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Aweto, caoor, caterpillar fungus, Chinese caterpillar fungus, chongcao, cordycepin, Cordyceps cicadae, Cordyceps militaris, Cordyceps nipponica, Cordyceps ophioglossoides, Cordyceps pseudomilitaris, Cordyceps sinensis, Cordyceps sinensis (Berk) Succ., Cordyceps sinensis mycelium, Cordyceps spp., Cordyceps tuberbulata, Cs4, CS-4, deer fungus parasite, dong chong xia cao, dong chong zia cao, dong zhong chang cao, fungus, hsia ts'ao tung ch'uung, jinshuibao, mummio, semitake, shilajit, Sphaeria sinensis, summer grass winter worm, summer-plant winter-worm, tochukaso, vegetable caterpillar, yarsha gumba, yertsa gonbu ze-e cordyceps.
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.
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.
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.
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.
Cordyceps may reduce some asthma symptoms. Additional studies are needed to make a firm recommendation.
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.
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.
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.
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.
Liver disease (hepatic cirrhosis):
In traditional Chinese medicine, cordyceps has been used to support and improve liver function. In two studies using herbal combinations that included cordyceps, liver function improved liver and immune function. However, as these studies used combination treatments, the effect of cordyceps alone is unknown.
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.
There is not enough available scientific evidence in this area.
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).
There is no proven safe or effective dose for cordyceps in children, and use is not recommended.
Avoid in individuals with a known allergy or hypersensitivity to cordyceps, mold, or fungi.
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.
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.
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.
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.
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.
This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ashley Brigham, PharmD (Northeastern University); J. Kathryn Bryan, BA (Natural Standard Research Collaboration); James Ceurvels, PharmD (Northeastern University); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Nicole Giese, MS (Natural Standard Research Collaboration); Sadaf Hashmi, MD, MPh (Johns Hopkins School of Hygiene and Public Health); Ernest B. Hawkins, MS, BSPharm (Health Education Resources); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Thuy-Duong Le, PharmD (Oregon State University); Wendy Weissner, BA (Natural Standard Research Collaboration).
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