Medicinal Mushrooms for Anxiety: A Doctor’s Evidence-Based Guide

Discover how reishi, lion’s mane and cordyceps can naturally reduce anxiety and manage symptoms of chronic stress. Evidence-based dosing, clinical insights, and protocols from an integrative medicine doctor

Last updated:

November 14, 2025

Medicinal mushrooms for anxiety relief: what actually works

When most people think about mushrooms and anxiety, their minds often go to either psychedelic mushrooms for PTSD, or the fear of encountering a poisonous one. While psychedelic mushrooms can be helpful for anxiety, this article will be focusing on mushrooms that are a little more accessible and a lot more legal.

Medicinal mushrooms - reishi, lion’s mane and cordyceps specifically - are an important part of any anxiety treatment plan. Through my clinical experience, I have seen these mushrooms, when combined with other diet and lifestyle changes, make dramatic differences in people’s lives. Differences like improved sleep, fewer panic attacks, stabilized mood and overall improved quality of life.

After reading this article, you will understand how mushrooms help with anxiety, how to implement the 3 best mushrooms for anxiety, proper dosing protocols, medication safety, and what to expect as far as treatment timelines.

Quick Protocols: Medicinal Mushrooms for Anxiety (Doses & Timing)

At-a-Glance Guide: Individual Mushrooms

If you have	Primary mushroom	Secondary mushroom	Dose and timing	Add if needed	Feel it in
Nighttime anxiety (sleep-onset/early waking)	Reishi (PM) (Ganoderma lucidum)	Lion’s mane (AM) (Hericium erinaceus)	Reishi 500–1500 mg, 60–90 min before bed	Glycine 3 g before bed; Passionflower 250–500 mg before bed	3–5 nights; 2–3 weeks steadier sleep
Anxious brain fog/focus issues	Lion’s mane (Hericium erinaceus)	Cordyceps (AM) (Cordyceps militaris)	Lion’s mane 500–1000 mg AM (± midday)	Bacopa 150–300 mg PM	1–2 weeks; cognition 4–8 weeks
Burnout/“tired-but-wired” stress & anxiety	Cordyceps (Cordyceps militaris)	Reishi (PM) (Ganoderma lucidum)	Cordyceps 500–1000 mg AM (avoid late PM)	Adaptogens you tolerate (e.g., Rhodiola AM)	5–10 days; stamina 3–4 wks
Generalized anxiety (daytime baseline)	Reishi (Ganoderma lucidum)	Lion’s mane (Hericium erinaceus)	Reishi 500–1000 mg AM + PM	L-theanine 100–200 mg Magnesium glycinate 200–300 mg HS	3–7 days; 2–4 weeks fuller effect

Nighttime anxiety (sleep-onset/early waking)

Primary mushroom

Reishi (PM) (Ganoderma lucidum)

Secondary mushroom

Lion’s mane (AM) (Hericium erinaceus)

Dose & timing*

Reishi 500–1500 mg, 60–90 min before bed

Add if needed

Glycine 3 g before bed;
Passionflower 250–500 mg before bed

Feel it in

3–5 nights; 2–3 weeks steadier sleep

Burnout/“tired-but-wired” stress & anxiety

Primary mushroom

Cordyceps (Cordyceps militaris)

Secondary mushroom

Reishi (PM) (Ganoderma lucidum)

Dose & timing*

Cordyceps 500–1000 mg AM (avoid late PM)

Add if needed

Adaptogens you tolerate (e.g., Rhodiola AM)

Feel it in

5–10 days; stamina 3–4 wks

Anxious brain fog/focus issues

Primary mushroom

Lion’s mane (Hericium erinaceus)

Secondary mushroom

Cordyceps (AM) (Cordyceps militaris)

Dose & timing*

Lion’s mane 500–1000 mg AM (± midday)

Add if needed

Bacopa 150–300 mg PM

Feel it in

1–2 weeks; cognition 4–8 weeks

Generalized anxiety (daytime baseline)

Primary mushroom

Reishi (Ganoderma lucidum)

Secondary mushroom

Lion’s mane (Hericium erinaceus)

Dose & timing*

Reishi 500–1000 mg AM + PM

Add if needed

L-theanine 100–200 mg
Magnesium glycinate 200–300 mg HS

Feel it in

3–7 days; 2–4 weeks fuller effect

At-a-Glance Guide: Mushroom Formula For Anxiety

If you have	Mushroom Formula	Dose and timing	Add if needed	Feel it in
Anxiety (any type)	Reishi Lion's Mane Cordyceps	1,500 mg AM + PM	See above for specific situations

Anxiety (any type)

Mushroom formula

Reishi

Lion's Mane

Cordyceps

Dose & timing

1,500 mg AM + PM

Add if needed

See above for specific situations

Feel it in

How to choose a mushroom supplement: quality checklist

✓ Fruiting body (not myceliated grain)

✓ Extracted (hot water or dual extract (water/alcohol), not just dried powder

✓ β-glucans quantified (not just “polysaccharides”)

✓ Reishi: triterpenes quantified

✓ Cordyceps: cordycepin quantified

✓ Lion’s mane: Pure mycelium if available(unlikely); in addition to fruiting body

✓ Species ID verified (Latin binomial on label)

✓ Third-party tested (heavy metals, pesticides, microbes)

✓ Transparent extract ratio

Understanding how medicinal mushrooms help with anxiety

Anxiety can manifest in several forms including generalized anxiety disorder (GAD), panic disorder, social anxiety, and situational anxiety. It may be caused or exacerbated by chronic stress, hormonal imbalances, gut dysbiosis, nutrient deficiencies, trauma, or neuroinflammation. Symptoms range from restlessness and racing thoughts to palpitations, muscle tension, and sleep disturbances.

Mushrooms help to manage symptoms and underlying causes of anxiety through multiple different mechanisms - supporting calming neurotransmitters, increasing brain derived neurotrophic factor, regulating cortisol levels, supporting healthy mitochondrial function, decreasing neuroinflammation and supporting a healthy intestinal microbiome.

Considering historical use, modern research and my own clinical experience, the three best mushrooms for anxiety are reishi, lion’s mane and cordyceps.

Reishi for Anxiety: The Calming Adaptogen

Reishi has been used for anxiety for thousands of years, and Traditional Chinese Medicine (TCM) describes reishi as a shen tonic. The shen is akin to the spirit or mind, and a disturbed shen is thought to be the root of states like anxiety and insomnia. Reishi calms the spirit and quells anxiety. This traditional understanding is supported by modern scientific research and contemporary clinical practice, which continue to explore and validate reishi's calming effects on the mind and body (1,2).

In practice: what reishi does best

In my clinical practice, I most often prescribe reishi for:

Anxiety-induced insomnia
General mood stability throughout the day and
An improved response to stress

Human clinical trials

There have been few human clinical trials with anxiety as the primary outcome measured, but the research that has been published has shown promising results. One notable study found that reishi spore powder significantly reduced anxiety in females with breast cancer (3). Another trial involving women with fibromyalgia indicated that reishi improved happiness, life satisfaction, and depression compared to their baseline, though the differences between groups were not statistically significant (4). Furthermore, a proprietary blend containing reishi, cordyceps, and lion’s mane was shown to significantly decrease anxiety and salivary cortisol in young adults, suggesting that reishi, especially in combination with other mushrooms like lion’s mane and cordyceps, can effectively support emotional well-being and stress resilience (5).

Mechanism of action (mostly deduced from animal studies)

The primary mechanisms of action by which reishi helps to alleviate anxiety revolves around neurotransmitter modulation (specifically GABAergic activity), mitigation of inflammation and oxidative stress, and modulation of the body’s stress response via HPA axis regulation.

GABAergic action

One of the most frequently cited mechanisms is through the GABAergic system, the primary inhibitory system in the central nervous system that is targeted by anti-anxiety medications like benzodiazepines. Reishi extract has been shown to have mild, benzodiazepine-like hypnotic activity. Polysaccharides isolated from Ganoderma species were found to have an anxiolytic-like effect and evoked endogenous GABA release and increased its concentration in vitro (6,7). Ganoderma applanatum, artist conk, a close relative to reishi, has shown anxiolytic activity via binding of saponins and flavonoids to GABAa receptors (8).

Neuroinflammation

Anxiety is closely linked to neuroinflammation and several studies indicate Ganoderma components act by protecting the central nervous system from stress-induced inflammatory damage. Reishi triterpenes alleviate anxiety-like behaviors by mitigating inflammation in the periphery and brain, specifically inhibiting activation of microglia (the main immune modulator cells in the brain) in the prefrontal cortex and hippocampus.Ganoderma triterpenes also decreased inflammation in brain regions critical for anxiety and depression (9-11).

Modulation of the hypothalamic-pituitary-adrenal (HPA) axis

Reishi is categorized as an adaptogen and this mechanism for mitigating stress and anxiety is directly related to the body’s central stress communication system. Reishi helps to reduce salivary cortisol levels, and the benefits on mood and anxiety are believed to be mediated at least in part through the modulation of the HPA axis. Reishi triterpenes, specifically ganoderic acids, exhibit a molecular structure similar to steroid hormones and are likely key to the adaptogenic properties of reishi (5).

Antioxidant

In models of stress-induced behavioral disorders, like binge drinking, reishi’s anti-anxiety action was strongly correlated with antioxidant capacity. Reishi extract reduces lipid peroxidation and promotes antioxidant defenses due to the presence of flavonoids, unsaturated fatty acids, ganoderic acids and polysaccharides (10).

Active Compounds in Reishi

Triterpenoids (ganoderic acids)

Fat-soluble compounds that are key for decreasing neuroinflammation and modulating HPA axis

Polysaccharides

Water-soluble compounds that display anxiolytic activity and evoke GABA release

Phenols and flavonoids

Anxiolytic activity observed in a methanol extract of reishi was suggested to be due to the presence of these compounds

Sterols (Beta-sitosterol)

Beta-sitosterol is considered a potential central active compound for sedation and linked to anti-anxiety effects

Dosing for Reishi

If I use reishi alone, in my practice I usually recommend between 2-3g daily, and depending on the person they may need a little more or less and we adjust based on their response. I recommend taking reishi at night if you primarily experience night time anxiety, or during the day for day-time anxiety. Taking twice daily (morning and afternoon) provides the most comprehensive 24-hour relief.

In clinical trials, the following doses showed the greatest efficacy:

Spore powder: 3g/day

Fruiting body: 6g/day, in divided doses

Timeline

2 days - 2 weeks for onset of action

Best forms

Fruiting body (with spores if possible)

How to take reishi for anxiety

If you have	Primary mushroom	Secondary mushroom	Dose and timing	Add if needed	Feel it in
Generalized anxiety (daytime baseline)	Reishi (Ganoderma lucidum)	Lion’s mane (Hericium erinaceus)	Reishi 500–1000 mg AM + PM	L-theanine 100–200 mg Magnesium glycinate 200–300 mg HS	3–7 days; 2–4 weeks fuller effect
Nighttime anxiety (sleep-onset/early waking)	Reishi (PM) (Ganoderma lucidum)	Lion’s mane (AM) (Hericium erinaceus)	Reishi 500–1500 mg, 60–90 min before bed	Glycine 3 g before bed; Passionflower 250–500 mg before bed	3–5 nights; 2–3 weeks steadier sleep

Generalized anxiety (daytime baseline)

Primary mushroom

Reishi (Ganoderma lucidum)

Secondary mushroom

Lion’s mane (Hericium erinaceus)

Dose & timing*

Reishi 500–1000 mg AM + PM

Add if needed

L-theanine 100–200 mg
Magnesium glycinate 200–300 mg HS

Feel it in

3–7 days; 2–4 weeks fuller effect

Nighttime anxiety (sleep-onset/early waking)

Primary mushroom

Reishi (PM) (Ganoderma lucidum)

Secondary mushroom

Lion’s mane (AM) (Hericium erinaceus)

Dose & timing*

Reishi 500–1500 mg, 60–90 min before bed

Add if needed

Glycine 3 g before bed;
Passionflower 250–500 mg before bed

Feel it in

3–5 nights; 2–3 weeks steadier sleep

How to choose a reishi: quality checklist

✓ Fruiting body (not myceliated grain)

✓ Extracted (hot water or dual extract (water/alcohol), not just dried powder

✓ β-glucans quantified (not just “polysaccharides”)

✓ Triterpenes quantified

✓ Species ID verified (Latin binomial on label)

✓ Third-party tested (heavy metals, pesticides, microbes)

✓ Transparent extract ratio

Lion’s Mane for Anxiety and Mood

Lion’s mane was used by yamabushi monks of Japan to enhance focus, clarity, and presence during meditation. Though less documented in ancient herbal texts than reishi, it was valued in folk medicine as a tonic for the stomach and nerves. Its ability to “open the mind” and “lift the spirit” was attributed to its nervine and adaptogenic qualities.

In practice: what lion's mane does best

In my clinical practice, I most often prescribe lion's mane:

When there is a brain fog and ADHD component present or
When memory issues start to arise as a result of chronic stress

Human clinical trials

Human trials generally show positive trends in reducing anxiety and related mood symptoms, especially in populations already experiencing some distress, such as perimenopausal women. For example, a four-week trial using the lion's mane fruiting body demonstrated a significant reduction in depression, with anxiety also tending to be lower in the lion's mane group (12). To reiterate the study mentioned earlier, a mushroom blend of lion's mane, reishi, and cordyceps significantly decreased anxiety and salivary cortisol in young adults.

Another study, utilizing a product composed of 80% mycelium and 20% fruiting body, found a significant reduction in depression and anxiety symptoms in overweight individuals, with anxiety symptoms decreasing by over 40%.13 Furthermore, a separate trial showed that participants experienced reduced stress after 28 days of using a fruiting body extract, compared to a placebo (14).

Mechanism of action (mostly deduced from animal studies)

A number of animal studies have demonstrated anxiolytic action from both the lion's mane fruiting body and mycelium (15-18). The anxiolytic and anti-depressant effects of lion’s mane are linked primarily to the bioactive compounds, hericenones (found in the fruiting body) and erinacines (found in the mycelium), both of which cross the blood brain barrier. The mechanisms primarily focus on stimulation of neurogenesis, decreased inflammation and HPA axis modulation.

Stimulation of Neurotrophic Factors and Neurogenesis

Hericenones and erinacines are both stimulators of nerve growth factor (NGF) synthesis. NGF enhances neurochemical differentiation and neurogenesis-inducing effects, both linked to antianxiety and antidepressant activity (12). In mice, lion’s mane reduces anxiety by promoting hippocampal neurogenesis. Brain derived neurotrophic factor is often deficient in mood disorders and lion’s mane positively modulates these pathways (13).

Anti-inflammatory and Neuroprotective

Lion’s mane acts as an anti-inflammatory agent by reducing peripheral and brain inflammation. Studies have shown reduced inflammation via downregulating proinflammatory cytokines and blocking NF𝛋B signalling (16).

HPA Axis Modulation

Lion’s mane is a nervous system-specific adaptogen or a nervous system trophorestorative. While an adaptogen helps to modulate the stress response, a nervous system trophorestorative has restorative action to the nervous system. In the previously mentioned clinical trial on young adults, supplementation with the mushroom blend containing lion’s mane, reishi and cordyceps significantly reduced salivary cortisol levels compared to placebo (5).

Psychobiotic

Lion’s mane decreases gastrointestinal inflammation and improves gut microbiome parameters, which, through the gut-brain axis, support mood regulation (11,19, 20).

Mitochondria support/antioxidant

Ergothioneine found in lion's mane supports healthy mitochondrial function through its antioxidant activity. While it doesn't have a direct anxiolytic effect, its neuroprotective and anti-inflammatory impacts indirectly contribute to anxiety reduction. Anxiety and depression are often linked to cellular stress and inflammation, and ergothioneine, as a potent antioxidant, protects cells by preventing damage to proteins, DNA, and lipids (21,22).

Active Compounds in Lion's mane

Hericenones

Found in the fruiting body, stimulate NGF synthesis

Erinacines

Found in the mycelium, stimulates NGF synthesis, modulates brain-derived neurotrophic factor (BDNF) pathways, restores monoamine levels

Polysaccharides

Contribute to overall anti-inflammatory, anti-oxidant and neuroprotective effects

Ergothioneine

Antioxidant amino acid derivative that crosses the blood brain barrier and protects mitochondrial health

Dosing for Lion's mane

If I use Lion's mane alone, in my practice I usually recommend between 1-3g daily and depending on the person they may need a little more or less and we adjust based on the person’s response.

I recommend taking lion’s mane earlier in the day because it can cause sleep disturbance in some people. If no issues taking it later in the day, then twice daily dosing is usually recommended.

In clinical trials, the following doses showed the greatest efficacy:

Mycelium + fruiting body (80% + 20%) - 1.5g/day

Fruiting body - 2g/day, in divided doses

Timeline

1–2 weeks; cognition 4–8 weeks

Best forms

Fruiting body and pure mycelium

How to take lion's mane for anxiety

If you have	Primary mushroom	Secondary mushroom	Dose and timing	Add if needed	Feel it in
Anxious brain fog/focus issues	Lion’s mane (Hericium erinaceus)	Cordyceps (AM) (Cordyceps militaris)	Lion’s mane 500–1000 mg AM (± midday)	Bacopa 150–300 mg PM	1–2 weeks; cognition 4–8 weeks

Anxious brain fog/focus issues

Primary mushroom

Lion’s mane (Hericium erinaceus)

Secondary mushroom

Cordyceps (AM) (Cordyceps militaris)

Dose & timing*

Lion’s mane 500–1000 mg AM (± midday)

Add if needed

Bacopa 150–300 mg PM

Feel it in

1–2 weeks; cognition 4–8 weeks

How to choose a reishi: quality checklist

✓ Fruiting body (not myceliated grain)

✓ Extracted (hot water or dual extract (water/alcohol), not just dried powder

✓ β-glucans quantified (not just “polysaccharides”)

✓ Triterpenes quantified

✓ Species ID verified (Latin binomial on label)

✓ Third-party tested (heavy metals, pesticides, microbes)

✓ Transparent extract ratio

How to take medicinal mushrooms for anxiety

Lion's mane, reishi, and cordyceps each offer distinct benefits for anxiety:

Reishi is ideal for anxiety-induced insomnia and generalized anxiety
Lion's mane addresses brain fog and scattered thinking, and
Cordyceps combats fatigue stemming from prolonged anxiety and stress

Although these mushrooms often complement each other, you can consider taking them individually at first to observe your personal response to each. Some find cordyceps or lion's mane to be stimulating, potentially interfering with sleep, so I typically recommend consuming cordyceps and lion's mane earlier in the day, while reishi can be taken at any time.

An initial "loading" dose of 3g of total mushroom extract powder may help alleviate immediate anxiety and stress, followed by a maintenance dose of 2g daily for ongoing support.

For optimal absorption, I recommend taking mushroom extracts on an empty stomach. However, for mood-related benefits, the timing with food seems less critical. I encourage you to experiment with both methods to discover what works best for you.

At-a-Glance Guide: Individual Mushrooms

If you have	Primary mushroom	Secondary mushroom	Dose and timing	Add if needed	Feel it in
Nighttime anxiety (sleep-onset/early waking)	Reishi (PM) (Ganoderma lucidum)	Lion’s mane (AM) (Hericium erinaceus)	Reishi 500–1500 mg, 60–90 min before bed	Glycine 3 g before bed; Passionflower 250–500 mg before bed	3–5 nights; 2–3 weeks steadier sleep
Anxious brain fog/focus issues	Lion’s mane (Hericium erinaceus)	Cordyceps (AM) (Cordyceps militaris)	Lion’s mane 500–1000 mg AM (± midday)	Bacopa 150–300 mg PM	1–2 weeks; cognition 4–8 weeks
Burnout/“tired-but-wired” stress & anxiety	Cordyceps (Cordyceps militaris)	Reishi (PM) (Ganoderma lucidum)	Cordyceps 500–1000 mg AM (avoid late PM)	Adaptogens you tolerate (e.g., Rhodiola AM)	5–10 days; stamina 3–4 wks
Generalized anxiety (daytime baseline)	Reishi (Ganoderma lucidum)	Lion’s mane (Hericium erinaceus)	Reishi 500–1000 mg AM + PM	L-theanine 100–200 mg Magnesium glycinate 200–300 mg HS	3–7 days; 2–4 weeks fuller effect

Nighttime anxiety (sleep-onset/early waking)

Primary mushroom

Reishi (PM) (Ganoderma lucidum)

Secondary mushroom

Lion’s mane (AM) (Hericium erinaceus)

Dose & timing*

Reishi 500–1500 mg, 60–90 min before bed

Add if needed

Glycine 3 g before bed;
Passionflower 250–500 mg before bed

Feel it in

3–5 nights; 2–3 weeks steadier sleep

Burnout/“tired-but-wired” stress & anxiety

Primary mushroom

Cordyceps (Cordyceps militaris)

Secondary mushroom

Reishi (PM) (Ganoderma lucidum)

Dose & timing*

Cordyceps 500–1000 mg AM (avoid late PM)

Add if needed

Adaptogens you tolerate (e.g., Rhodiola AM)

Feel it in

5–10 days; stamina 3–4 wks

Anxious brain fog/focus issues

Primary mushroom

Lion’s mane (Hericium erinaceus)

Secondary mushroom

Cordyceps (AM) (Cordyceps militaris)

Dose & timing*

Lion’s mane 500–1000 mg AM (± midday)

Add if needed

Bacopa 150–300 mg PM

Feel it in

1–2 weeks; cognition 4–8 weeks

Generalized anxiety (daytime baseline)

Primary mushroom

Reishi (Ganoderma lucidum)

Secondary mushroom

Lion’s mane (Hericium erinaceus)

Dose & timing*

Reishi 500–1000 mg AM + PM

Add if needed

L-theanine 100–200 mg
Magnesium glycinate 200–300 mg HS

Feel it in

3–7 days; 2–4 weeks fuller effect

At-a-Glance Guide: Mushroom Formula

If you have	Mushroom Formula	Dose and timing	Add if needed	Feel it in
Anxiety (any type)	Reishi Lion's Mane Cordyceps	1,500 mg AM + PM	See above for specific situations

Combining mushrooms with other natural anxiety remedies

Medicinal mushrooms often work well on their own, though they also complement other natural remedies and work synergistically with many botanicals and nutraceuticals. Remember when starting a new therapy to introduce one element at a time. Instead of combining reishi, cordyceps, lion's mane, and other listed herbs and supplements all at once, try each individually. Give each a few weeks to assess tolerance and effectiveness. If well-tolerated and you desire further improvement, then consider adding another therapy. If a therapy isn't helpful, discontinue its use.

Nutraceuticals that pair well:

L-theanine 100-400mg/day

L-theanine proves most effective for anxiety-induced insomnia and intermittent anxiety throughout the day, particularly when combined with reishi mushroom. For enhanced focus, L-theanine combines well with lion's mane.

Magnesium (glycinate or threonate) 200 - 500 mg/day

Magnesium is another excellent daily supplement for anxiety. I consistently recommend taking magnesium at night, as it also helps with sleep. While most magnesium types are best taken at night, magnesium-L threonate, a specialized form that crosses the blood-brain barrier to support memory and focus, can be taken earlier in the day.

Botanicals that pair well:

Adaptogens

Ashwagandha: 300–600 mg/day of a high-quality extract (standardized to ≥ 5% withanolides)

Bacopa monnieri (Brahmi) 300-600 mg/day

Licorice: 250–500 mg of dried root, 1–2 times daily or 100–200 mg of a 10:1 extract standardized to 4–6% glycyrrhizin (monitor blood pressure)

Nervines

Kava: 250–300 mg of kavalactones daily (divided or at bedtime)

Lavender:

Oral extract: 80–160 mg/day of Silexan® (standardized essential oil used in trials)
Aromatherapy: 2–4 drops essential oil in a diffuser or on wrists/temples

Lemon balm: 300–600 mg 2–3x/day or 600-1200 mg at bedtime

Passionflower: 250–500 mg extract or 1-2 mL tincture 1–3x/day

Hawthorne: 250–500 mg extract or 1-2 mL tincture, 1–3x/day

Motherwort: 300–600 mg extract or 1-2 mL tincture, 1–3x/day

Milky oat seed: 2-5 ml tincture 2-3x/day

Jujube dates:

Dried fruit: 5–15 g daily
Tincture - 2-4 mL 1-3x/day

Magnolia bark: 1-3 g/day of powder or 1-3 mL tincture 1-3x/day

Dr. Anna's favorite herb + mushroom combinations

Reishi and ashwagandha

Ideal for daily support during chronic stress. Consider adding milky oat seed and passionflower for enhanced relief from burnout and nervous system depletion, especially when there are sleep challenges.

Reishi, hawthorn, and motherwort

Beneficial for anxiety accompanied by heart palpitations and high blood pressure.

Reishi, jujube, magnolia and licorice

For anxiety and burnout-induced insomnia

Reishi, passionflower, kava, lavender

For anxiety-induced insomnia

Lion’s mane and bacopa

Anxiety accompanied by brain fog and forgetfulness

Cordyceps and milky oat seed

Anxiety and nervous system exhaustion that dampens libido and vitality

Reishi and cordyceps, and to a lesser degree lion's mane, are recognized adaptogens that effectively complement other adaptogenic herbs. Adaptogens are crucial for supporting the body's stress response and mitigating conditions frequently exacerbated by chronic stress, such as hormone dysregulation, illness, and fatigue. The experience of anxiety is a common consequence of chronic stress, manifesting both acutely and as burnout, making adaptogens valuable therapeutics for anxiety. While lion's mane exhibits some adaptogenic qualities, it is more precisely categorized as a nervous system trophorestorative, though the distinction can occasionally be subtle.

Nervines, a class of herbs also often considered nervous system trophorestoratives, are invaluable for supporting the nervous system. They synergize particularly well with adaptogens; consider adaptogens as addressing the fundamental issues, while nervines provide crucial support at the periphery of nervous system dysregulation.

Different nervines offer varying benefits and often work best when combined. Experimenting with several nervines simultaneously, especially when paired with adaptogens, provides a more comprehensive therapeutic effect than when used in isolation.

Safety and Side Effects

Mushrooms are generally considered very safe and can often be categorized more as a food than a supplement.

Cordyceps will not take over your mind and turn you into a zombie, and generally has very few safety concerns.

There is theoretical concern around lion’s mane possibly increasing endometriosis pain, but I have never seen this clinically.

Reishi is often pigeonholed as a blood thinner, but I have never seen reishi cause issues with bleeding. That being said, discontinue reishi at least 2 weeks prior to any surgery just to be on the safe side.

There have been some cases of lion’s mane causing vertigo and dizziness, though these are mostly Reddit reports and I have yet to see this in clinical practice.

One common concern when considering supplements for anxiety is their safety when taken with medications like SSRIs, SNRIs, benzodiazepines, or anti-psychotics.

There are no known drug interactions between reishi, cordyceps, or lion's mane and any of these medication classes. Therefore, I consider them all safe to take alongside these medications without interference or interaction.

Below, I've created a table of theoretical side effects. This is based purely on the mechanism of action, not on clinical observation. I have never actually seen any of these drug interactions or side effects occur clinically.

Drug interactions (theoretical)

Mushroom	Interaction	Rating
Cordyceps	Immunosuppressants	Moderate
Cordyceps	Testosterone	Minor
Cordyceps	Anticoagulant/antiplatelet	Moderate
Lion's mane	Immunosuppressants	Moderate
Lion’s mane	Antidiabetes drugs	Moderate
Lion’s mane	Anticoagulant/antiplatelet	Moderate
Reishi	Antihypertensive drugs	Moderate
Reishi	Anticoagulant/antiplatelet	Moderate
Reishi	Antidiabetes drugs	Moderate

In practice: what reishi does best

In my clinical practice, I most often prescribe reishi for:

Anxiety-induced insomnia
General mood stability throughout the day and
An improved response to stress

In practice: what reishi does best

In my clinical practice, I most often prescribe reishi for:

Anxiety-induced insomnia
General mood stability throughout the day and
An improved response to stress

In practice: what reishi does best

In my clinical practice, I most often prescribe reishi for:

Anxiety-induced insomnia
General mood stability throughout the day and
An improved response to stress