Cordyceps for Improved Energy Levels and Sports Performance
March 2000; Volume 3: 28-30
By Dónal P. O’Mathúna, PhD
Cordyceps is an ancient chinese herbal remedy made from the fungus Cordyceps sinensis. The fungus grows in the Himalayan regions of China and Tibet. Public attention was drawn to the herb when unknown female Chinese runners swept the long-distance events at the 1993 world championships and later broke a number of world records.1 The following year, female Chinese swimmers performed similarly at their world championships.2 In spite of many accusations, Chinese coaches denied their athletes were using banned drugs, and instead attributed the improvements to rigorous training and a special diet that included cordyceps.
Could this product bring such amazing performance improvements to athletes? If it benefits athletes, what might it do for your patients’ everyday energy levels?
Background
Cordyceps has been used for centuries in China as a food supplement and tonic beverage, but only for the very rich because of a limited supply. Harvesting cordyceps remains controversial because devout Buddhists living where cordyceps grows naturally view the fungus as sacred, and oppose harvesting it for profit. The scarc- ity of the wild form stimulated researchers to produce strains that could be grown using fermentation technology.3 These products have allowed widespread use of cordyceps. The most commonly used extract is called Cs-4 and is available in the United States as CordyMax (Pharmanex, Inc.).
Life Cycle
The Latin term cordyceps means "swollen head" and its Chinese names convey some of the fungus’ fascinating appearance and life cycle. Half of the three-inch-long harvested fungus looks like a mummified caterpillar and the other half looks like a brown blade of grass. Its Chinese names literally mean "winter worm, summer grass" or "caterpillar fungus."4 The parasitic fungus grows inside several caterpillar species during winter until nothing remains except a mummified caterpillar shell. When summer arrives, the cordyceps’ fruiting body bursts through the caterpillar’s head, looking like a blade of grass.
General Uses
Cordyceps is traditionally used as a general tonic or to rejuvenate people after sickness or overexertion. It is said to be more potent than ginseng. The herb is also used to treat a wide variety of illnesses, including respiratory, renal, liver, and cardiovascular diseases, sexual dysfunction, hyperlipidemia, and cancer.
Pharmacology
Cordyceps extracts contain a wide variety of constituents, including proteins, unusual cyclic dipeptides, sugars, sterols, nucleosides, fatty acids, vitamins, and minerals.3 It contains a relatively high level of adenosine and adenosine derivatives. Adenosine is a vital constituent of DNA, RNA, and adenosine triphosphate (ATP), the high-energy molecule fueling many cellular processes. Cordyceps extracts also contain high levels of the essential amino acid tryptophan (24 mg/g), which can have a calming effect on humans.4
Mechanism of Action
According to traditional Chinese medicine, the components in cordyceps go to the lung and kidney Qi meridians to provide lung protection, kidney improvement, and "Yin-Yang double invigoration."3
The mechanism of action for cordyceps is poorly understood, but a number of active ingredients have the potential to impact exercise performance.
Mice fed a cordyceps extract showed a significantly higher ATP/inorganic phosphate (Pi) level (P < 0.05) compared to controls.5 This metabolic high energy state returned to normal within one week of stopping cordyceps supplementation. A number of other Chinese studies with mice fed Cs-4 water extracts (0.2 or 0.4 g/kg) gave an average ATP/Pi ratio increase of 45-55% (P < 0.001).3 Higher ATP levels could in theory boost sports performance, primarily in short-duration events.
Use of cordyceps in treating respiratory diseases led to several Japanese studies showing that cordyceps relaxes the trachea of animals and allows better ventilation.4 Other studies show that cordyceps can activate the immune system, with the potential to speed recovery from exercise or illness.6 Its proposed anticancer effects may also be mediated through an immune response.7 Finally, studies on the use of cordyceps for sexual dysfunction revealed some male sex hormone-like effects in rabbits and castrated mice.3 All of these mechanisms and effects are intriguing, but none have demonstrated improved athletic performances with cordyceps.
The nucleoside found in high quantities in cordyceps is:
a. adenosine.
b. guanine.
c. cytosine.
d. thymine.
Clinical Studies
The results of extensive animal and clinical research in China are available primarily in Chinese. However, Zhu, Halpern, and Jones recently reviewed this research in English, making the conclusions available to Western medicine.3,8 Their review found studies to support many of the uses of cordyceps. They did not state how exhaustively they searched the Chinese literature, and discussed only studies with positive results. The authors did describe an unpublished, uncontrolled study in which 82.9% of patients with respiratory diseases performed better on a 200-meter jog compared to 40.2% of those taking another herbal remedy.3
Only one exercise-related clinical study was found after a search of MEDLINE, TOXLINE, International Pharmaceutical Abstracts, Conference Papers Index, and the Cochrane Library. This 1999 study with CordyMax was a placebo-controlled trial involving 30 healthy, elderly people.9 Sixteen subjects (average age, 64 years) took 3 g/d cordyceps for six weeks while the control group (n = 14; average age, 66 years) took identical placebo capsules. Exercise performance was measured before and after treatment using a cycle ergometer.
Those taking cordyceps increased their VO2max from 1.88 to 2.00 L/min (P = 0.05) while the values for the placebo group were unchanged. The anaerobic thresholds for those taking cordyceps increased from 1.15 to 1.30 L/min (P = 0.01), while a non-significant decrease occurred in those taking the placebo.
Adverse Effects
Some animal researchers report being unable to attain an LD50, as no mice died within seven days of being given 80 g/kg.8 Cordyceps caused no liver damage to mice at 200 mg/kg/d.5 Animals fed cordyceps for three months showed no detectable differences compared to controls.8 Subjects in clinical trials report some mild GI discomfort, such as dry mouth, nausea, and stomach discomfort, and one patient had an allergic reaction.8
Drug Interactions
Drug interactions have not been studied. Research has shown that cordyceps has monoamine oxidase (MAO) inhibitory effects, warranting caution with patients taking other MAO inhibitors or consuming foods containing large amounts of tyramine.3 Cordyceps can interfere with platelet aggregation and may magnify anticoagulant therapy.10 Its effect on relaxing the trachea may also accentuate epinephrine bronchodilators.4
Formulation
CordyMax contains 525 mg of a dried extract standardized to contain at least 0.14% adenosine. The extract is made from cultivated Cordyceps mycelia (the underground portion of the fungus). The manufacturer recommends taking two capsules, two or three times daily. The traditional recommendation is to include 3-9 g/d cordyceps in a hot tea or cooked meals.
Conclusion
Cordyceps enjoys a long tradition of use in China. Recent fermentation technology has overcome scarcity problems, making it available to consumers and researchers. Early results show it contains numerous biologically active ingredients. Some of these lend support to the wide variety of conditions for which cordyceps is traditionally used. Very little clinical evidence exists regarding cordyceps’ effects on exercise performance, though limited results are encouraging, at least for the elderly. No clinical studies were found on its effect on athletic performance.
Recommendation
It is premature to recommend cordyceps to patients: Too little is known. The wide variety of active ingredients present in cordyceps suggests caution in those already taking other medications, especially MAO inhibitors, anticoagulants, and bronchodilators. Athletes considering using cordyceps can rely only on anecdotal evidence, though the improvements seen among Chinese athletes are intriguing, and cordyceps by itself appears to be very safe. Dietary supplements, however, will never replace the need to train, whether for general exercise benefits or a competitive edge.
Dr. O’Mathúna is Professor of Bioethics and Chemistry at Mount Carmel College of Nursing in Columbus, OH.
The available evidence for the exercise performance enhancement effects of cordyceps is based on a study with:
a. trained athletes.
b. recreational joggers.
c. elderly people.
d. teenagers.
References
1. Gordon D. The rumored dope on Beijing’s women. Newsweek. September 27, 1993:63.
2. Harvey R. China makes big splash with 100 freestyle record, controversy. Los Angeles Times. September 16, 1994:C4.
3. Zhu JS, et al. The scientific rediscovery of an ancient Chinese herbal medicine: Cordyceps sinensis: Part I. J Altern Complement Med 1998;4:289-303.
4. Jones K. Cordyceps: Tonic Food of Ancient China. Seattle, WA: Sylvan Press; 1997.
5. Manabe N, et al. Effects of the mycelial extract of cultured Cordyceps sinensis on in vivo hepatic energy metabolism in the mouse. Jpn J Pharmacol 1996;70:85-88.
6. Kuo YC, et al. Cordyceps sinensis as an immunomodulatory agent. Am J Chin Med 1996;24:111-125.
7. Chen YJ, et al. Effect of Cordyceps sinensis on the proliferation and differentiation of human leukemic U937 cells. Life Sci 1997;60:2349-2359.
8. Zhu JS, et al. The scientific rediscovery of a precious ancient Chinese herbal regimen: Cordyceps sinensis: Part II. J Altern Complement Med 1998;4:429-457.
9. Xiao Y, et al. Increased aerobic capacity in healthy elderly humans given a fermentation product of Cordyceps Cs-4. Med Sci Sports Exer 1999;31(suppl 5):S174.
10. Ikumoto T, et al. Physiologically active compounds in the extracts from tochukaso and cultured mycelia of Cordyceps and Isaria. J Pharm Soc Jpn 1991;111: 504-509.
March 2000; Volume 3: 28-30
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