Cordyceps

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Cordyceps

Common Names

  • Vegetable caterpillar
  • Chinese caterpillar fungus
  • Dong chong xia cao
  • Semitake
  • Hsia ts'ao tung ch'ung
  • Yarsha gumba

For Patients & Caregivers

How It Works

Cordyceps has not been shown to treat or prevent cancer.

Cordyceps is used in traditional Chinese medicine. It contains a fungus that grows on caterpillar larvae. Both are contained in the product and both are consumed. Lab studies show that cordyceps can stimulate immune cells, but it is not known if this effect occurs in humans. Animal studies suggest that cordyceps can stimulate progesterone production and reduce kidney toxicity from harsh medications, but whether this would occur in humans is also unknown. Studies in kidney transplant patients suggest cordyceps can help improve kidney function, but more study is needed.

Cordyceps has blood-thinning properties. It may also reduce blood sugar levels.

Purported Uses
  • To stimulate the immune system
    Lab studies show that cordyceps stimulates the immune system, but it is not known whether this effect occurs in humans.
  • To treat kidney failure
    A few studies show that cordyceps may help improve renal function, but additional studies are needed.
Do Not Take If
  • You are having a surgical procedure: A case report of excessive bleeding from a dental extraction was linked to taking cordyceps.
  • You have a myelogenous type cancer such as AML or CML: Lab studies show cordyceps can increase the number of red blood cell precursor cells. These cells arise from the same cell lines that cause myelogenous cancers.
  • You take insulin or other blood-glucose lowering medications: Lab studies suggest cordyceps may increase effects of these medications. Although clinical relevance has yet to be determined, blood glucose should be closely monitored.
  • You take a drug that has blood-thinning activity: Cordyceps may increase bleeding risk.
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For Healthcare Professionals

Scientific Name
Ophiocordyceps sinensis (renamed 2007), Cordyceps sinensis, Sphaeria sinensis
Clinical Summary

Cordyceps includes the fungus that grows on the larvae of the caterpillar Hepialus armoricanus Oberthuer. Both are contained in the product and both are consumed. Cordyceps is used for a wide range of conditions including fatigue, sexual dysfunction, coughs, and as an adaptogen or immune stimulant. In vitro and animal studies show antitumor (10) (11) (14), radioprotective (12), antiplatelet (19) and antidiabetic effects (15) (16). In addition, cordyceps enhances recovery of mice with taxol-induced leukopenia (13) and increases the cytotoxicity of cisplatin in non-small cell lung cancer cells (17).

A few studies have also been conducted in humans. Cordyceps products improved renal function and reduced nephropathy in renal transplant patients (18) (21) (23) and diabetes patients with renal insufficiency undergoing coronary angiography (25). However, several analyses found that evidence for its utility as adjuvant treatment in renal transplant recipients and hemodialysis patients is insufficient (26) (27). Studies on exercise performance in healthy subjects yielded mixed results (22) (24).

Cordyceps may increase the adverse effects of antidiabetic or anticoagulant/antiplatelet drugs. Animal studies showed proliferation of progenitor red blood cells with cordyceps (8). Therefore, it should not be used by those with myelogenous type cancers. Cordyceps also stimulated testosterone production in mice (9). Whether it exerts similar effects in humans is not known.

Purported Uses
  • Kidney disease
  • Diabetes
  • Immunostimulation
  • Strength, stamina
Mechanism of Action

Laboratory studies demonstrate that cordyceps stimulates T helper cells, prolongs lymphocyte survival, enhances TNF-alpha and interleukin 1 production, and increases activity of natural killer cells (3). Enhanced proliferation of erythroid progenitor cells in murine bone marrow (8) and increased progesterone production in animal cells (5) have also been shown. Other experiments suggest cordyceps may inhibit tumor celIs by downregulating MHC class II antigen expression (7). Anecdotal data suggest reduction of cyclosporin and aminoglycoside-induced renal toxicity, although the mechanism of action is not known (4). Cordycepin, an active constituent in cordyceps, inhibits collagen-induced platelet aggregation by lowering calcium ion and thromboxane A2 activities (19).

Adverse Reactions

Case Report

Excessive bleeding: Post tooth extraction and associated with cordyceps being used daily as a tonic (28).

Herb-Drug Interactions

Hypoglycemics / Insulin: Laboratory studies suggest cordyceps may have additive hypoglycemic effects (16) (17). Clinical relevance has yet to be determined.
Anticoagulants / Antiplatelets: Laboratory studies suggest cordyceps inhibits platelet aggregation and may increase the effects of these drugs (19). There is also a case report of excessive bleeding from a dental procedure linked to cordyceps (28).

Dosage (OneMSK Only)
References
  1. Huang KC. The Pharmacology of Chinese Herbs, 2nd ed. Boca Raton: CRC Press; 1999.
  2. Zhu JS, Halpern GM, Jones K. The scientific rediscovery of a precious ancient Chinese herbal regime: Cordyceps sinensis, Part I. J Altern Complement Med 1998;4:289-303.
  3. Zhu JS, Halpern GM, Jones K. The scientific rediscovery of a precious ancient Chinese herbal regime: Cordyceps sinensis, Part II. J Altern Complement Med 1998;4:429-57.
  4. Xu F, et al. Amelioration of cyclosporin nephrotoxicity by Cordyceps sinensis in kidney-transplant recipients. Nephrol Dial Transplant 1995;10:142-3.
  5. Huang B, et al. Cordyceps sinensis and its fractions stimulate MA-10 mouse Leydig tumor cell steroidogenesis. J Androl 2001;22:831-7.
  6. Nakamura K, et al. Inhibitory effect of Cordyceps sinensis on spontaneous liver metastasis of Lewis lung carcinoma and B16 melanoma cells in syngeneic mice. Jpn J Pharmacol 1999;79:335-41.
  7. Chiu JH, et al. Cordyceps sinensis increases the expression of major histocompatibility complex class II antigens in human hepatoma cell line HA22T/VGH cells. Am J Chin Med 1998;26:59-70.
  8. Li, Y. et. al. Effect of Cordyceps sinensis on erythropoiesis in mouse bone marrow. Chin Med J (Engl). 1993 Apr;106(4):313-6.
  9. Huang YL, Leu SF, Liu BC, et al. In vivo stimulatory effect of Cordyceps sinensis mycelium and its fractions on reproductive functions in male mouse. Life Sci 2004 Jul 16;75(9):1051-62.
  10. 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 Jun;60(1):103-11.
  11. Oh JY, Baek YM, Kim SW, et al. Apoptosis of human hepatocarcinoma (HepG2) and neuroblastoma (SKN-SH) cells induced by polysaccharides-peptide complexes produced by submerged mycelial culture of an entomopathogenic fungus Cordyceps sphecocephala. J Microbiol Biotechnol. 2008 Mar;18(3):512-9.
  12. 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 Dec;166(6):900-7.
  13. Liu WC, Chuang WL, Tsai ML, et al. Cordyceps sinensis health supplement enhances recovery from taxol-induced leukopenia. Exp Biol Med (Maywood). 2008 Apr;233(4):447-55.
  14. Kubo E, Yoshikawa N, Kunitomo M, et al. Inhibitory effect of Cordyceps sinensis on experimental hepatic metastasis of melanoma by suppressing tumor cell invasion. Anticancer Res. 2010 Sep;30(9):3429-33.
  15. Lo HC, Hsu TH, Tu ST, Lin KC. Anti-hyperglycemic activity of natural and fermented Cordyceps sinensis in rats with diabetes induced by nicotinamide and streptozotocin. Am J Chin Med. 2006;34(5):819-32.
  16. Shi B, Wang Z, Jin H, et al. Immunoregulatory Cordyceps sinensis increases regulatory T cells to Th17 cell ratio and delays diabetes in NOD mice. Int Immunopharmacol. 2009 May;9(5):582-6.
  17. Ji NF, Yao LS, Li Y, et al. Polysaccharide of Cordyceps sinensis Enhances Cisplatin Cytotoxicity in Non-Small Cell Lung Cancer H157 Cell Line. Integr Cancer Ther. 2011;10(4):359-67.
  18. Zhang Z, Wang X, Zhang Y, Ye G. Effect of Cordyceps sinensis on Renal Function of Patients with Chronic Allograft Nephropathy. Urol Int. 2011;86(3):298-301.
  19. Cho HJ, Cho JY, Rhee MH, et al. Cordycepin (3’-deoxyadenosine) inhibits human platelet aggregation in a cyclic AMP- and cyclic GMP-dependent manner. Eur J Pharmacol. 2007 Mar 8;558(1-3):43-51.
  20. Zhao K, Li Y, Zhang H. Role of dongchongxiacao (Cordyceps) in prevention of contrast-induced nephropathy in patients with stable angina pectoris. J Tradit Chin Med. 2013 Jun;33(3):283-6.
  21. Ding C, Tian PX, Xue W, et al. Efficacy of Cordyceps sinensis in long term treatment of renal transplant patients. Front Biosci (Elite Ed). 2011 Jan 1;3:301-7.
  22. Chen S, Li Z, Krochmal R, et al. Effect of Cs-4 (Cordyceps sinensis) on exercise performance in healthy older subjects: a double-blind, placebo-controlled trial. J Altern Complement Med. 2010 May;16(5):585-90.
  23. Li Y, Xue WJ, Tian PX, et al. Clinical application of Cordyceps sinensis on immunosuppressive therapy in renal transplantation. Transplant Proc. 2009 Jun;41(5):1565-9.
  24. Parcell AC, Smith JM, Schulthies SS, et al. Cordyceps sinensis (CordyMax Cs-4) supplementation does not improve endurance exercise performance. Int J Sport Nutr Exerc Metab. 2004 Apr;14(2):236-42.
  25. Kai Z, Yongjian L, Sheng G, et al. Effect of Dongchongxiacao (Cordyceps) therapy on contrast-induced nephropathy in patients with type 2 diabetes and renal insufficiency undergoing coronary angiography. J Tradit Chin Med. Aug 2015;35(4):422-427.
  26. Hong T, Zhang M, Fan J. Cordyceps sinensis (a traditional Chinese medicine) for kidney transplant recipients. Cochrane Database Syst Rev. Oct 12 2015(10):Cd009698.
  27. Bee Yean O, Zoriah A. Efficacy of Cordyceps sinensis as an adjunctive treatment in hemodialysis patients: A systematic review and meta-analysis. J Tradit Chin Med. Feb 2019;39(1):1-14.
  28. Hatton MN, Desai K, Le D, et al. Excessive postextraction bleeding associated with Cordyceps sinensis: A case report and review of select traditional medicines used by Vietnamese people living in the United States. Oral Surg Oral Med Oral Pathol Oral Radiol. Dec 2018;126(6):494-500.
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