Traditional Chinese medicinal fungus with strong evidence for respiratory conditions, kidney support, and immune function. Wild harvesting is unsustainable - modern standardized extracts from cultivated sources show clinical efficacy.
Traditions: Traditional Chinese Medicine, Tibetan medicine
Multiple traditions agree on use.
Official in Chinese Pharmacopoeia since 1964. Sweet, neutral, acts on lung and kidney meridians. Used to replenish kidney, soothe lung, stop bleeding, eliminate phlegm. Traditional for fatigue, chronic cough, sexual dysfunction, post-illness recovery.
Known as Yarsagumba. Major economic resource for high-altitude communities. Traditional uses align with TCM applications.
Cordyceps has particularly strong evidence for respiratory conditions and kidney support, with multiple large systematic reviews. A 48-week trial in chronic bronchitis found 72% reduction in exacerbations. Renal dysfunction meta-analysis included 1,310 participants. Wild cordyceps is nearly extinct - all modern evidence uses cultivated alternatives (Cs-4, Bailing, etc.) which appear equally effective.
15 studies, n=1,310. Diagnostic odds ratio 18.0 (95% CI: 8.0-39.0), reduced creatinine, improved urine osmolality
240 participants, 48 weeks, 6 g/day Bailing. Exacerbations: 0.43 vs 1.56 placebo (72% reduction, p<0.001)
12 trials, n=928. Improved tumor response (RR 1.17), +4.98% CD4+ cells, +4.17% NK cells, 62% reduction in myelosuppression
110 participants, 12 weeks. -10.1 point reduction in symptoms (p<0.001), -8.1 fatigue reduction (p=0.011)
Most studied preparations. Cs-4 for exercise/general use, Bailing for respiratory/kidney, JinShuiBao for diabetic nephropathy. All are cultivated mycelium extracts standardized to polysaccharides (40%), mannitol (8%), adenosine (0.2%).
Can mix into beverages. Polysaccharides are water-soluble - works in tea or warm water. Higher crude doses needed vs extracts.
Traditional preparation. Extremely expensive with wild cordyceps (US$25,000/kg in 2007). Use cultivated powder as modern equivalent.
Cordyceps represents an unusual case in herbal medicine: strong traditional use for specific conditions (kidney, lung) backed by unusually large and consistent clinical evidence. The chronic bronchitis trial stands out - 240 people tracked for 48 weeks is rare in herbal research.
Strong evidence (systematic reviews and meta-analyses):
Moderate evidence:
Critical context discovered: Wild Cordyceps sinensis has declined >90% in 25 years and costs ~$25,000/kg [8]. Every modern clinical trial uses cultivated alternatives (fermented mycelium: Cs-4, Bailing, JinShuiBao). These work. The evidence suggests polysaccharides and nucleosides drive effects more than the famously scarce wild fruiting bodies.
Traditional Chinese Medicine (official since 1694):
Traditional indications:
Tibetan medicine:
Etymology tells the story:
What’s absent: No traditional use in Ayurveda, European herbalism, or other systems. This is a high-altitude Asian specialty (Tibetan Plateau, 3,000-5,000m). When traditional use is geographically and culturally specific, and modern RCTs confirm those exact uses (lung, kidney, vitality), that convergence matters.
Standardized extracts (most studied, most practical):
Three main types - choose based on your goal:
| Extract | Best For | Dose | Evidence |
|---|---|---|---|
| Cs-4 | General wellness, exercise, Long COVID | 1-3 g/day | Most RCTs, exercise trials |
| Bailing | Chronic bronchitis, kidney disease, post-transplant | 3-6 g/day | 48-week bronchitis trial |
| JinShuiBao | Diabetic nephropathy, kidney support | 1.5-6 g/day | Chinese clinical use |
All are cultivated mycelium extracts standardized to:
For general wellness/exercise: Cs-4 1 g/day (333 mg × 3 times daily)
For chronic bronchitis or kidney support: Bailing 6 g/day (2 g × 3 times daily with meals)
For immune support: Look for C. militaris products (higher cordycepin) at 1-3 g/day
Traditional decoction (now impractical):
Week 1-4: 1 g/day standardized extract (split into 2-3 doses with meals)
Week 5-8: If targeting specific conditions (respiratory, kidney), increase to 3 g/day (1 g × 3)
Week 9+: For chronic bronchitis or kidney support, increase to 6 g/day (2 g × 3) if needed
Give it at least 8-12 weeks before deciding if it’s working. Most clinical benefits appeared after sustained use, not immediately.
Baseline (1 week before starting):
During trial (weeks 1-12): Track the same markers weekly. Compare:
What to notice:
RED FLAGS - Stop and consult doctor:
What they report: “I can climb stairs without gasping,” “haven’t had bronchitis flare in months,” “recovering faster from workouts,” “energy is more steady.”
What they report: “Didn’t notice anything,” “no change in how I feel.”
Action: If you’re healthy with no specific respiratory/kidney/immune issues, you may not notice subjective effects even if objective markers improve (like cortisol with ashwagandha). That’s okay - not every herb works for every person.
Pregnancy/breastfeeding: Avoid - no safety data.
The problem: Wild Cordyceps sinensis is nearly extinct [8] and prohibitively expensive (~$25,000/kg) [8]. The supplement market has substitution issues (C. militaris sold as C. sinensis, low-quality mycelium, synthetic compounds). Quality control studies document widespread adulteration and counterfeit fermented products.
What to look for:
Avoid:
Brands with good reputation (not exhaustive): Nootropics Depot, Real Mushrooms, Host Defense (look for products specifying Cs-4 or similar standardized extracts).
This is a specialty tool with strong evidence for specific conditions - particularly respiratory and kidney support. The 48-week chronic bronchitis trial showing 72% reduction in exacerbations is impressive [2]. The kidney dysfunction meta-analysis with 1,310 people is unusually large for herbal medicine [1].
When it works: Fewer respiratory flare-ups, easier breathing during exertion, improved kidney markers, better exercise recovery, enhanced immune resilience.
When it doesn’t: You’re healthy with no respiratory/kidney/immune issues, or you’re in the subset that doesn’t respond to the polysaccharide/nucleoside mechanisms.
Critical nuance: Wild cordyceps is essentially gone. Every modern study used cultivated mycelium extracts (Cs-4, Bailing, etc.). These work. Don’t chase expensive “wild” products - you’re paying for scarcity theater, not better efficacy.
Start with 1-3 g/day standardized extract, use therapeutic doses (3-6 g/day) for specific conditions under medical supervision, prioritize quality and species specificity, give it 8-12 weeks minimum. This isn’t a quick fix - it’s a sustained support tool for specific systems (lung, kidney, immune).
Duration: Minimum 8 weeks, optimal 12 weeks. Chronic bronchitis showed benefits at 48 weeks. Kidney support may require months to years under medical supervision.
What to notice:
Start with 1-3 g/day standardized extract, taken in 2-3 divided doses with meals. For respiratory or kidney conditions, therapeutic dose is 3-6 g/day (2 g three times daily). Effects build gradually - this isn't a quick fix. Most clinical benefits appeared after 4-12 weeks. Species matters: C. sinensis (higher polysaccharides) for kidney/respiratory, C. militaris (higher cordycepin) for immune support.
Generally considered: safe
Contraindications:
Pregnancy/Nursing: Avoid - no safety data in pregnancy or lactation. No evidence of harm, but precautionary principle applies.
Excellent safety profile. LD50 >5 g/kg (non-toxic) [9]. Extreme testing at 80 g/kg/day for 7 days showed no fatality [8]. 48-week trial at 6 g/day showed adverse events similar to placebo (29.6% vs 30.4%) [2]. No hepatotoxicity or nephrotoxicity documented [7] - actually used therapeutically for liver and kidney support [1]. No documented drug interactions, but theoretical monitoring recommended with immunosuppressants (may enhance immune function), anticoagulants (traditional use includes hemostasis), and diabetes medications. Bailing is specifically used post-kidney transplant in China without reported rejection issues [8]. Quality matters: choose third-party tested standardized extracts over crude herb to avoid heavy metal contamination.