What to Combine Cordyceps With

Cordyceps is a medicinal fungus marketed for stamina, oxygen use and recovery. It often appears in blends with adaptogens, caffeine or other mushrooms. Our editorial team examines which combinations have some logic behind them, which are mostly marketing and which may interact with medicines.

Cordyceps basics

The name cordyceps covers several species. Wild Ophiocordyceps sinensis, which grows on caterpillar larvae in the Himalayas, is extremely expensive and rarely found in supplements. Most products today use cultivated Cordyceps militaris or a fermented mycelium strain known as Cs-4.

Active compounds include cordycepin (3'-deoxyadenosine), adenosine, polysaccharides and various nucleosides. Their levels vary greatly between species, cultivation methods and whether the product uses the fruiting body or mycelium grown on grain.

Exercise studies have produced mixed findings. Some small trials reported modest improvements in VO2 max or ventilatory threshold in older or untrained adults, while studies in trained athletes often found no benefit. Overall, the evidence is promising but not robust.

In the UK, cordyceps products are sold as food supplements. Certain extracts might fall under novel food rules depending on their history of use, which is one reason product quality and composition vary so much.

Combinations with some rationale

Rhodiola rosea is perhaps the most logical partner. Both are marketed for fatigue and endurance, and a few studies have tested blends of rhodiola and cordyceps on aerobic performance, with mixed results. The combination is generally well tolerated, though evidence for a true synergy is limited.

Caffeine has well-established ergogenic effects at around 3–6 mg per kilogram body weight taken before exercise. Adding cordyceps to caffeine is unlikely to cause problems in healthy people, but any benefit is probably driven mostly by the caffeine.

Dietary nitrate from beetroot juice improves exercise efficiency in some people by increasing nitric oxide. Cordyceps is proposed to support oxygen use through different pathways. No robust trials have tested the combination, so it remains theoretical.

Mushroom blends and multi-ingredient products

Many brands combine cordyceps with lion's mane, reishi, chaga or turkey tail in a single 'mushroom complex'. These products are fashionable, but each ingredient is usually present in small amounts, and combined clinical trials are rare.

Reishi in particular has reported effects on blood clotting and blood pressure, and rare cases of liver injury have been linked to reishi powder. Combining several mushrooms increases the number of potential effects to consider, especially in people taking medicines.

When evaluating a blend, check whether each mushroom's quantity and the part used (fruiting body or mycelium) are stated. Products made largely from mycelium grown on grain may contain substantial amounts of starch rather than fungal compounds.

A product listing a single well-characterised extract with a stated dose is often more useful than a long blend with impressive names but undisclosed amounts.

Combinations that need caution

Cordyceps has shown antiplatelet activity in laboratory studies. People taking anticoagulants such as warfarin, or antiplatelet drugs such as clopidogrel or aspirin, should speak to a doctor before using it, and stop it before surgery.

Some research suggests cordyceps may lower blood glucose. Combined with insulin or other diabetes medicines, this could, in theory, increase the risk of hypoglycaemia. Monitoring and medical advice are sensible.

Because cordyceps may stimulate immune function, it could counteract immunosuppressant drugs used after transplants or in autoimmune diseases. People with autoimmune conditions such as rheumatoid arthritis, lupus or multiple sclerosis should also be cautious.

• Anticoagulant and antiplatelet medicines.
• Insulin and other glucose-lowering medicines.
• Immunosuppressants such as ciclosporin, tacrolimus or prednisolone.
• Combinations with other herbs affecting clotting, such as ginkgo or high-dose fish oil.

Practical guidance

Studies have used a range of doses, commonly 1–3 g per day of cordyceps extract or powder, often for several weeks. Because preparations differ so much, follow the manufacturer's labelled dose and do not exceed it.

Choose products that state the species, the part used and, ideally, the content of key compounds such as cordycepin or beta-glucans. Third-party testing for heavy metals and contaminants is particularly important for fungal products.

Introduce one new supplement at a time and wait a couple of weeks before adding another. This makes it easier to identify any side effects, which for cordyceps most often include mild digestive upset, dry mouth or nausea.

Pregnant or breastfeeding women and children should avoid cordyceps because of a lack of safety data. Competitive athletes should prefer batch-tested products to reduce the risk of contamination with prohibited substances.

Editorial conclusions

Cordyceps combines plausibly with rhodiola, caffeine or nitrate, though evidence for real synergy is limited and caffeine usually does most of the work.

Mushroom complexes often contain small, undisclosed amounts and add complexity without proven benefit.

Anyone taking anticoagulants, diabetes medicines or immunosuppressants should seek medical advice first.

Our editorial team suggests reading next about rhodiola for endurance, beetroot juice and nitrate, and how to evaluate medicinal mushroom products.

References

1. 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;16(5):585–590.
2. 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;14(2):236–242.
3. Hirsch KR, Smith-Ryan AE, Roelofs EJ, et al. Cordyceps militaris improves tolerance to high-intensity exercise after acute and chronic supplementation. J Diet Suppl. 2017;14(1):42–53.
4. Tuli HS, Sandhu SS, Sharma AK. Pharmacological and therapeutic potential of Cordyceps with special reference to Cordycepin. 3 Biotech. 2014;4(1):1–12.
5. Guest NS, VanDusseldorp TA, Nelson MT, et al. International society of sports nutrition position stand: caffeine and exercise performance. J Int Soc Sports Nutr. 2021;18(1):1.
6. Jones AM. Dietary nitrate supplementation and exercise performance. Sports Med. 2014;44 Suppl 1:S35–S45.