Supplement
Cordyceps (Cordyceps sinensis / militaris)
Exercise performance: two named Cs-4 trials found no change in VO2max The most oxygen the body can use during all-out exercise, a standard measure of aerobic fitness. and one raised lactate and ventilatory thresholds in older adults; a 2025 meta-analysis A study that pools the numbers from several trials into one combined estimate. pooled a small VO2peak gain that rests on one small high-risk trial.
Grade C: human trials exist, but they are small, mixed or not yet repeated. This is not a finding that it does not work. How to read a grade →
Cordyceps is a fungus sold for energy and exercise. Two studies of one branded extract found no change in how much oxygen the body could use during hard exercise. One study in older adults found small gains in endurance markers. A pooled review found a small gain that rests on weak studies. So the evidence is small and does not agree.
- Dose studied
- 3 g/day (CS-4)
- Form graded
- Cordyceps (CS-4 mycelium or fruiting body)
- Cited PMIDs PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed.
- PMID 15118196 →
A letter describes the human evidence, not the product, the manufacturer, or the ingredient's worth.
See the full evidence record →Who responds: this record's trial reading reports no subgroup that identifies who responds.
Cordyceps (sinensis / militaris) for exercise performance and VO2 surrogate measures, graded on human trial evidence.
How this letter has changed · latest: October 2026 · Corrected
The review of October asked that the trials pooled by Shu et al. (Front Nutr, 2025; PMID 41280379) be identified before the letter moved. The full text names them: the Cordyceps sinensis pools for VO2peak and ventilatory threshold rest on Parcell et al. (Int J Sport Nutr Exerc Metab, 2004; PMID 15118196), null; a 2021 Thai crossover A trial design in which each participant receives both the treatment and the comparison, one after the other, and serves as their own control. in 12 runners, rated high risk of bias by the reviewers and published in a journal PubMed does not index, positive on VO2max; and a 2022 Brazilian marathoner trial, also unindexed, with no VO2max change. The pooled VO2peak gain is carried by the one high-risk trial. Two named null trials on VO2max, one positive small trial, and a threshold gain in older adults (Chen et al., 2010; PMID 20804368) is thin, mixed randomized evidence: C, unchanged. Applied the written grade definition under the editor's standing instruction of October 2026 (Arnold Sandlow, D.C.).PMID 15118196 PMID 20804368 PMID 41280379
Every change to a letter on this site is dated and published. The full evidence log →
Commercial disclosure
EBL earns no commission on any supplement it grades. A purchase made through the dispensary link below pays EBL nothing, the practitioner discount goes to you in full. The dispensary is Fullscript, a practitioner dispensary, and many of the professional-grade brands in it are sold mainly through practitioners rather than in health food stores. Grades are assigned by published rubric before any commercial relationship exists and are never influenced by one. Full disclosure.
No dose is published here. This record carries no authored dose, because the cited trials do not converge on a single figure. Each trial cited on this page states the dose it used, and EBL has not turned those into a recommendation.
Standardized extracts were used in the cited trials; product quality varies.
The cited trial gave 3 g a day for 5 weeks (PMID 15118196). Its summary does not state a time of day or whether it was taken with food.
Checked against the published summary; the full paper could not be read. What the cited trials did, not a schedule. Every supplement, by trial timing →
Autoimmune disease and pregnancy. Raised bleeding risk.
Immunosuppressants, including ciclosporin and tacrolimus: cordyceps is immune-stimulating, which runs against the purpose of the drug, and altered ciclosporin levels have been described. Anticoagulants and antiplatelets, on antiplatelet activity in laboratory work. Diabetes medication: additive glucose lowering. The immunosuppressant pair is the exception: randomized trials have given cordyceps to kidney transplant recipients alongside ciclosporin and measured ciclosporin dose and whole-blood levels directly. The anticoagulant and diabetes-medication cautions remain mechanistic, with no trial measuring either.
This one has been measured, in transplant patients, on the drug itself. The ciclosporin caution is not mechanism. A randomized trial in 202 kidney transplant recipients added cordyceps 1 g three times daily to the standard immunosuppressive regimen and compared ciclosporin dosage and whole-blood trough concentration against control. From two to six months after transplantation the ciclosporin doses in the cordyceps group were significantly lower, and from three to six months the trough concentrations were lower too, alongside less hepatotoxicity and nephrotoxicity. A Cochrane review of five trials in 447 participants covers the same use, including one trial of cordyceps plus low-dose ciclosporin against standard-dose ciclosporin. Note the direction: in that setting the interaction was managed deliberately by clinicians who lowered the drug. For someone taking cordyceps on their own initiative while on a calcineurin inhibitor, the same interaction is unmanaged, and both trials rate as unclear risk of bias with limited method reporting. Ding et al. (Transplant Proc, 2009;41(5):1565-9; PMID 19545680): randomized study of 202 renal transplant recipients, cordyceps added to the immunosuppressive regimen, comparing ciclosporin dosage and whole-blood trough concentration. Cochrane Kidney and Transplant (Cochrane Database Syst Rev, 2015;(10):CD009698; PMID 26457607): systematic review A review that searches for every study on a question using a method set in advance, then assesses them together. and meta-analysis of five studies and 447 participants of Cordyceps sinensis in kidney transplant recipients.
The bleeding and glucose cautions are still mechanism only. The same record also warns about anticoagulants, antiplatelets and diabetes medication. Those have not been measured. A scoped human search for cordyceps with an anticoagulant returns a single record, and nothing has co-administered cordyceps with warfarin or with a glucose-lowering drug and reported what happened. The transplant literature says nothing about either, because those trials were not asking. Basis: pharmacological mechanism, not a human study. Searched PubMed in August 2026: 2 queries, 1 human result.
VO2max or time-to-exhaustion on a standardized aerobic test at baseline and 6 weeks. Fatigue scores and subjective energy ratings weekly. CS-4 (mycelium fermentation) is the form used in most published trials; wild-harvested Cordyceps sinensis has different and less documented pharmacology.
Primary evidenceThree papers, each linked to its PubMed record.
Parcell et al. (International Journal of Sport Nutrition and Exercise Metabolism, 2004; PMID 15118196): 5-week randomized placebo-controlled trial of CordyMax Cs-4 in endurance-trained cyclists; VO2peak and time-trial performance did not change. Chen et al. (J Altern Complement Med, 2010; PMID 20804368): 12-week randomized placebo-controlled pilot, 20 healthy adults aged 50 to 75, Cs-4 1 g/day; the metabolic threshold rose 10.5 percent and the ventilatory threshold 8.5 percent, with no change in VO2max. Shu et al. (Front Nutr, 2025; PMID 41280379): systematic review and meta-analysis of 14 randomized trials of fungal supplements in 528 athletes, 8 pooled; Cordyceps sinensis improved endurance performance (P=0.05), ventilatory threshold (P=0.03) and VO2peak (P=0.04), with low heterogeneity How much the results of the pooled trials differ from each other. High heterogeneity makes a combined estimate less reliable.; read in full in October 2026: the VO2peak and ventilatory-threshold pools rest on three Cordyceps sinensis trials, Parcell 2004 (PMID 15118196; null), a 2021 Thai crossover in 12 runners published in a journal PubMed does not index and rated at high risk of bias by the reviewers (positive on VO2max), and a 2022 Brazilian trial in 22 amateur marathoners in a journal PubMed does not index (5 km time improved, VO2max and thresholds unchanged). The pooled VO2peak gain is carried by the one high-risk trial. Trials of mushroom blends containing Cordyceps militaris are not evidence for cordyceps alone. Grade C: the two named Cs-4 trials found no change in VO2max, and the 2025 pooled VO2peak gain rests on one small high-risk trial. Mixed, thin randomized evidence.
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