Psoriasis and Natural Treatment: What Was Measured, and What About Biologics and Methotrexate

Psoriasis (in older Hebrew, “sapachat”) is a chronic, immune-mediated inflammatory skin disease, and a search for “natural treatment” brings up reishi (Ganoderma lucidum, the lingzhi of Chinese medicine), cordyceps and turkey tail right beside it. The honest answer: none of our four mushrooms has been tested in humans with psoriasis. There are mice, isolated compounds and a gel on the skin. And with biologics, methotrexate and apremilast (Otezla) — zero combination studies in humans.

The kinds of evidence that do exist, from closest to a person to furthest away: one randomized trial in humans with psoriasis — of a different Chinese mushroom (Huaier), given on top of an herbal preparation; a human trial in kidney transplant recipients, in which those given cordyceps were prescribed lower cyclosporine doses by their physicians and had lower trough levels — with no interaction measured; a trial in healthy volunteers in which purified beta-glucan from reishi raised immune-cell markers; mice in which a compound from reishi and a compound from cordyceps improved psoriasis-like lesions; and test-tube studies of liver enzymes. On the question that matters to you — a mushroom taken by mouth, in a person with psoriasis who takes a drug — there is no measurement. This page continues our page on medicinal mushrooms and autoimmune disease, and focuses on what you are actually asking: your drug, stress, sleep, and what was measured.

Do medicinal mushrooms help with psoriasis — what was actually tested?

In humans — nothing. No trial has given reishi, lion’s mane, cordyceps or turkey tail to people with psoriasis. What was tested is one compound from reishi and one compound from cordyceps, in mice whose lesions were induced with an immune-stimulating ointment — in some of the experiments applied straight to the skin. That is not “proven not to work”. It is “not measured in a person”.

To understand what that means, it helps to know the model. Almost all psoriasis research in mice is done in the IMQ model: imiquimod ointment — a substance that stimulates the innate immune system through the TLR7 receptor — is rubbed onto the mouse’s skin, and the skin develops redness, scaling and thickening that resemble psoriasis. It is a useful model for testing mechanisms. It is not a model of a person who has lived with the disease for twenty years and takes a biologic.

And what the market sells as “mushrooms for psoriasis” is usually a capsule or drops taken by mouth. The mouse studies tested something else: isolated ganoderic acid A, injected into the abdominal cavity or applied to the skin; and cordycepin in a gel. Neither is a whole extract that is swallowed. What to ask your doctor: not “does reishi help psoriasis” — but “is there anything about my drug that means I should tell you about every supplement?” The answer, almost always, is yes.

What was measured, in what system — and what came out?

The table sorts the questions you ask by what was measured and in which organism. The mushroom rows are full of mice and test tubes. The drug rows are almost entirely empty — except for one human data point from the world of transplantation. And the only row with a randomized trial in humans with psoriasis belongs to a mushroom we do not grow.

Taking adalimumab (Humira), secukinumab (Cosentyx), ustekinumab (Stelara) or risankizumab (Skyrizi) — can you add medicinal mushrooms?

Not measured. We found not a single study that tested any of our four mushrooms with TNF blockers such as adalimumab (Humira), with IL-17 inhibitors such as secukinumab (Cosentyx), with ustekinumab (Stelara) or with risankizumab (Skyrizi). Biologics are proteins that are broken down in the body like any protein, so an interaction through liver enzymes is theoretically less likely — but theory is not measurement.

What the market claims. “Mushrooms balance the immune system, so they complement the biologic.” There is not a single patient behind that sentence. We searched PubMed for the drug names together with mushrooms — secukinumab, ixekizumab, ustekinumab, risankizumab — and got zero for each one. For TNF blockers, rituximab and IL-6 blockers — the same answer, in the search we ran for the parent page.

What exactly was measured. On the drugs themselves — a lot. A 2025 meta-analysis of 29 papers on randomized trials found that IL-17 inhibitors were associated with Candida (yeast) infection at an odds ratio of 2.39 compared with placebo, while TNF blockers and IL-12/23 inhibitors did not reach significance; for all biologics together, the odds ratio for superficial fungal infection was 2.10. It is important to say what this is not: Candida is a yeast, not an edible mushroom and not a medicinal mushroom, and no study has tested whether a mushroom extract changes anything about this risk — for better or for worse.

A question nobody asks. In Japan, the biologics committee of the dermatological association recommends testing, among other things, blood β-D-glucan before starting a biologic — a marker of fungal infection. In a series of 127 patients, 7 of them (5.5%) were above the range. Beta-glucan is exactly what we measure in our extracts. Does beta-glucan taken by mouth affect this test? We searched — and found no study either way. This is not a claim that there is a problem; it is a simple reason to tell your doctor about the supplement before the screening tests.

What can be known today. That an interaction study does not exist, that the “stimulation versus suppression” question is open (details in the chapter on the immune system), and that the right answer is neither “safe” nor “dangerous” but “not measured”. What to ask your doctor: “I’m considering a mushroom supplement — is there any reason not to, while I’m on the biologic? And before the blood tests — should I tell you?” We gathered the general list of what was measured and what was not on our page on drug interactions.

Methotrexate and the liver: what is known about combining it with reishi?

The combination has never been tested in humans. What is known: in a meta-analysis of 32 trials, methotrexate raised any liver event 2.19-fold and significant liver-enzyme abnormalities 2.63-fold — with no increase in liver failure. Reishi is graded D in the LiverTox database — a “possible rare cause” of liver injury. Two things that touch the liver — and therefore a question for your doctor, not a decision to make alone.

What is known about methotrexate. A 2015 meta-analysis of 32 randomized double-blind trials, 13,177 participants with rheumatoid arthritis, psoriasis, psoriatic arthritis or inflammatory bowel disease: methotrexate raised any liver event 2.19-fold, mild enzyme abnormalities 2.16-fold, and significant abnormalities — more than 3 times the upper limit of normal, or stopping treatment — 2.63-fold. But liver failure, cirrhosis or death did not rise (RR 0.12, with a confidence interval that crosses 1). The authors add a caveat: the trials were short, so long-term toxicity was not assessed. That is why people taking methotrexate have regular liver function tests.

What is known about reishi and the liver. In the NIH’s LiverTox database reishi is graded D, and in small placebo-controlled trials the enzymes did not move. On the other side there are case reports: a 47-year-old man who developed acute hepatitis after reishi powder together with alcohol, and recovered fully within two weeks. Cordyceps and lion’s mane are graded E — “unlikely as a cause”. We set all of this out on our page on medicinal mushrooms and the liver.

And the only study that connects the two — in mice, and in the opposite direction. A search for reishi with methotrexate returns three records; two are about cancer drugs, and one is from 2011: mice received reishi polysaccharides by mouth for 10 days, and on days 7–8 an injection of methotrexate at 50 mg/kg into the abdominal cavity. The methotrexate caused severe damage to the lining of the small intestine, and at doses of 100 and 200 mg/kg the polysaccharides “clearly reversed” the damage. Why this does not carry over to a person. The methotrexate dose there is an injected chemotherapy dose, not the low weekly dose used in psoriasis; the gut was measured, not the liver; and the drug’s level in the blood was not measured. Anyone who quotes this as “reishi protects against methotrexate” has not read the methods. What to ask your doctor: “If I start a supplement — should I bring my next liver function test forward?” And in any case: our extract contains 32% alcohol, and people on methotrexate usually get instructions about alcohol — a figure worth bringing to your doctor.

Cyclosporine, apremilast (Otezla) and JAK inhibitors: what about the drugs that pass through liver enzymes?

Here is the only human data point on this page: in kidney transplant recipients, those who received cordyceps were given lower cyclosporine doses by their physicians, and their blood trough levels were significantly lower — no pharmacokinetic interaction was measured. For apremilast and JAK inhibitors there is no measurement with mushrooms — only a test-tube study of the CYP3A enzyme. All three are a question for the pharmacist.

Cyclosporine. This is one of the long-established systemic drugs for psoriasis, and it is also the drug on which the cordyceps literature is richest — because in China cordyceps is given to kidney transplant recipients on purpose, under blood monitoring. In a randomized trial in 202 kidney transplant recipients, 93 received cordyceps at 1 gram three times a day: cyclosporine doses in their group were significantly lower in months 2–6, and blood trough levels were significantly lower in months 3–6 (P<.05). The abstract does not describe blinding, and the doses were set by the physicians according to blood levels — so no mechanism can be inferred from the trial. A 2015 Cochrane review of 5 studies in 447 kidney transplant recipients found that in the arm of cordyceps + low-dose cyclosporine versus standard dose (182 patients) there was no significant difference in survival, rejection or graft function, and described the evidence for secondary benefits as “limited, of low quality”. But this is the benchmark: this is what a measured change looks like. Anyone who takes cyclosporine for psoriasis and adds cordyceps without saying so is changing a variable their doctor is measuring.

Apremilast (Otezla). In 2014, healthy volunteers received apremilast together with ketoconazole, a strong inhibitor of the enzyme CYP3A4 — and exposure to the drug rose by about 36%, a change the authors (from the company that makes the drug) described as “likely not clinically meaningful”. With rifampicin, which increases the enzyme’s activity, exposure plunged by about 72%, and hence the warning: strong CYP3A4 inducers may cause loss of efficacy. Reishi, for its part, inhibited CYP3A in rat liver microsomes, and in human microsomes it was weak — an IC50 above 10 micrograms per milliliter. In other words: the risky direction measured for apremilast is the opposite of the one measured for reishi, and the two were never tested together. A search for apremilast with mushrooms or herbs — zero.

JAK inhibitors. Zero studies. Some of them undergo substantial metabolism via CYP3A4, so the link to reishi is purely theoretical. What to ask the pharmacist: “Does my drug go through CYP3A4? And what is known about supplements that affect it?” — and name the supplement and the mushroom.

“Mushrooms boost the immune system” — isn’t that the opposite of what my drug does?

The question is legitimate, and the honest answer is “unknown”. What was measured: in healthy humans, purified beta-glucan from reishi raised CD3, CD4, CD8 and NK cells. What was not measured: what that rise does to the skin of a person with psoriasis, or to a drug that suppresses exactly one pathway. We found no report of a flare from our four mushrooms — and adverse-event reporting for supplements is voluntary.

What was measured in humans. In a 2023 randomized trial, healthy adults who received purified beta-glucan from reishi for 84 days showed a significant rise in CD3, CD4 and CD8 cells, in the CD4/CD8 ratio and in NK cells, and a significant difference in IgA and NK cytotoxicity — whose direction is not stated in the abstract. A Cochrane review of reishi in cancer patients found a rise of 3.91% in CD3, 3.05% in CD4 and 2.02% in CD8. These are small numbers, but they rule out the claim that “reishi does nothing to the immune system”. We set out the difference between “modulation” and “boosting” on our page on medicinal mushrooms and the immune system.

Why this is especially interesting in psoriasis. In 2004, physicians in Zurich described a patient whose psoriatic plaque was treated with imiquimod — an ointment that stimulates the innate immune system — and the plaque worsened and spread, with a massive rise in interferon in the lesion. That is one case report, about a substance that is not a mushroom; but it is the basis of the mouse model in which reishi and cordyceps were tested, and it shows that in psoriasis “immune stimulation” is not a neutral term. And for beta-glucan itself the picture is contradictory: in 2022, three forms of beta-glucan calmed a psoriasis model in genetically susceptible mice, and at the doses tested did not trigger psoriasis in ordinary mice; in 2019, in SKG mice with a different mutation — a model in which a bacterial beta-glucan (curdlan) actually ignites psoriasis-like skin inflammation, arthritis and gut inflammation, via IL-23 — that was the study’s starting point, and the study itself examined IL-23 blockade and the microbiome. The same family of molecules, two directions, in engineered mice — and not a single person.

What can be known today. We searched specifically for a report of an autoimmune flare after reishi, lion’s mane, cordyceps or turkey tail — and found none. The closest report is three cases of flares (pemphigus and dermatomyositis) while taking echinacea and spirulina — not mushrooms. But consumer and physician reporting of adverse events from supplements is voluntary, so an absence of reports also reflects how loose the reporting system is. “Not tested” is neither “safe” nor “dangerous”. What to ask your doctor: “My drug blocks a specific pathway — are there pathways it’s better not to stimulate?”

“Reishi fights skin inflammation” — what was measured in psoriasis?

One study, in mice. In 2025, ganoderic acid A — a single compound from reishi — was given to mice in the IMQ model, by injection into the abdominal cavity and by application to the skin, and skin thickness, redness and scaling went down. It is the only PubMed record we found for reishi and psoriasis. In humans: zero. As a whole extract taken by mouth: zero.

What the market claims. “Reishi is anti-inflammatory”, “reishi calms the skin”, “reishi for scalp psoriasis”. The first sentence rests on cell and mouse studies — we reviewed them on our page on reishi and inflammation. The other two rest on nothing that was measured.

What exactly was measured. The study, from Xiangya Hospital in China, induced psoriasis in mice with IMQ ointment and measured a mouse-adapted PASI score, tissue staining and RNA sequencing. Ganoderic acid A, by both routes of administration, reduced the signs and the expression of inflammatory cytokines, and the proposed mechanism is inhibition of pyroptosis (an inflammatory form of cell death) via the protein GSDMD. The dose is not stated in the abstract. And the authors conclude that the compound “may be considered for inclusion in dietary recommendations for patients” — a sentence about patients, in a study that did not include a single patient.

Why this does not automatically carry over to a person. Three leaps: from a single compound to a whole extract, in which the amount of ganoderic acid A is unknown (ours included — we measure beta-glucan, not triterpenes); from injection and application to swallowing; and from a days-long model of immune stimulation to human skin with a chronic disease. What can be known: that there is a research direction here, nothing more. What to ask: if your doctor suggests an ointment, what was measured on it — psoriasis ointments were tested in human trials, and that is the difference.

And what about cordyceps and turkey tail?

Cordyceps: three records — cordycepin in a gel on mice, a synthetic derivative of it in microneedles, and a human adverse-event review in which the psoriasis relapse was with a different plant. Trials in humans with psoriasis: none. Turkey tail: zero. The three records for “Trametes” and psoriasis are all about Huaier — a different Chinese mushroom — and one of them is a randomized trial in humans. That is the trial that is easiest to cite wrongly.

Cordyceps. Cordycepin is the substance cordyceps is identified with. In a study published online in 2024 it inhibited the proliferation of skin cells (keratinocytes) induced by IL-17A, and a cordycepin gel improved psoriasis-like lesions in mice; the authors write that it could develop into a “pharmaceutically active agent”. In 2026 a different group went a step further: it synthesized 22 derivatives, because cordycepin itself has “poor metabolic stability that limits clinical use”, and delivered the best of them through a microneedle array on the mouse’s skin. In other words: the most advanced research on cordyceps and psoriasis has moved to a laboratory substance that is not in the mushroom, delivered by a route that is not swallowing. The third record is a 2023 retrospective review of 1,816 adverse-event reports in humans on adaptogens combined with antidepressants, in which 30 cases met the test for a causal link: cordyceps together with sertraline — upper gastrointestinal bleeding; the one psoriasis relapse on the list was with trazodone and a different plant (Tribulus), not with cordyceps.

Huaier — the human trial, and what it is not. In 2018 a randomized double-blind trial in mild-to-moderate psoriasis was published: both arms received Yinxie granules — a Chinese herbal preparation — and one arm additionally received Huaiqihuang granules — a multi-herb formula based on Huaier — while the other received placebo. After 4 weeks, the rates of reaching PASI 50, 75 and 90 differed significantly (P<0.01), as did the affected skin area, the physician’s assessment and quality of life. Three reasons this is not turkey tail: Huaier is Trametes robiniophila, an entirely different species; it was given as a finished preparation on top of another herbal preparation; and the number of participants does not appear in the abstract, and the authors themselves call it a “preliminary study”. A 2025 mouse study of Huaier in the IMQ model showed a decrease in IL-17A and TNF-α. What can be known: that within the genus Trametes something was tested in humans with psoriasis — and that it is not what is sold as “turkey tail”, ours included. What to ask: if someone presents this trial to you as proof for turkey tail — ask for the species name.

And psoriatic arthritis?

Zero. A search for psoriatic arthritis with reishi, cordyceps, turkey tail or “mushroom” returns zero results in PubMed — not in humans, not in animals. The closest trial is reishi in rheumatoid arthritis: 65 patients, 24 weeks, and the primary endpoint was not met — 15% versus 9.1% on placebo.

“Psoriasis and arthritis” is one of the most prominent searches in Hebrew, and rightly so: people living with psoriatic arthritis deal with pain, stiffness and fatigue, and according to a 2024 meta-analysis the sleep gap compared with healthy controls is larger in the psoriatic-arthritis subgroup. On mushrooms — there is no measurement. What the market cites as “reishi for arthritis” is the 2007 trial in rheumatoid arthritis: reishi 4 grams together with San Miao San 2.4 grams a day, on top of existing medication. ACR20 — the main endpoint — did not differ from placebo, immune cells and five inflammatory cytokines did not move, and only pain and the patient’s global assessment improved. And not even that can be attributed to reishi, because it was given with another herb. We set out the trial, and what it means for people on methotrexate, on our page on rheumatoid arthritis and natural treatment, and what was measured on pain that lasts for months on our chronic pain page. What to ask your rheumatologist: whether the pain is inflammatory or mechanical — because that also determines which supplements are even relevant.

Stress and sleep: what was measured on what sets off a flare?

On the link itself — a lot: 31–88% of patients report that stress sets off a flare for them, and people with psoriasis are 6.64 times more likely to have a sleep disorder. On mushrooms — very little: lion’s mane in 41 healthy young adults showed a trend toward lower stress, p=0.051, not significant. Reishi and sleep: not a single human trial.

Stress. A 2018 review summarizes that 31 to 88 percent of patients report stress as a trigger, that the incidence of psoriasis is higher in people who went through a stressful event in the previous year, and that stress is also a result of flares — a cycle. A systematic review from the same year found a “plausible temporal association” between stress and onset, recurrence and severity. And what was found effective in controlled trials: relaxation, hypnosis, biofeedback and cognitive-behavioral therapy for stress management. These are not supplements.

What was measured on mushrooms and stress. The trial that gets cited: 41 healthy adults aged 18–45, lion’s mane 1.8 grams. After a single dose — a faster Stroop test; after 28 days — a “trend” toward lower subjective stress, p=0.051. That is not significant, the authors write “with caution”, and they also report null and negative results. Not people with psoriasis, not flares. We gathered what was measured on reishi and stress on our page on reishi for anxiety and stress.

Sleep. A 2024 meta-analysis of 15 studies — 1,274 patients and 775 controls — found a PSQI score higher by 3.397 points, a risk of sleep disorder at OR 6.640, more insomnia, more restless legs syndrome and higher depression scores; daytime sleepiness, notably, did not differ. And here is the biggest gap in the market: “sleep” is the most common completion of “reishi for…” in Hebrew — six out of fifteen — and we found not a single randomized trial in humans on reishi and sleep. We set this out on our page on reishi for sleep. The closest thing measured is fatigue: in 132 patients with neurasthenia, a reishi polysaccharide extract for 8 weeks reduced the feeling of fatigue by 28.3% — versus 20.1% on placebo. The real difference is about 8 points, not 28. What to ask your doctor: whether itching at night is what wakes you up — because that is something treating the skin itself should improve.

What happened when reishi was tested in a population with fatigue, pain and inflammation?

In a 2021 placebo-controlled, pseudo-randomized trial in 29 men with Gulf War Illness, at the high dose symptom severity was higher than on placebo (p=0.012); at the low dose — no change (p=0.603). This is not psoriasis and not an “autoimmune flare” — but it is the only trial we found in which symptom severity was higher with reishi than with placebo.

What was tested. Gulf War Illness is a multi-system syndrome that has affected soldiers since the Gulf War: chronic fatigue, pain and a neuro-inflammatory component. Researchers at the University of Alabama tested two plants and one mushroom in a crossover design: 30 days of baseline, 30 days of placebo, 30 days of a low dose and 30 days of a high dose. Stinging nettle at the high dose lowered symptom severity (p=0.048); epimedium did nothing; and with reishi — at the high dose — symptom severity was higher than on placebo. The authors: “reishi may increase symptoms in some GWI sufferers”, and in the same breath: “the results are from a small sample and are preliminary”.

Why this is here, on a page about psoriasis. Because it is a different population — but with an overlap in symptoms many of you know: fatigue, pain and an inflammatory component. And it is the only sick population in which the result came out in the opposite direction — dose-dependently. What this does not say: that reishi worsens psoriasis — that was not tested. What it does say: that the sentence “it’s natural, so at worst it won’t help” is not supported by the data. What to do with this: if you add a supplement — one at a time, in a diary, with a date, so that if something changes you can tell your doctor when.

So what was measured in “psoriasis natural treatment”?

The medical board of the US National Psoriasis Foundation reviewed 55 studies and about 77,557 participants. One strong recommendation: weight loss on a low-calorie diet for people who are overweight. A weak recommendation: a gluten-free diet — only for people whose blood tests are positive. Medicinal mushrooms do not appear. And no diet is a substitute for treatment.

This may be the most important chapter on the page, because “psoriasis and diet” and “psoriasis and obesity” are real searches, and there is data behind them. The 2018 review in JAMA Dermatology included 4,534 people with psoriasis within the total sample, and graded each intervention by the quality of its evidence. Weight loss received the highest grade. A gluten-free diet — only for people found to have blood markers of gluten sensitivity; if that is you, there is a real link to celiac disease, and we set out the question of gluten in supplements on our page on celiac disease and supplements. For psoriatic arthritis — a weak recommendation for vitamin D. For the other foods, nutrients and dietary patterns, the wording is “based on low-quality data”. And the sentence that closes the recommendations: dietary interventions “should always be used in conjunction with standard medical therapies”.

And what about the branch of searches — “scalp psoriasis natural treatment”, “on the nails”, “on the face”, “in children”? For these subtypes the answer about mushrooms is the same: zero studies in each of them, and each of them belongs with a dermatologist — especially in children. We do not sell vitamin D supplements or weight-loss programs; we are writing this because it is what was measured.

What we actually measure in our bottle

After a whole page of “not measured”, you deserve to know what was measured — and about what exactly. We grow the mushrooms ourselves, on a farm in the Galilee: fresh fruiting body, not mycelium grown on grain and not imported powder. The mushroom goes from harvest straight to extraction, with no drying step in between; as far as we know, we are among the few in the world who work this way. The extraction is triple, and its alcohol stage runs for 7 weeks. Extraction ratios on a fresh-mushroom basis: reishi 1:3, cordyceps 1:2.5, lion’s mane 1:2, and turkey tail + reishi 1:3. Alcohol in the finished extract: 32% — a figure worth bringing to your doctor and pharmacist together with the name of your drug, especially if you are on methotrexate.

And the numbers are not ours to set. We sent the finished extracts for testing at TÜV Austria, and what came back is the beta-glucan percentage on a dry-matter basis — and alongside it alpha-glucan, meaning starch, which was not detected in any of them. Alpha-glucan not detected is the chemical proof that there is no grain in the bottle. To understand why that matters, it helps to know the market’s three-step ladder: mycelium grown on grain, where beta-glucan is usually below 7% and most of the weight is the grain’s starch; imported dried fruiting body, whose quality depends on who dried it and when; and fresh fruiting body from the farm, which is what we do. And on a page that has talked about ganoderic acid A and cordycepin, it should also be said: we have not measured either of these compounds in our extracts, so we will not write a number for them.

All our tests are public, and anyone who wants to read the report themselves will find our explanation of how to read a COA. Kosher certification — Mateh Yehuda Rabbinate, Rabbi Gad Atias. That is what we know how to measure and prove about what is in the bottle. What it will do for psoriasis was not measured — so it is not written.

What this page does not say — and what we do not claim

We do not claim that reishi, lion’s mane, cordyceps or turkey tail improve psoriasis, calm the skin, shrink plaques, lengthen remission or affect psoriatic arthritis — none of them has been tested in humans with the disease. We do not claim that the mouse studies on ganoderic acid A or on cordycepin are relevant to our extract. We do not claim that the Huaier trial applies to turkey tail. We do not claim that combining with adalimumab (Humira), secukinumab (Cosentyx), ustekinumab (Stelara), risankizumab (Skyrizi), methotrexate, apremilast (Otezla) or JAK inhibitors is safe — nor that it is dangerous: it was not measured. We do not claim that mushrooms worsen psoriasis; we do not claim that they do not. We do not claim that lion’s mane reduces stress or that reishi improves sleep. And we do not deal here with national insurance, disability ratings or entitlements — we have no expertise in those and no sources on them. What we do say: psoriasis is treated by a dermatologist, and sometimes also a rheumatologist; anyone taking a biologic, methotrexate, cyclosporine or any systemic drug talks to them before any supplement, including ours. Under DSHEA, a dietary supplement may not claim to diagnose, treat, cure or prevent any disease. We sell mushroom extracts, and we are telling you explicitly not to buy them for psoriasis.

The bottom line

None of our four mushrooms has been tested in humans with psoriasis. There are mice — a compound from reishi, a compound from cordyceps, some of it applied to the skin — and one human trial of a different Chinese mushroom given with an herbal preparation. With biologics, methotrexate, apremilast (Otezla) and JAK inhibitors — zero combination studies in humans; the only human data point comes from kidney transplant recipients, in whom those given cordyceps were prescribed lower cyclosporine doses by their physicians and had lower trough levels — no interaction was measured. Purified beta-glucan from reishi raised immune-cell markers in healthy people, and what that does in psoriasis is unknown. On stress and sleep, which many of you feel as triggers, mushrooms have no significant number. What was measured — weight loss, and gluten only for people whose tests are positive — has nothing to do with us. And if someone sells you a mushroom “for psoriasis” — ask them for the study in humans. For our four mushrooms — it does not exist.

Frequently asked questions

Does reishi help with psoriasis?

Not tested in humans. The only PubMed record is a 2025 study in mice, in which an isolated compound from reishi — ganoderic acid A — was given by injection and applied to the skin, and reduced redness, scaling and skin thickness in the IMQ model. That is not an extract taken by mouth and not a person. What is known in humans: purified beta-glucan from reishi raised immune-cell markers in healthy people — and what that does in psoriasis was not measured.

Can I take medicinal mushrooms with adalimumab (Humira) or secukinumab (Cosentyx)?

Not measured — a question for your doctor. We searched for mushrooms with TNF blockers, secukinumab, ustekinumab and risankizumab, and found zero studies for each one. Biologics are proteins, so an interaction through liver enzymes is theoretically less likely; but whether immune stimulation clashes with a drug that suppresses a specific pathway is an open question. Tell your doctor before the screening tests too.

And what about methotrexate?

The combination has not been tested in humans. Methotrexate raised any liver event 2.19-fold and significant liver-enzyme abnormalities 2.63-fold in a meta-analysis of 32 trials, and reishi is graded D in LiverTox — a possible rare cause of liver injury. The only study on both is in mice, at a chemotherapy dose of methotrexate, and it measured the gut, not the liver. Our extract also contains 32% alcohol — tell your doctor.

Is cordyceps dangerous with cyclosporine?

This is the only place where there is human data. In kidney transplant recipients, those who received cordyceps were given lower cyclosporine doses by their physicians, and their blood trough levels were significantly lower in months 3–6; no interaction was measured. In China the two are combined on purpose, under monitoring. Anyone who takes cyclosporine for psoriasis and adds cordyceps without saying so is changing a value their doctor is measuring.

Has turkey tail been tested in psoriasis?

No. The human trial cited as “turkey tail for psoriasis” is about Huaier — Trametes robiniophila, a different species — given for 4 weeks as a finished preparation, together with a Chinese herbal preparation in both arms. PASI improved significantly, but this is not our mushroom, nor that of any seller of turkey tail.

Do mushrooms reduce the stress that sets off a flare?

Not proven. The trial that gets cited — lion’s mane in 41 healthy young adults, 28 days — showed a trend toward lower subjective stress, p=0.051, not significant. What was found effective in controlled trials in psoriasis: relaxation, biofeedback and cognitive-behavioral therapy for stress management.

Will reishi help me sleep with psoriasis?

There is not a single randomized trial in humans on reishi and sleep — not in psoriasis and not at all. The closest is fatigue: a 28.3% reduction in the feeling of fatigue versus 20.1% on placebo, in patients with neurasthenia. In psoriasis sleep disorders are very common, and sometimes it is the itching that wakes you — a question for your dermatologist.

So what does work as a “natural treatment” for psoriasis?

According to the medical board of the National Psoriasis Foundation: weight loss on a low-calorie diet for people who are overweight — a strong recommendation; a gluten-free diet only for people whose blood tests are positive — a weak recommendation. And any dietary intervention comes on top of medical treatment, not instead of it. Medicinal mushrooms do not appear in the recommendations.

Scientific sources (peer-reviewed)

• Ganoderic acid A from reishi in the IMQ mouse model, by intraperitoneal injection and topical application: lower skin thickness, redness, scaling and inflammatory cytokines, via inhibition of pyroptosis (GSDMD). The only PubMed record for reishi and psoriasis; no patients — Xiao C, et al. Tissue & Cell, 2025. View on PubMed
• Cordycepin inhibited IL-17A-induced keratinocyte (HaCaT) proliferation; a cordycepin gel improved psoriasis-like lesions in mice (IMQ), p53/MDM2 pathway — Chen Y, et al. Molecular Biotechnology, 2025. View on PubMed
• 22 synthetic derivatives of cordycepin, because of “poor metabolic stability”; the derivative CPD3a in a microneedle array reduced psoriasis-like signs in mice, dose-dependently — Pan W, et al. Advanced Science, 2026. View on PubMed
• Retrospective review of 1,816 adverse-event reports on adaptogens combined with antidepressants, 30 cases with a probable causal link: cordyceps + sertraline — upper gastrointestinal bleeding; psoriasis relapse — with trazodone and Tribulus, not with cordyceps — Siwek M, et al. Frontiers in Pharmacology, 2023. View on PubMed
• Randomized double-blind trial in mild-to-moderate psoriasis, 4 weeks: Huaier granules (Trametes robiniophila) + Yinxie preparation versus placebo + Yinxie — PASI 50/75/90, affected area, sPGA and DLQI significant (P<0.01). Number of participants not in the abstract; “preliminary study”; not turkey tail — Su D, et al. BioMed Research International, 2018. View on PubMed
• Huaier in HaCaT cells and in the IMQ mouse model: less redness, scaling and inflammatory infiltration; lower IL-17A and TNF-α; key target STAT1 — Keyao LI, et al. Journal of Traditional Chinese Medicine, 2025. View on PubMed
• Three forms of beta-glucan reduced disease in a mannan-induced psoriasis/PsA model in genetically susceptible mice; at the doses tested they did not trigger psoriasis or arthritis in ordinary mice — Fahlquist-Hagert C, et al. Communications Biology, 2022. View on PubMed
• SKG model: mice develop arthritis, psoriasis-like skin inflammation and gut inflammation in response to a bacterial beta-1,3-glucan (curdlan), dependent on IL-23 (study background; the paper itself examined IL-23 blockade and the microbiome) — Rehaume LM, et al. Annals of the Rheumatic Diseases, 2019. View on PubMed
• Case report: imiquimod (a TLR7 agonist) on a psoriatic plaque — worsening and spread, with induction of type I interferon; plasmacytoid dendritic cells up to 16% of the infiltrate in lesions. The basis of the mouse model — Gilliet M, et al. Archives of Dermatology, 2004. View on PubMed
• Purified beta-glucan from reishi, healthy adults aged 18–55, 84 days, double-blind: significant rise in CD3, CD4, CD8, the CD4/CD8 ratio and NK; significant difference in IgA and NK cytotoxicity (direction not stated); no change in kidney and liver function — Chen SN, et al. Foods, 2023. View on PubMed
• Cochrane, reishi in cancer patients: CD3 +3.91%, CD4 +3.05%, CD8 +2.02%; methodological quality “not sufficient” — Jin X, et al. Cochrane Database of Systematic Reviews, 2016. View on PubMed
• Meta-analysis, 29 papers of randomized trials in psoriasis: IL-17 inhibitors — Candida OR 2.39; TNF-α and IL-12/23 — not significant; all biologics — superficial fungal infection OR 2.10 — Liu H, et al. Mycoses, 2025. View on PubMed
• Japan, 127 patients before a biologic: recommended screening tests include blood β-D-glucan; 7 (5.5%) above the range — Ozaki S, et al. The Journal of Dermatology, 2022. View on PubMed
• Meta-analysis of 32 randomized trials, 13,177 participants: methotrexate — liver events RR 2.19, significant abnormalities RR 2.63; liver failure, cirrhosis or death — RR 0.12, not significant — Conway R, et al. Seminars in Arthritis and Rheumatism, 2015. View on PubMed
• Mice: reishi polysaccharides at 100–200 mg/kg reversed small-intestine damage from injected methotrexate at 50 mg/kg. A chemotherapy dose; gut, not liver — Chen LH, et al. Acta Pharmacologica Sinica, 2011. View on PubMed
• Case report: a 47-year-old man, acute hepatitis after reishi powder with alcohol; full recovery within two weeks — Guedikian R, et al. Cureus, 2023. View on PubMed
• Randomized trial in 202 kidney transplant recipients, cordyceps 1 gram ×3 a day: cyclosporine doses significantly lower in months 2–6, and blood trough levels significantly lower in months 3–6 (P<.05); doses set by the physicians, no interaction measured, blinding not described in the abstract — Li Y, et al. Transplantation Proceedings, 2009. View on PubMed
• Cochrane, 5 studies, 447 kidney transplant recipients: cordyceps + low-dose cyclosporine versus standard dose (one study, 182 patients) — no significant difference in survival, rejection or graft function; “limited low quality evidence” for secondary benefits — Hong T, et al. Cochrane Database of Systematic Reviews, 2015. View on PubMed
• Healthy volunteers: ketoconazole (a CYP3A4 inhibitor) raised apremilast exposure by about 36%; rifampicin (an inducer) lowered it by about 72% — “strong inducers may result in loss of efficacy” — Liu Y, et al. British Journal of Clinical Pharmacology, 2014. View on PubMed
• A reishi polysaccharide dose-dependently inhibited CYP2E1, CYP1A2 and CYP3A in rat liver microsomes — Wang X, et al. Biological & Pharmaceutical Bulletin, 2007. View on PubMed
• In human liver microsomes, on CYP3A: reishi — “lesser effect”, IC50 above 10 micrograms per milliliter — Rodseeda C, et al. Toxicology Reports, 2022. View on PubMed
• Review: 31–88% of patients report stress as a trigger; higher incidence after a stressful event; relaxation, hypnosis, biofeedback and cognitive-behavioral therapy were found effective in controlled trials — Rousset L, Halioua B. International Journal of Dermatology, 2018. View on PubMed
• Systematic review: a “plausible temporal association” between psychological stress and the onset, recurrence and severity of psoriasis — Stewart TJ, et al. International Journal of Dermatology, 2018. View on PubMed
• Meta-analysis, 15 studies, 1,274 patients and 775 controls: PSQI higher by 3.397; sleep disorder OR 6.640; restless legs OR 4.689; daytime sleepiness — no difference — Guo M, et al. Journal of Psychosomatic Research, 2024. View on PubMed
• 41 healthy adults, lion’s mane 1.8 grams: faster Stroop after 60 minutes; subjective stress after 28 days — p=0.051, not significant — Docherty S, et al. Nutrients, 2023. View on PubMed
• 132 patients with neurasthenia, reishi polysaccharide extract 1,800 mg ×3 a day, 8 weeks: fatigue −28.3% versus −20.1% on placebo; “more than minimally improved” 51.6% versus 24.6% — Tang W, et al. Journal of Medicinal Food, 2005. View on PubMed
• 29 men with Gulf War Illness, placebo-controlled crossover: low-dose reishi — no change (p=0.603); high dose — higher symptom severity (p=0.012). “Preliminary results” — Younger J, et al. International Journal of Environmental Research and Public Health, 2021. View on PubMed
• Reishi 4 grams + San Miao San 2.4 grams a day, 65 patients with rheumatoid arthritis, 24 weeks: ACR20 15% versus 9.1% — not significant; immune cells and cytokines unchanged — Li EK, et al. Arthritis and Rheumatism, 2007. View on PubMed
• Dietary recommendations of the medical board of the National Psoriasis Foundation: 55 studies, 77,557 participants (4,534 with psoriasis); weight loss — strong recommendation; gluten-free only with positive serology — weak — Ford AR, et al. JAMA Dermatology, 2018. View on PubMed
• Erinacine A-enriched lion’s mane mycelium, patients with mild Alzheimer’s disease, 49 weeks, double-blind: 4 subjects dropped out for abdominal discomfort, nausea and skin rash — Li IC, et al. Frontiers in Aging Neuroscience, 2020. View on PubMed
• Series of 3 cases: flares of pemphigus and dermatomyositis while taking echinacea and spirulina — immune-stimulating supplements that are not mushrooms — Lee AN, Werth VP. Archives of Dermatology, 2004. View on PubMed

Read next

• Medicinal mushrooms and autoimmune disease
• Rheumatoid arthritis and natural treatment
• Medicinal mushrooms and the liver
• Medicinal mushrooms and the immune system: modulation or boost?
• Does reishi affect the inflammatory response?
• Drug interactions
• Do medicinal mushrooms have side effects?
• Reishi for sleep — what was measured and what was not
• Reishi for anxiety and stress
• Chronic pain and medicinal mushrooms
• Who shouldn’t take reishi
• Who shouldn’t take cordyceps
• Lab results — beta-glucan
• How to read a certificate of analysis (COA)

This page is educational and does not constitute medical advice, diagnosis or a substitute for professional care. Medicinal mushroom extracts are dietary supplements, not drugs, and are not intended to treat psoriasis, psoriatic arthritis or any other medical condition. Psoriasis requires diagnosis and follow-up by a dermatologist. Do not stop, replace or change the dose of a biologic, methotrexate, cyclosporine, apremilast, a JAK inhibitor or any other medication without your treating physician’s guidance. It describes what published trials and case reports recorded — and what was not recorded; it is not a prediction of what any individual will experience, and it is not a recommendation to start, stop or combine any supplement with any medication — those decisions belong with your physician, especially if you take regular medication, are pregnant or breastfeeding, have surgery planned, have liver or kidney disease, or have any existing medical condition. *These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.*