Reishi is the Japanese name for Ganoderma lucidum and closely related Ganoderma species, a woody, shiny, reddish-brown bracket fungus that grows on trees and stumps. In China it is called lingzhi. It has been used in East Asian traditional medicine for more than 2,000 years and is now sold worldwide as powders, extracts, spore products and teas marketed for immunity, stress, sleep, “vitality” and recovery.
The most important fact is that reishi’s health claims have not held up in the better-controlled human trials. A Cochrane review of its use in cancer found no good evidence to support it as a first-line treatment, and a second Cochrane review found no effect on blood sugar, cholesterol or blood pressure in people with type 2 diabetes. Reishi is usually well tolerated in short trials, but rare cases of acute liver injury, including one death, have been reported, mostly with powdered products.
This page summarizes what the clinical trials, systematic reviews, case reports and regulators report. It is for education only and is not medical advice.
| Property | Detail |
|---|---|
| Type | Medicinal fungus (Ganoderma lucidum, G. lingzhi); fruiting body, mycelium or spores are used |
| Other names | Lingzhi, ling zhi, mannentake, yeongji |
| Forms sold | Ground fruiting-body powder, hot-water or ethanol extracts, spore powder and spore oil, tea, multi-ingredient blends |
| Doses used in trials | From 6 mg/day of a concentrated extract to 6 g/day of mushroom powder, for 10 days to 24 weeks; LiverTox gives 500 mg–3 g/day as the usual range |
| Main constituents | Polysaccharides (including beta-glucans), peptidoglycans and triterpenes (ganoderic and lucidenic acids) |
| Half-life | Not established for reishi as a whole. Ganoderic acid A, one marker triterpene, had a half-life of ≈0.66 h in healthy men |
| Liver injury | LiverTox likelihood score D: a possible rare cause of clinically apparent liver injury |
| US status | Sold as a dietary supplement; FDA does not approve supplements before marketing |
| WADA status | Not named on the 2026 Prohibited List |
What it is
Ganoderma lucidum is a polypore fungus with a hard, woody texture and a lacquered-looking cap. The Latin lucidus means “shiny.” In Chinese, lingzhi was regarded as an “herb of spiritual potency,” and the mushroom appears in early Chinese materia medica texts. Wild lingzhi is rare, and in the past only the wealthy could afford it. The authors of a standard textbook chapter suggest its reputation as a cure-all may owe as much to that rarity as to any proven effect (Wachtel-Galor et al., Herbal Medicine 2011).
The naming is untidy. More than 200 species have been assigned to the genus Ganoderma, and shape and color vary with growing conditions, so the taxonomy is confused and overlapping (Wachtel-Galor et al., 2011). LiverTox lists Lingzhi as Ganoderma lingzhi and reishi as “usually Ganoderma lucidum” (LiverTox). Since the early 1970s, most reishi has been cultivated on logs, sawdust or grain rather than collected wild.
Products are made from different parts of the fungus, and that matters, because their chemistry differs (Wachtel-Galor et al., 2011):
| Product type | What it is |
|---|---|
| Fruiting-body powder | The whole mushroom, dried and ground, put in capsules or tablets |
| Mycelial products | Fungal threads grown in fermentation tanks or on grain, then dried |
| Spore powder | Spores, intact or mechanically “broken”; any extra benefit of breaking the spore wall is unproven |
| Extracts | Hot-water extracts (rich in polysaccharides) or ethanol extracts (rich in triterpenes) |
The three groups of compounds most often studied are:
- Polysaccharides and peptidoglycans, mostly glucose-based beta-glucans, studied for effects on immune cells;
- Triterpenes, more than 100 of them, mainly ganoderic and lucidenic acids. They give reishi its bitter taste;
- Other components such as ergosterol (a vitamin D2 precursor), nucleosides, proteins and minerals.
Content varies widely between products. When 11 commercial lingzhi products bought in Hong Kong were tested, triterpene content ranged from undetectable to 7.8% and polysaccharide content from 1.1% to 5.8% (Wachtel-Galor et al., 2011).
Reishi is one of several “functional” mushrooms in this library, alongside chaga, cordyceps and lion’s mane. They are different species with different chemistry and evidence.
How it behaves in the body
Reishi is a mixture of hundreds of compounds, so it has no single half-life. The only human pharmacokinetic data come from measuring ganoderic acid A, one triterpene, after a single 3,000 mg dose of a water extract of the fruiting body in 12 healthy young men (Tawasri et al., Biomed Res Int 2016):
| Parameter (ganoderic acid A, fasting) | Mean ± SD |
|---|---|
| Peak plasma level | 2.24 ± 1.31 ng/mL |
| Time to peak | 0.54 ± 0.10 h |
| Elimination half-life | 0.66 ± 0.33 h (≈40 min) |
| Total exposure (AUC to infinity) | 2.71 ± 1.09 ng·h/mL |
In one subject, levels were below the detection limit at almost every time point. The authors note that food lowered and delayed the peak in their earlier study, without changing total absorption. Taking 2,500 mg of vitamin C with the extract did not change any of these values. These numbers describe one marker compound. They say nothing about how long the large polysaccharides, which are poorly absorbed, or any other constituent stay in the body.
Regulatory status
In the US, reishi is sold as a dietary supplement. Under the Dietary Supplement Health and Education Act (DSHEA), FDA does not have the authority to approve dietary supplements before they are marketed, and it does not approve their labeling (FDA). Strength, species and plant part are not standardized between brands.
Reishi is not named anywhere on the WADA 2026 Prohibited List. As with any supplement, that says nothing about whether a given product is free of undeclared ingredients.
What the research shows
LiverTox summarizes the overall picture: cell and animal studies suggest many effects, but “none of the purported beneficial activities” has been shown in adequately sized, properly controlled human trials (LiverTox). The human trials that exist are mostly small, short and done with different products.
Cancer: the Cochrane review
A Cochrane systematic review searched English and Chinese databases for randomized trials of G. lucidum in people with cancer (Jin et al., Cochrane 2016). Only five trials qualified. Four were published in Chinese, all were done in Chinese patients, and most enrolled fewer than 100 people. Three were in advanced lung cancer, one in rectal cancer after surgery and one in mixed cancers. No trial measured long-term survival.
| Outcome | Pooled result |
|---|---|
| Tumor response, reishi plus chemo/radiotherapy vs chemo/radiotherapy alone | RR 1.50 (95% CI 0.90–2.51; reported P = 0.02) |
| Tumor response, reishi alone | Did not show the same regression rate as combined therapy |
| CD3 T cells (share of white cells) | +3.91 percentage points (95% CI 1.92–5.90) |
| CD4 T cells | +3.05 percentage points (95% CI 1.00–5.11) |
| CD8 T cells | +2.02 percentage points (95% CI 0.21–3.84) |
| Long-term survival | Not measured in any trial |
| Adverse events | Reported in one study only: nausea and insomnia; no blood or liver toxicity reported |
The review judged the trials’ quality “generally unsatisfying.” Note that the confidence interval for tumor response includes 1.0 (no difference), even though a P value of 0.02 was reported. Changes in immune cell counts are laboratory markers, not proof of benefit against cancer. The authors concluded there was not enough evidence to justify reishi as a first-line cancer treatment and that it remains uncertain whether it prolongs survival. They suggested it could be considered as an add-on given its possible effects on tumor response and immunity, while urging that its use be “judicious.”
Smaller trials since then have been mixed. In 48 women with breast cancer on endocrine therapy, 4 weeks of spore powder improved fatigue and quality-of-life scores in a pilot trial (Zhao et al., Evid Based Complement Alternat Med 2012). In 82 people with non-small cell lung cancer on chemotherapy, a reishi-and-privet formula did no better than placebo on quality of life over 6 weeks (Liu et al., Integr Cancer Ther 2020; summarized in LiverTox).
Cardiovascular and metabolic risk: the second Cochrane review
A Cochrane review of reishi for cardiovascular risk factors found five trials with 398 participants (Klupp et al., Cochrane 2015). The trials with usable data compared 1.4–3 g/day of G. lucidum with placebo for 12–16 weeks, all in people with type 2 diabetes.
| Outcome | Difference vs placebo (95% CI) |
|---|---|
| HbA1c (long-term blood sugar) | −0.10% (−1.05 to 0.85) |
| Total cholesterol | −0.07 mmol/L (−0.57 to 0.42) |
| LDL cholesterol | +0.02 mmol/L (−0.41 to 0.45) |
| Body-mass index | −0.32 kg/m² (−2.67 to 2.03) |
| Fasting plasma glucose (one trial) | +0.30 mmol/L (−0.95 to 1.55) |
| Blood pressure, triglycerides | No significant difference |
| Any adverse event | RR 1.67 (0.86–3.24); none serious |
The reviewers concluded that the evidence does not support reishi for treating cardiovascular risk factors in people with type 2 diabetes.
The largest trial in that review randomized 84 people with type 2 diabetes and metabolic syndrome to 3 g/day of G. lucidum, G. lucidum plus cordyceps, or placebo for 16 weeks (Klupp et al., Sci Rep 2016). The combined active groups showed no change in HbA1c (+0.13%, 95% CI −0.35 to 0.60) or fasting glucose compared with placebo, and no secondary outcome improved.
Earlier, a crossover trial gave 1.44 g/day of lingzhi or placebo for 12 weeks to 26 people with borderline high blood pressure or cholesterol (Chu et al., Br J Nutr 2012). Body-mass index and blood pressure did not change. Insulin and insulin resistance were lower after lingzhi than after placebo; lipid changes could not be fully analyzed because of carry-over effects between treatment periods. In 18 healthy adults, the same dose for 4 weeks changed none of the antioxidant, heart-risk, DNA-damage or immune markers measured (Wachtel-Galor et al., Br J Nutr 2004).
Immune markers in healthy people
Reishi is mostly marketed for “immune support.” In 157 healthy adults, a G. lucidum beta-glucan product taken for 84 days raised CD3, CD4 and CD8 T-cell counts, natural killer (NK) cell counts and NK activity, and serum IgA compared with placebo, with no change in liver or kidney tests (Chen et al., Foods 2023; n from LiverTox). Shifts in blood cell counts are surrogate markers. The trial did not show fewer or milder infections. In a smaller 10-day trial of 2 g twice daily in 16 volunteers, there were no clear changes in CD4, CD8 or CD19 cells, and a rise in NK (CD56) cells was not statistically significant (Wicks et al., Am J Chin Med 2007).
Fatigue, mood and well-being
In 132 people with neurasthenia (a diagnosis of chronic fatigue and weakness used in China), a polysaccharide extract at 1,800 mg three times daily for 8 weeks was compared with placebo (Tang et al., J Med Food 2005). Among 123 who could be assessed:
| Outcome at 8 weeks | Extract | Placebo |
|---|---|---|
| Fall in fatigue score from baseline | 28.3% | 20.1% |
| Rated more than minimally improved | 51.6% (32 of 62) | 24.6% (15 of 61) |
This is a single trial of one branded extract, and it has not been independently replicated. In 42 people with Alzheimer disease, spore powder for 6 weeks did not improve cognition, behavior or quality of life compared with placebo (Wang et al., Medicine 2018).
Exercise and physical fitness
Interest in reishi for training and recovery rests on a few small trials:
- Football players at simulated altitude. Forty male players were split into a sea-level control and three “live high, train low” groups given placebo, 10 capsules or 20 capsules of G. lucidum a day. The high-dose group showed a non-significant trend toward a smaller fall in the CD4/CD8 T-cell ratio. Performance was not the outcome (Zhang et al., Br J Sports Med 2008).
- Sedentary female students. In a 30-day placebo-controlled trial (n = 78), 1,000 mg/day improved heart rate, estimated VO2max, a work-capacity test and right-hand grip strength compared with placebo, and beat 500 mg/day on VO2max and work capacity (Mitra et al., Int J Med Mushrooms 2024).
- Women with fibromyalgia. Sixty-four women took 6 g/day of G. lucidum or carob flour for 6 weeks. The reishi group improved on aerobic endurance, lower-body flexibility and speed tests; the carob group did not (Collado Mateo et al., Nutr Hosp 2015). There was no placebo group.
No trial has tested reishi for muscle growth, strength gains with training or recovery in trained athletes.
Urinary symptoms in men
A Japanese group picked a G. lucidum ethanol extract because, of 19 mushroom extracts tested in the lab, it most strongly inhibited 5α-reductase (the enzyme that converts testosterone to DHT). In 88 men over 49 with mild-to-moderate lower urinary tract symptoms, 6 mg/day of the extract for 12 weeks lowered the International Prostate Symptom Score (IPSS) more than placebo (mean difference −1.18 points, 95% CI −1.74 to −0.62) (Noguchi et al., Asian J Androl 2008). Urine flow, residual urine, prostate size, PSA and testosterone levels did not change. An earlier dose-ranging trial in 50 men tested 0.6, 6 and 60 mg/day over 8 weeks (Noguchi et al., Asian J Androl 2008).
Rheumatoid arthritis
In 65 people with active rheumatoid arthritis on standard drugs, G. lucidum 4 g/day plus a Chinese herbal formula (San Miao San) for 24 weeks did not significantly increase the share reaching the main response target (ACR20: 15% vs 9.1% with placebo) (Li et al., Arthritis Rheum 2007). Pain and patient global scores improved only in the herbal group. No antioxidant, anti-inflammatory or immune effects were found.
Side effects and risks
In short trials, reishi is usually well tolerated. Placebo-controlled studies lasting from 10 days to 12 weeks reported no changes in liver enzymes, blood counts or kidney tests (Wicks et al., 2007; Wachtel-Galor et al., 2004; LiverTox). Side effects reported in trials and case reports include nausea, insomnia, dry mouth, constipation, itching and vertigo (MSK About Herbs). In the Cochrane diabetes review, adverse events were somewhat more common with reishi (RR 1.67) but the difference was not significant and none were serious (Klupp et al., 2015).
Liver injury
LiverTox, the NIH database on drug-induced liver injury, rates reishi as likelihood score D: a possible rare cause of clinically apparent liver injury (LiverTox). It notes a small number of reports from China, Japan, Thailand and India. In those reports:
- symptoms began typically 1–2 months after starting, but ranged from a few days to 6 months;
- the injury was hepatocellular (liver cell damage, with high ALT and AST);
- severity ranged from symptom-free enzyme rises to severe hepatitis with liver failure;
- most patients recovered within 1–3 months of stopping, and no chronic injury has been reported.
The published cases include:
| Case | Product and timing | Outcome |
|---|---|---|
| 78-year-old woman, Hong Kong (2004) | Took lingzhi for a year without problems, then switched to a powdered product; fatigue and dark urine one month later | Bilirubin 15.8 mg/dL, ALT 306 U/L; liver tests near normal 5 months after stopping (Yuen et al., J Hepatol 2004; details from LiverTox) |
| 47-year-old woman, Thailand (2005) | Switched from boiled lingzhi slices to a powder, 200 mg daily; jaundice and coma about 2 months later | INR 4.7, bilirubin 40.4 mg/dL; died 6 days later, with widespread liver necrosis at autopsy (Wanmuang et al., J Med Assoc Thai 2007; details from LiverTox) |
| 61-year-old man, Japan (2021) | Commercial G. lucidum product taken “for his liver function” after rectal cancer surgery | Marked rise in eosinophils (a type of white cell), multiple liver nodules and mildly raised liver enzymes; all resolved after stopping (Kogure et al., Intern Med 2021) |
| 47-year-old man, USA (2023) | Several tablespoons of reishi powder plus 2–3 bottles of vodka over 3 days; background fatty liver | ALT 990 U/L, AST 301 U/L; ALT 45 U/L and symptoms resolved at 2 weeks (Guedikian et al., Cureus 2023) |
The Thai authors pointed out that both of the first two patients had used traditionally boiled lingzhi without harm and became ill only 1–2 months after switching to powder. Both had also taken other medicines (Wanmuang et al., 2007). In the US case, heavy alcohol use makes it hard to separate the two causes.
LiverTox stresses the limits of this evidence. Many cases were poorly documented, other causes (gallstones, acetaminophen, other herbs, product contaminants) were not always ruled out, and the ingredient responsible is unknown. Given how widely reishi is used, it concludes that clinically apparent liver injury “must be extremely rare.”
Bleeding
Lab studies suggested reishi might inhibit platelets, and MSK lists a possible increased bleeding risk with anticoagulant and antiplatelet drugs such as warfarin, as well as possible prolongation of clotting tests (MSK About Herbs). However, in a randomized, double-blind trial in healthy volunteers, G. lucidum 1.5 g/day for 4 weeks caused no changes in platelet function, clotting screens or thromboelastography compared with placebo (Kwok et al., Anesth Analg 2005). That trial did not include people taking blood thinners.
Other interactions and test effects
MSK lists further potential interactions, based mostly on theory or lab data (MSK About Herbs):
- Immunosuppressants: reishi may enhance immune responses, which could work against these drugs.
- Drugs metabolized by liver enzymes: in lab studies, reishi polysaccharides inhibited CYP2E1, CYP1A2 and CYP3A; the clinical relevance is unknown.
- Tumor-marker tests: reishi spore powder has been reported to raise CA72-4, a blood marker used in some cancers, which could confuse test results.
Product variability
Products differ in species, plant part, extraction method and active-compound content, with triterpenes undetectable in some commercial products (Wachtel-Galor et al., 2011). Results from one trial product cannot be assumed to apply to another.
Key takeaways
- A traditional medicinal fungus, sold as a supplement. Reishi (lingzhi, Ganoderma lucidum) has a 2,000-year history in East Asian medicine; in the US it is a dietary supplement that FDA does not approve before sale.
- Two Cochrane reviews found weak or no support. Five small, low-quality trials did not justify reishi as a first-line cancer treatment, and trials in type 2 diabetes found no effect on blood sugar, cholesterol or blood pressure.
- Mostly marker-level human benefits. Some trials show shifts in immune-cell counts or symptom scores (fatigue, urinary symptoms), but no trial has shown fewer infections, longer survival or better athletic adaptation.
- Usually well tolerated, with rare liver injury. Short trials showed no liver-enzyme changes, but LiverTox rates reishi a possible rare cause of acute liver injury, including one fatal case linked to a powdered product.
- No established half-life. The only human data are for one triterpene, ganoderic acid A, with a half-life of about 40 minutes after a single dose.
- Products vary widely. Fruiting-body, mycelium and spore products differ, and triterpene content ranged from undetectable to 7.8% across commercial products tested.
Sources
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