This mycotherapy guide draws in particular on the expertise of Alexandra Courio, doctor of pharmacy and founder of Mycelab, the first French brand specialising in medicinal mushroom supplements.
"Mushrooms offer a particularly interesting therapeutic response where conventional medicine can find itself limited. They act not simply on the symptom, but on the cause behind the cause of the symptom. Their ability to modulate the immune system, along with their anti-inflammatory and metabolic properties and their supportive role in oncology, makes them valuable allies for today's practitioner."
– Alexandra Courio, founder of Mycelab
1. Clinical applications of medicinal mushrooms by physiological system
To help you quickly identify the relevant options for each patient profile, here is a system-by-system summary of the main clinical applications, put together by Alexandra Courio.
System Key mushrooms Active compounds Clinical applications Mechanisms of action Specific precautions Immune Reishi, Shiitake, Brazilian agaric Beta-glucans (1,3/1,6), polysaccharides Immunodeficiencies, allergies, autoimmune diseases, oncology adjuvant Mobilisation of macrophages, NK cells and Th1 lymphocytes; Th1/Th2 balancing Individual monitoring according to the patient's terrain Nervous Lion's mane, Reishi, Cordyceps Erinacines, hericenones, triterpenes Neurodegenerative disorders, peripheral neuropathies, cognitive stress, burnout NGF stimulation, myelin protection, inhibition of amyloid β peptide toxicity Possible interactions with psychotropic drugs (rare), monitoring recommended Cardiovascular Reishi, Shiitake, Oyster mushroom Ganoderic acids, natural lovastatin, adenosine Hyperlipidaemia, hypertension, atherosclerosis, arrhythmias Inhibition of cholesterol synthesis, vasodilation, antithrombotic effect Extra caution with anticoagulants (VKAs, heparin), medical follow-up recommended Digestive Reishi, Shiitake, Lion's mane Prebiotic polysaccharides, β-glucans, ergosterol Liver disorders, irritable bowel syndrome, intestinal dysbiosis Hepatoprotection, regeneration of the digestive epithelium, microbiota modulation Monitoring of bowel transit Endocrine Brazilian agaric, Maitake, Cordyceps Beta-glucans, SX fraction, complex polysaccharides Type 1 and type 2 diabetes, metabolic syndrome, hormonal imbalances Reduced insulin resistance, protection of β cells, regulation of hormone secretion Strict blood glucose monitoring recommended, especially on antidiabetic treatment
Practical applications and clinical synergies
To get the most therapeutic benefit, an integrative approach is called for:
- Primary/secondary targeting: Identify one priority physiological system while keeping in mind the knock-on effects on the others
- Synergistic combinations: Pair complementary mushrooms according to their action profiles
- Nutritional integration: Recommend including suitable culinary mushrooms in the diet (40g daily minimum)
- Therapeutic timeframe: Plan extended courses (3 months) for deep action on the terrain
2. Major medicinal mushrooms: 7 detailed therapeutic profiles
1. Brazilian agaric (Agaricus blazei)
Profile: Powerful immunomodulator, exceptional beta-glucan content.
Main clinical applications:
- Immune support (stimulation or regulation as needed)
- Protection against autoimmune disorders
- Adjuvant in oncology
- Blood glucose regulation (types 1 and 2)
- Hepatoprotection
- Detoxification (heavy metal chelation)
Recommended dosage: 2 to 4 g of standardised extract per day (equivalent to 10-20 g of raw powder), in 2 daily doses with meals.
Precautions: Medical monitoring required with glucose-lowering treatment (risk of hypoglycaemia).
2. Reishi (Ganoderma lucidum)
Profile: The "mushroom of immortality", a major adaptogen, with more than 350 active molecules identified.
Main clinical applications:
- Bidirectional adaptogen (anxiolytic in the morning, sedative in the evening)
- Sophisticated immunomodulation
- Blood pressure regulation (hypotensive)
- Lipid balance
- Anti-fibrotic liver protection
- Prostate regulation (5-alpha reductase inhibition)
- Systemic anti-ageing
Recommended dosage: 2-6 g of standardised extract/day (equivalent to roughly 10-30 g of raw powder), in 2 to 3 daily doses with meals. The last dose is best taken in the evening to support relaxation.
Precautions: Significant anticoagulant effect. Must be stopped 7-10 days before surgery. Contraindicated with potent anticoagulants (VKAs, NOACs) without close medical supervision.
3. Maitake (Grifola frondosa)
Profile: The "king of mushrooms", whose D and SX fractions have remarkable metabolic properties.
Main clinical applications:
- Comprehensive regulation of metabolic syndrome
- Optimisation of weight control
- Immune balancing (Th1 orientation)
- Protection against hepatic steatosis
- Potent anti-inflammatory (comparable to NSAIDs without the adverse effects)
Recommended dosage: 2-5 g of standardised extract/day (equivalent to roughly 10-25 g of powder), in 2 daily doses with meals.
Precautions: Medical monitoring is mandatory alongside antihypertensives or glucose-lowering drugs. Conventional treatments often need adjusting.
4. Shiitake (Lentinus edodes)
Profile: The "elixir of life", a complete nutritional profile, unique active compounds (lentinan, eritadenine).
Main clinical applications:
- Oncology support (improved survival rates and quality of life)
- Cholesterol regulation
- Liver protection
- Libido stimulation and improvement in erectile dysfunction of vascular origin
- Anti-infective immunomodulation
Recommended dosage: 3-9 g of standardised extract/day (equivalent to roughly 15-45 g of fresh mushroom), in 2 to 3 daily doses with meals.
Precautions: Theoretical interactions with azole antifungals. Space doses by at least 2h.
5. Cordyceps (Cordyceps sinensis)
Profile: The "Himalayan Viagra", an entomopathogenic fungus, a unique energy complex.
Main clinical applications:
- Deep restoration of energy (chronic fatigue)
- Post-infectious convalescence
- Optimisation of endurance performance
- Kidney protection (autoimmune nephritis)
- Harmonisation of stress responses
- Cognitive and memory support
Recommended dosage: 2-4 g of standardised extract/day (equivalent to roughly 10-20 g of raw mycelium), in 2 daily doses with meals. Avoid any dose after 4pm to limit the risk of insomnia.
Precautions: Caution with stimulants (caffeine, guarana): risk of overstimulation. Not advised in uncontrolled hyperthyroidism.
6. Lion's mane (Hericium erinaceus)
Profile: Unique neuroactive compounds (erinacines and hericenones), selective affinity for nervous tissue.
Main clinical applications:
- Neurodegenerative protection (Alzheimer's, Parkinson's)
- Nerve regeneration (peripheral neuropathies)
- Support in multiple sclerosis
- Regulation of chronic inflammatory digestive disorders
- Improvement in treatment-resistant depression and anxiety disorders
- Cognitive preservation in older adults
Recommended dosage: 2-3 g of standardised extract/day (equivalent to roughly 10-15 g of fresh mushroom), in 2 daily doses with meals.
Precautions: Theoretical potentiation with psychotropic drugs (rare). Inform the treating psychiatrist if it is combined with antidepressants or anxiolytics.
7. Oyster mushroom (Pleurotus ostreatus)
Profile: Sophisticated biochemical architecture, natural lovastatin, a complete antioxidant complex.
Main clinical applications:
- Natural regulation of hypercholesterolaemia
- Rebalancing of the gut microbiota
- Support in metabolic syndrome
- Overall cardiovascular prevention
- Liver protection
- Ideal nutritional supplement for vegetarians and vegans
Recommended dosage: 3-6 g of standardised extract/day (equivalent to roughly 15-30 g of fresh mushroom), in 2 daily doses during or after meals.
Precautions: Monitoring alongside lipid-lowering drugs (statins, fibrates). The dosage of conventional treatments may need adjusting.
3. Principles for integrating mycotherapy into clinical practice
Therapeutic timeframe and individualisation
Phase Timing Expected observations Practical recommendations Initiation 7-10 days First noticeable effects Start at 50% of the target dose · Assess tolerance · Ask about the earliest changes Optimisation 4-6 weeks Benefits settle Adjust to the individual response · Synergies may be added · First clinical assessment Restructuring 3-6 months Deep biological changes Maintain or reduce the dosage · Consider cycling (3 months on / 1 month off) · Comparative biological assessment
Practical tip: Explain this timeframe clearly to your patients so they know what to expect. Mycotherapy is not a fast symptomatic treatment but a fundamental approach to the underlying terrain.
Therapeutic synergies: recommended combinations
Clinical indication Recommended combination Expected benefit Immunity & chronic inflammation Reishi + Brazilian agaric Bidirectional immunomodulation + anti-inflammatory Stress & cognition Reishi + Lion's mane Adaptogen + neuroprotection Fatigue & recovery Cordyceps + Reishi Controlled energy stimulation Metabolism & blood glucose Maitake + Brazilian agaric Complete metabolic regulation Liver protection Reishi + Shiitake Synergistic hepatoprotection
Examples of complete protocols
Post-viral chronic fatigue
Patient profile: Woman, 42, persistent fatigue for 3 months following a viral infection, moderate immune deficiency, disturbed sleep.
Step-by-step protocol:
- Weeks 1-2: Cordyceps 1g/day (morning) · Reishi 1g/day (evening) · Introduce culinary shiitake (2x/week)
- Weeks 3-6: Cordyceps 2g/day (1g morning + 1g midday) · Reishi 2g/day (1g midday + 1g evening) · Culinary shiitake (3x/week)
- Months 2-3: Continue the mushroom protocol · Add lion's mane 1g/day (evening) from week 8
Expected results:
- Week 2: Better sleep quality
- Week 4: Less morning fatigue
- Week 8: Noticeably better overall energy
- Month 3: Normalisation of immune parameters
Personalised follow-up: Daily energy diary (scale of 1-10) · Blood tests at weeks 1 and 12 · Adjust to tolerance and individual response.
Liver disturbance on statins
Patient profile: Man, 65, treated for hypercholesterolaemia on statins for 3 years, recent rise in transaminases (moderate hepatic cytolysis), mild fatigue.
Step-by-step protocol:
- Weeks 1-2: Reishi 1g/day (evening) · Oyster mushroom 1g/day (morning) · Introduce culinary Shiitake (2x/week)
- Weeks 3-6: Reishi 2g/day (1g midday + 1g evening) · Oyster mushroom 2g/day (1g morning + 1g midday) · Culinary shiitake (3x/week)
- Months 2-3: Continue the protocol · Add a short course of Cordyceps 1g/day (morning) from week 8 for hepatic energy support (optional, depending on tolerance)
Expected results:
- Week 4: Transaminases expected to settle
- Week 8: Clear improvement in the mild fatigue
- Month 3: Optimisation of the lipid profile + better liver tolerance of statins
Personalised follow-up: Liver function tests (transaminases, GGT) at week 0, week 6 and week 12 · Weekly fatigue/energy diary · Close monitoring of liver function in collaboration with the prescribing doctor.
Early cognitive changes and anxiety
Patient profile: Woman, 58, onset of mild memory problems (frequent "memory blanks"), diffuse anxiety, slightly disturbed sleep, no diagnosis of dementia.
Step-by-step protocol:
- Weeks 1-2: Lion's mane 1g/day (midday) · Reishi 1g/day (evening)
- Weeks 3-6: Lion's mane 2g/day (1g morning + 1g midday) · Reishi 2g/day (1g midday + 1g evening)
- Months 2-3: Continue the protocol · Gradually introduce stimulating cognitive activities (memory work, puzzles)
Expected results:
- Week 2: Easier sleep onset and better sleep quality
- Week 6: Anxiety settles and the first signs of better attention
- Month 3: Better cognitive fluency and fewer everyday lapses
Personalised follow-up: Daily memory diary (self-assessment: attention, lapses) · Somatic/emotional anxiety questionnaire at week 0, week 6, week 12 · A standardised neurocognitive assessment if one is available.
The practitioner's quick memo
- Patience and consistency are the keys to success in mycotherapy
- Personalisation to the individual biochemical terrain matters more than standardised protocols
- Synergies between mushrooms often go beyond the sum of the individual effects
- Nutritional support and work on the underlying terrain enhance the results
- Regular objective assessment lets you fine-tune the protocols
FAQ for practitioners: clinical mycotherapy
What are the main active compounds in medicinal mushrooms and their mechanisms of action?
Made up mostly of water, mushrooms still show a significant concentration of minerals and trace elements and a full spectrum of vitamins, with the B group predominating.
- Beta-glucans: polysaccharides with beta 1-3/1-6 linkages acting bidirectionally on the immune system, stimulating where there is deficiency and regulating in the face of over-reactivity.
- Triterpenes: 30-carbon structures with antiviral, cholesterol-lowering and antiplatelet properties. The ganoderic acids in reishi stand out for their hepatoprotective effects and their inhibition of 5-alpha reductase.
- Ergothioneine: an amino acid with an exceptional half-life (30 days). Heavy metal chelation, mitochondrial protection, preservation of other antioxidants.
- Specific compounds: erinacines (nerve growth factor), ergosterol (anti-angiogenic properties), lectins and various enzyme complexes round out this therapeutic repertoire.
What side effects are possible with mycotherapy?
Mycotherapy has a remarkably gentle tolerance profile. Patients may occasionally notice a temporary shift in bowel transit. These medicinal mushrooms stand out for their near-zero toxicity and the almost complete absence of drug interactions. Only a few medical precautions apply, notably around the anticoagulant properties of Reishi and its potential glucose-lowering effects in diabetic patients on treatment.
How is mycotherapy viewed in the medical community?
Medical attitudes are moving quickly, from initial scepticism to growing recognition. Learned societies in integrative oncology are starting to acknowledge the therapeutic interest of fungal beta-glucans. The picture remains mixed, however: where China readily integrates these mushrooms into its hospital protocols, Europe keeps a more cautious approach.
Which is the best mushroom for health?
Naming a single champion would be reductive. Each medicinal mushroom has its own therapeutic profile: Reishi brings a remarkable adaptogenic action, lion's mane works on neurodegenerative disorders, Cordyceps counters chronic fatigue, and Maitake regulates metabolic syndrome. Real expertise lies in a personalised approach, one that pinpoints the specific needs of each patient.
What are the benefits of mycelium?
Mycelium, a complex filamentous structure, concentrates a fascinating biochemical richness. The "full spectrum" approach gives access to the complete range of active compounds, with 50% polysaccharides and more than 15% beta-glucans offering higher bioavailability. Extracellular secondary metabolites add a further dimension to the therapeutic action.
Mycotherapy, a therapeutic revival between tradition and science
Modern mycotherapy embodies a subtle meeting of thousand-year-old wisdom and contemporary biochemistry. More than a simple alternative, it offers an integrative approach that moves past the traditional divide between conventional and natural medicine.
Faced with complex chronic conditions, these medicinal mushrooms offer a modulating therapeutic toolkit and the promise of a more holistic, more nuanced view of health. It is a view Simplycure shares, supporting health professionals day to day in their preventive, personalised approach to care.
