Mushroom Supplement and Medicine Interactions: Documented vs Theoretical
Which medicine interactions with mushroom supplements are documented in people, which come from lab or animal work, and which are only theoretical, by medicine group.
Content last updated . This page has not been medically reviewed.
Safety first. Supplements can cause side effects and interact with medicines. Read mushroom safety and interactions before you use any mushroom product.
Whether a mushroom supplement affects a medicine is a question for your pharmacist, who can see your full medicine list. This page shows how strong the evidence is for each concern, so a theoretical worry is not mistaken for a proven one, and a missing warning is not mistaken for safety. NCCIH states that dietary supplements may interact with your medications. [1] For how interactions are graded across the site, see How Interactions Work and Interactions by Drug Class.
How to read the levels
- Documented in people: seen in a case report or a study of people.
- Lab or animal only: seen in cells or animals; the effect in people is unknown.
- Listed as a caution: a cancer center or reference page lists it, with the evidence behind it unclear or theoretical.
Interactions by medicine group
| Medicine group | Mushroom and form | What the sources say | Level |
|---|---|---|---|
| Blood thinners (warfarin, antiplatelets) | Reishi (Ganoderma lucidum) | Memorial Sloan Kettering tells patients on warfarin to talk to their provider, because reishi can increase bleeding risk. [2] Extracts may prolong clotting tests. [2] But in a trial of healthy volunteers taking reishi capsules (1.5 g daily for 4 weeks) versus placebo, clotting and platelet measures stayed normal. [3] | Mixed: listed caution and lab results, plus one small human trial with no effect in healthy people |
| Blood thinners | Chaga (Inonotus obliquus) | Chaga extract inhibited platelet clumping in mice; clinical relevance is not known. [4] | Lab or animal only |
| Blood thinners | Cordyceps (Ophiocordyceps sinensis) | One case report of excessive bleeding after a tooth extraction in someone using it daily. [5] | Documented in one person |
| Diabetes medicines, insulin | Cordyceps | Laboratory studies suggest additive blood-sugar lowering; clinical relevance is not determined. [5] | Lab only |
| Diabetes medicines | Chaga | Additive blood-sugar lowering in vitro; clinical significance is unknown. [4] | Lab only |
| Immune-suppressing medicines, including transplant medicines | Reishi | Listed as able to enhance immune response; reishi may not be safe for people on immunosuppressants. [2] | Listed caution |
| Immune-suppressing medicines | Agaricus (Agaricus subrufescens, sold as A. blazei) | Authors of two liver-injury case reports proposed that the immune-stimulating action caused injury resembling autoimmune hepatitis. [6] | Case reports, cause proposed |
| Medicines cleared by liver enzymes | Reishi | In vitro, reishi polysaccharides inhibited several enzymes (CYP2E1, CYP1A2, CYP3A); clinical relevance is not known. [2] A triterpenoid extract inhibited enzymes in vitro and changed drug levels in rats. [7] | Lab or animal only |
| Chemotherapy | Reishi (Lingzhi) and Yunzhi extracts | Memorial Sloan Kettering lists a theoretical interaction with chemotherapy that relies on free radicals. [2] A systematic review of 77 clinical studies of Lingzhi (reishi) or Yunzhi with cytotoxic drugs found no reported adverse effects, but study quality was modest and only two pharmacokinetic studies existed. [8] | Mixed; tell the oncology team |
Other situations the sources raise
Alcohol. One 47-year-old developed acute hepatitis after reishi powder and alcohol and recovered fully. [9] This is one case.Blood tests. Reishi spore powder was linked to raised CA72-4, a tumor marker, in three patients, which led to extra tests in two. [10][2] Tell your care team if you take it before cancer blood tests.
Transplant and kidney patients. Reviews of cordyceps used with transplant or dialysis care found that adverse events were mostly not monitored or poorly documented, so those trials cannot show safety. [11][12] See Mushrooms, Autoimmune Conditions and Transplants.
What the sources we read did not describe
We did not find a documented interaction between any mushroom and blood pressure medicines, antidepressants, sedatives or thyroid medicines in the sources we read. That is not proof of safety; many products have not been studied. Treat missing information as unknown, not as safe.What to do
Bring the product label to your pharmacist, and tell them the species, the form (powder, extract, capsule, coffee) and any other supplements. Do not stop or change a prescribed medicine on your own; ask the prescriber. Tell the surgical team before a procedure ([1]). See Before Surgery and With Bleeding Conditions and Talking With a Health Professional.Frequently asked questions
Is reishi dangerous with warfarin?
Cancer-center guidance lists a bleeding caution. [2] A small trial in healthy volunteers found no change in clotting measures. [3] Neither settles it for a person on warfarin, so ask the prescriber or pharmacist.
Can mushroom supplements lower blood sugar?
Lab studies suggest cordyceps and chaga may add to blood-sugar lowering; clinical relevance is unknown. [5][4]
Are mushroom interactions the same as herbal ones?
Not necessarily. Each species and form is separate. See Medicinal Mushrooms vs Adaptogen Herbs.
Do mushroom supplements interfere with cancer treatment?
Evidence is limited. A review found modest-quality studies with no reported adverse effects, and a theoretical concern exists. [8][2] The National Cancer Institute says the FDA has not approved medicinal mushrooms as a cancer treatment. [13]
Where can I check an interaction?
A pharmacist is the best first step. [1]
References
- National Center for Complementary and Integrative Health (NIH). Using Dietary Supplements Wisely. Read 2026-10-23.
- Memorial Sloan Kettering Cancer Center. Reishi Mushroom (About Herbs; last updated May 5, 2026). Read 2026-10-23.
- A prospective, randomized, double-blind, placebo-controlled study of the platelet and global hemostatic effects of Ganoderma lucidum (Ling-Zhi) in healthy volunteers. 2005. PubMed 16037156. Read 2026-10-23.
- Memorial Sloan Kettering Cancer Center. Chaga Mushroom (About Herbs; last updated February 20, 2023). Read 2026-10-23.
- Memorial Sloan Kettering Cancer Center. Cordyceps (About Herbs; last updated February 10, 2022). Read 2026-10-23.
- Drug-induced liver injury associated with Agaricus blazei Murill which is very similar to autoimmune hepatitis. 2013. PubMed 26181451. Read 2026-10-23.
- Triterpenoids from Ganoderma lucidum inhibit cytochrome P450 enzymes interfering with the metabolic process of specific clinical drugs. 2024. PubMed 39619618. Read 2026-10-23.
- Herb-drug interactions between the medicinal mushrooms Lingzhi and Yunzhi and cytotoxic anticancer drugs: a systematic review. 2020. PubMed 32724333. Read 2026-10-23.
- Ganoderma lingzhi (Reishi Mushroom)-Induced Acute Liver Injury in the Setting of Alcohol Use: A Case Report and Review of the Literature. 2023. PubMed 37885515. Read 2026-10-23.
- An abnormal elevation of serum CA72-4 by ganoderma lucidum spore powder. 2013. PubMed 23884232. Read 2026-10-23.
- Efficacy of Cordyceps sinensis as an adjunctive treatment in kidney transplant patients: a systematic review and meta-analysis. 2017. PubMed 28137532. Read 2026-10-23.
- Efficacy of Cordyceps sinensis as an adjunctive treatment in hemodialysis patients: a systematic review and meta-analysis. 2019. PubMed 32186018. Read 2026-10-23.
- National Cancer Institute. Medicinal Mushrooms (PDQ), health professional version. Read 2026-10-23.