylactic reactions in a mouse model of peanut allergy⁵².

LIVER DISEASE – The fruiting body of G. lucidum has long been a popular traditional treatment for liver diseases and demonstrates wide hepatoprotective properties^53-59. It appears that at least part of its action in this regard may be through the ability of G. lucidum triterpenes to block platelet-derived growth factor beta receptor (PDGFbetaR), thus inhibiting the activation and proliferation of hepatic stellate cells, a key event in hepatic fibrosis^60. G. lucidum is also traditionally used in the treatment of hepatitis and in a clinical study of 355 cases of hepatitis B treated with Wulingdan Pill, of which G. lucidum is the major component, 92.4% of patients were reported to have positive results⁶¹. Again, it appears that triterpenes are the key components^62,63.

HYPERTENSION – G. lucidum has a broad range of action on cardiovascular health. Polysaccharides and triterpenes isolated from G. lucidum have shown hyperlipidaemic, hypotensive, and anti-thrombotic effects while a polysaccharide preparation (Ganopoly) led to improved ECG and lowered chest pain, palpitation and shortness of breath in a double-blind, randomized, multi-centre study⁶⁴. MildACE-inhibitory activity has also been demonstrated for some of G. lucidum’s triterpenoid compounds^65,66.

INSOMNIA/ANXIETY – The traditional name ‘spirit mushroom’ points to the sedative action of its triterpenoid components and many herbalists value its benefits in cases of insomnia. Christopher Hobbs recommends G. lucidum for deficiency insomnia while Mizuno recommends it for ‘mental stabilisation’^67-70.

RHEUMATOID ARTHRITIS – G. lucidum’s combination of immuno-modulatory and anti-inflammatory action suggests potential application in the treatment of autoimmune conditions such as rheumatoid arthritis and a proteoglycan fraction from G. lucidum has been shown to inhibit production of rheumatoid arthritis synovial fibroblasts in vitro, in part through inhibition of the NF-kB transcription pathway⁷¹.

NEURO-PROTECTIVE – Traditionally considered to promote longevity, G. lucidum extract has been shown to inhibit beta-amyloid synaptic toxicity with potential benefits in Alzheimer’s disease⁷². Both polysaccharides and triterpenes from G. lucidum exhibit neuroprotective and anticonvulsant effects at levels of 10-80mg/kg while G. lucidum spores have shown ability to protect neurons from apoptosis and improve cognitive dysfunction in vivo^73-77.

ANTI-AGEING – Traditionally known as the ‘mushroom of immortality’, G. lucidum’s broad-spectrum cardiovascular, neurological and immunological benefits, together with its support for blood sugar and cholesterol control^79-82, contribute to its anti-ageing properties.

CLINICAL SUMMARY
Main Therapeutic Applications – Allergies, liver support, cancer (especially breast and prostate), hypertension, anxiety/insomnia. Together with Cordyceps sinensis, G. lucidum has the most extensive range of indications and combines well with it in treatment of lung and liver conditions, as well as to provide all-round adaptogenic support.
Key Components – Triterpenes and polysaccharides.
Dose – Traditional materia medica recommend a dose range for crude G. lucidum of 3-15g/day in decoctions or 1.5-3g as powder or in pills while doses of up to 30g/day have been reported and 5.4g/day of polysaccharide extract and 3.0g/day and G. lucidum spore powder have been used in clinical trials^23,47,82-84.
Dose range for dual-extraction products combining polysaccharide-rich hot-water and triterpene-rich ethanolic (alcohol-based) extracts is typically 1-3g/day while 500-1,000mg/day is normal for G. lucidum spore oil products.
Caution – Patients on anti-coagulantmedication should bemonitored due to G.lucidum’s actions in this area although a study of G. lucidum supplementation (1.5g/day) in healthy volunteers showed no effect on haemostatic function^85,86.

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