Reishi and Fibromyalgia: What the Evidence Shows
- , by SANUSq Research team
- 13 min reading time
Widespread pain, and tiredness that rest doesn't touch: living with fibromyalgia sends many people looking beyond the usual options, and reishi fibromyalgia claims turn up quickly in that search. Before you spend time and money on this mushroom, it is worth looking closely at what it has actually been tested for, and what those tests found.
What reishi has really been studied for
Reishi (Ganoderma lucidum, also called lingzhi) has been used in East Asia for more than two thousand years. Its best-studied compounds are polysaccharides, especially beta-glucans, and a family of bitter compounds called triterpenes. Modern research has concentrated on two areas: the immune system and metabolism.
Most immune research is laboratory or animal work, with a few small human trials.
Gao et al. (2003) gave a Ganoderma lucidum polysaccharide extract to 34 people with advanced-stage cancer for 12 weeks, with no placebo group. In the 30 who could be assessed, several immune markers changed compared with their starting values, including higher natural killer cell activity and lower levels of two inflammatory signalling molecules, IL-1 and TNF-alpha. These are laboratory measurements in a very particular group, not evidence of a clinical benefit in the general population.
On the metabolic side, the picture is less encouraging than many websites suggest.
A Cochrane review by Klupp et al. (2015) found five trials with 398 participants. The trials that could be analysed were all in people with type 2 diabetes, and reishi did not meaningfully lower HbA1c, cholesterol, blood pressure or body mass index compared with placebo. The authors concluded that the evidence does not support using it for cardiovascular risk factors in this group.
Is reishi anti-inflammatory?
You will often see reishi described as anti-inflammatory, and it is easy to see why people connect that to fibromyalgia. Laboratory studies show that reishi compounds can dampen inflammatory signals in cells, and the Gao trial above recorded lower levels of some inflammatory markers.
But changes in a blood marker are not the same as feeling less pain, and fibromyalgia is not understood as a classic inflammatory disease like rheumatoid arthritis. Current thinking puts more weight on how the nervous system processes pain signals, sometimes called central sensitisation, alongside sleep, stress and activity levels. So "reishi and inflammation" is an interesting research thread, but it doesn't tell us whether reishi makes any difference to how someone with fibromyalgia feels day to day.
Reishi and fibromyalgia: what the trials found
Unlike most claims you will read online, this question has actually been tested, if only on a small scale. A research group in Extremadura, Spain, ran a series of pilot studies in women with fibromyalgia, using 6 g a day of finely milled reishi fruiting body for six weeks.
Collado Mateo et al. (2015) randomised 64 women with fibromyalgia to reishi or carob flour. After six weeks, the reishi group showed significant improvements in aerobic endurance, lower-body flexibility and walking speed on fitness tests, while the carob group did not. Carob is not a true placebo, and the study did not assess pain as its main outcome.
In a double-blind, placebo-controlled pilot trial, Pazzi et al. (2020) looked at mood and quality of life in women with fibromyalgia taking reishi for six weeks. There were no statistically significant differences between the reishi and placebo groups. The authors noted a trend towards better happiness and life-satisfaction scores and lower depression scores within the reishi group, and said larger studies would be needed to confirm this.
A further pilot trial from the same group, Pazzi et al. (2021), found no significant effect of reishi on blood glucose, cholesterol, triglycerides, body composition or blood pressure in women with fibromyalgia.
Put together, these studies are small, short, run by a single team, limited to women, and mostly did not use a matched placebo. The one placebo-controlled trial found no significant difference between groups. That is a long way from showing that reishi relieves fibromyalgia pain or fatigue. The honest summary is that a few early signals exist, mainly on physical fitness scores, and they have not been confirmed.
Why the "adaptogen" argument isn't enough
Many pages skip the trials altogether and argue by chain of reasoning: reishi is an adaptogen, adaptogens help with stress, stress makes fibromyalgia worse, therefore reishi helps fibromyalgia. Each step may sound reasonable, but a chain of plausible ideas is not a substitute for a result. Selling certainty that doesn't exist costs people twice: in money, and in time taken away from approaches known to help.
Why fibromyalgia attracts so many promises
Three features of the condition help explain the flood of products aimed at it.
- It comes in waves. Symptoms often ease on their own after a bad patch, so anything started during a flare can look effective when natural improvement arrives.
- It is measured by how people feel. There is no simple blood test for fibromyalgia pain, which makes the placebo response especially strong. That response is real, but it doesn't belong to the product.
- It was overlooked for a long time. That understandably pushes people to look outside conventional care.
If you try a supplement, decide in advance what you hope for, over what period and at what cost, and treat "no change" as useful information rather than a reason to take more.
What evidence-based fibromyalgia care looks like
The most useful thing to know is that approaches with better evidence do exist. They tend to need patience more than money.
The European Alliance of Associations for Rheumatology (EULAR) revised recommendations, published by Macfarlane et al. (2017), reviewed 107 systematic reviews and meta-analyses. Exercise was the only therapy to receive a strong recommendation. The panel advised starting with patient education and non-drug approaches, then, if needed, adding psychological therapies, medication for severe pain or sleep problems, or a multidisciplinary rehabilitation programme.
In practice, that usually means:
- Understanding the condition. Good information about how fibromyalgia works can reduce fear and help you pace activity.
- Graded, gentle exercise. Walking, water-based exercise, stretching or light strength work, built up very slowly. It feels counterintuitive when every effort costs something, but this is where the evidence is strongest.
- Sleep as a priority. Unrefreshing sleep lowers the threshold for pain, so routines, light exposure and treating any sleep disorder matter.
- Psychological approaches such as cognitive behavioural therapy (CBT), which can help with coping, mood and the pain-stress cycle.
- Medication where appropriate, chosen and reviewed with your doctor.
On the supplement side, the area with a little more data is vitamin D, in people whose levels are low.
In a randomised placebo-controlled trial, Wepner et al. (2014) gave vitamin D to 30 women with fibromyalgia and low vitamin D levels, aiming to bring their levels into a target range over 20 weeks. Pain scores fell markedly in the treated group compared with placebo. The authors said larger studies are needed to confirm the result.
This is about correcting a shortfall, not treating the condition. Vitamin D contributes to the maintenance of normal muscle function, and a simple blood test shows whether yours is low.
If you still want to try reishi
That choice is yours, and it can be made sensibly. Talk to your doctor or pharmacist first, then keep these points in mind:
- Check which part is used. Fruiting body (the mushroom cap) and mycelium (the root-like network, often grown on grain) are not equivalent. The Spanish trials used fruiting body.
- Look for a stated beta-glucan content rather than a vague "polysaccharides" figure, which can include starch from the growing medium.
- Ask about heavy-metal testing. Mushrooms readily absorb metals from where they grow.
- Judge it over several weeks, on how you feel overall rather than on one symptom, and keep a simple diary.
- Don't stop anything that is already in place, including medication, exercise or therapy.
Reishi safety and interactions
Reishi is generally well tolerated in trials. The side effects most often reported are mild, such as a dry mouth or digestive discomfort. There are, however, some situations where medical advice should come first.
- Blood thinners and antiplatelet drugs (such as warfarin, apixaban, clopidogrel or aspirin), and before surgery, as reishi may affect bleeding.
- Diabetes medication. Reishi has been studied for its effects on blood glucose, so it is sensible to check with your doctor and monitor your levels.
- Immune-suppressing drugs, for example after a transplant or for an autoimmune condition, because reishi may affect immune activity.
- Pregnancy and breastfeeding, where safety has not been established.
- Liver disease, or any signs of liver trouble. Rare cases of serious liver injury have been reported with reishi powder.
Wanmuang et al. (2007) described a fatal case of fulminant hepatitis in Thailand associated with lingzhi powder, and referred to an earlier case from Hong Kong. Both people had previously used traditionally boiled lingzhi without problems, became ill one to two months after switching to the powdered form, and had also taken other therapeutic agents. Case reports cannot prove cause, but the authors called for close monitoring, especially when lingzhi is combined with other drugs.
Stop taking it and seek medical advice promptly if you notice yellowing of the skin or eyes, dark urine, unusual tiredness or pain in the upper right of the abdomen. And if you are being treated for fibromyalgia, tell your doctor about every supplement you take.
Reishi fibromyalgia claims: the bottom line
Reishi is a seriously studied mushroom, mainly for immune and metabolic effects, with mixed results and a negative Cochrane conclusion on diabetes-related risk factors. For fibromyalgia, a few small Spanish pilot studies in women reported changes in fitness scores, but the only placebo-controlled trial found no significant difference in mood or quality of life. Reishi is not an established option for fibromyalgia. Education, graded exercise, good sleep, psychological support and medication guided by your doctor remain the place to start.
Frequently asked questions
Does reishi help fibromyalgia?
It hasn't been shown to. A few small, short pilot studies in women with fibromyalgia reported some improvements in physical fitness tests, but the one placebo-controlled trial found no significant difference in mood or quality of life. Larger, better-designed trials would be needed before drawing any conclusion.
Is reishi anti-inflammatory?
Laboratory studies and a small human study have recorded changes in some inflammatory markers. That doesn't mean reishi reduces pain, and fibromyalgia is not thought of as a classic inflammatory disease.
Can reishi help with chronic fatigue?
Reishi is traditionally linked with rest and calm, but human research on fatigue is scarce and small. Long traditional use is not the same as proven benefit.
What actually helps fibromyalgia?
European guidelines give their strongest recommendation to exercise, built up gradually. Education about the condition, attention to sleep, psychological therapies such as CBT and, where needed, medication chosen with your doctor are the other main pillars. Checking and correcting low vitamin D is also reasonable.
How do I choose a good-quality reishi?
Check whether it is made from fruiting body or mycelium, look for a stated beta-glucan content rather than total polysaccharides, and make sure the supplier tests for heavy metals.
Who should avoid reishi?
Speak to your doctor first if you take blood thinners, diabetes medication or immune-suppressing drugs, have liver problems, are due to have surgery, or are pregnant or breastfeeding. Rare cases of serious liver injury have been reported.
References
- Gao Y, Zhou S, Jiang W, Huang M, Dai X. Effects of ganopoly (a Ganoderma lucidum polysaccharide extract) on the immune functions in advanced-stage cancer patients. Immunological Investigations. 2003;32(3):201–215. PMID 12916709
- Klupp NL, Chang D, Hawke F, Kiat H, Cao H, Grant SJ, Bensoussan A. Ganoderma lucidum mushroom for the treatment of cardiovascular risk factors. Cochrane Database of Systematic Reviews. 2015;2015(2):CD007259. PMID 25686270
- Collado Mateo D, Pazzi F, Domínguez Muñoz FJ, Martín Martínez JP, Olivares PR, Gusi N, Adsuar JC. Ganoderma lucidum improves physical fitness in women with fibromyalgia. Nutrición Hospitalaria. 2015;32(5):2126–2135. PMID 26545669
- Pazzi F, Adsuar JC, Domínguez-Muñoz FJ, García-Gordillo MA, Gusi N, Collado-Mateo D. Ganoderma lucidum effects on mood and health-related quality of life in women with fibromyalgia. Healthcare (Basel). 2020;8(4):520. PMID 33265969
- Pazzi F, Adsuar JC, Domínguez-Muñoz FJ, García-Gordillo MÁ, Gusi N, Collado-Mateo D. Effects of Ganoderma lucidum and Ceratonia siliqua on blood glucose, lipid profile, and body composition in women with fibromyalgia. Nutrición Hospitalaria. 2021;38(1):139–145. PMID 33319566
- Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Annals of the Rheumatic Diseases. 2017;76(2):318–328. PMID 27377815
- Wepner F, Scheuer R, Schuetz-Wieser B, et al. Effects of vitamin D on patients with fibromyalgia syndrome: a randomized placebo-controlled trial. Pain. 2014;155(2):261–268. PMID 24438771
- Wanmuang H, Leopairut J, Kositchaiwat C, Wananukul W, Bunyaratvej S. Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder. Journal of the Medical Association of Thailand. 2007;90(1):179–181. PMID 17621752
Read more on the blog
- Reishi (Ganoderma lucidum): The Mushroom of Immortality →
- Can Vitamin D Help with Fibromyalgia? →
- Medicinal Mushrooms: How Fungi Support Your Immune System →
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