Cordyceps
Cordyceps / Ophiocordyceps sinensis · Dōng Chóng Xià Cǎo 冬虫夏草
The 'caterpillar fungus' prized for energy & stamina.
Evidence tier
Mixed
Research weight
Citations
17 verified / 17
Classification
TCM Herb
❝
What the evidence says. Conflicting results across studies; benefit uncertain.
What is Cordyceps?
Cordyceps (Cordyceps / Ophiocordyceps sinensis · Dōng Chóng Xià Cǎo 冬虫夏草) is a traditional Chinese medicine herb used for possible exercise capacity. NutriDex grades the human evidence as Mixed. Cordyceps (Dōng Chóng Xià Cǎo) is a fungus traditionally used to tonify the kidney and lung and boost vitality. Lab work suggests it may improve oxygen utilization and have immunomodulating effects. Human exercise-performance trials are genuinely mixed — some show small gains in aerobic capacity in older or untrained adults, others show none, especially in trained athletes. Most products are cultivated strains rather than the rare wild fungus.
Purported Benefits
✓Possible exercise capacity
✓Anti-fatigue
✓Immune modulation
✓Traditional kidney/lung tonic
Evidence by outcome
The same supplement can be well-proven for one use and unproven for another — here is the human evidence graded outcome by outcome.
| Outcome | Evidence | Effect | Studies |
|---|---|---|---|
| Aerobic exercise capacity (VO2/ventilatory threshold)Meta-analyses show small VO2peak/threshold gains, mostly in older/untrained adults; trained cyclists showed no benefit (Earnest 2004). | Mixed | ↔ mixed · small | 4 |
| Renal function in chronic kidney disease (adjunct)Multiple meta-analyses show lower creatinine/proteinuria as add-on therapy, but Cochrane rated evidence low-quality with high bias risk. | Mixed | ↑ benefit · moderate | 4 |
| COPD lung function / quality of life (adjunct)One meta-analysis (15 studies) found improved FEV1 and 6-min walk, but author-rated low study quality. | Preliminary | ↑ benefit · moderate | 1 |
| Immune modulation (NK-cell activity)One small RCT (n=20) of C. militaris raised NK activity and lowered cytokines; tiny sample, preclinical support otherwise. | Preliminary | ↑ benefit | 1 |
Dosing & Compounds
Typical Dose
1–3 g/day of cultivated extract (Cs-4 / Cordyceps militaris).
Active Compounds
Safety & Cautions
Generally safe. Mild GI upset. May enhance immune activity and interact with anticoagulants/immunosuppressants. Educational only — always check with your doctor or pharmacist before combining Cordyceps with any medicine.
Key Studies ★ 17 studies
meta-analysis
Garcia-Merino 2025
✓ PubMed
Systematic review/meta-analysis of 14 RCTs (528 athletes; 8 trials/288 in synthesis) found Cordyceps sinensis significantly improved VO2peak (p=0.04, I2=0%) and ventilatory threshold (p=0.03), with marginal endurance benefit (p=0.05).
meta-analysis
Zhang 2024
✓ PubMed
Meta-analysis of 31 RCTs (2,934 CKD patients) showed Bailing capsule (Cordyceps sinensis) added to standard care reduced serum creatinine (SMD -1.30), BUN (SMD -0.98) and 24-h proteinuria (SMD -1.08), all p<0.00001.
Meta-analysis
Shu 2025
✓ Full text
Systematic review/meta-analysis (14 RCTs, 528 athletes; ~3 Cordyceps RCTs, ~47 participants for aerobic outcomes) found Cordyceps sinensis significantly improved VO2peak (p=0.04, I2=0%), ventilatory threshold (p=0.03, I2=0%), and endurance (p=0.05, I2=20%).
Meta-analysis
Frontiers in Medicine meta-analysis (renal dysfunction) 2024
✓ PubMed
Pooled 15 studies/1,310 patients with renal dysfunction: adjunctive Cordyceps sinensis significantly reduced serum creatinine, shortened the oliguria period and increased urine osmolality versus standard therapy alone, indicating improved glomerular and tubular function.
meta-analysis
Yu 2019 (COPD meta-analysis)
✓ PubMed
Systematic review/meta-analysis of 15 studies (1,238 patients) found oral Cordyceps sinensis added to standard care for stable GOLD 2-3 COPD increased FEV1% predicted by ~6.25%, improved 6-minute walk distance by ~45 m, and lowered SGRQ quality-of-life score by ~5.87 points, with no serious adverse events but low study quality.
Meta-analysis
Zhang/kidney-transplant meta-analysis 2017
✓ PubMed
Systematic review/meta-analysis in kidney transplant recipients: adjunctive Cordyceps sinensis was associated with reduced incidence of delayed graft function and lower nephrotoxicity/proteinuria, supporting a renoprotective adjunct role alongside immunosuppression.
Cochrane systematic review
Zhang 2014 (Cochrane)
✓ Full text
Cochrane review of 22 Chinese studies (1,746 CKD patients) found Cordyceps added to conventional therapy may improve renal function and complications, but evidence quality was poor and no definitive conclusions could be drawn.
Systematic review
Cochrane review (Cordyceps for CKD) 2014
✓ PubMed
Cochrane review of 22 studies (1,746 CKD participants) found Cordyceps as an adjunct may decrease serum creatinine, increase creatinine clearance, reduce proteinuria and raise hemoglobin/albumin, but rated the evidence low-quality with high risk of bias - efficacy not confirmed.
rct
Ohta 2024 (immune RCT)
✓ PubMed
Randomized placebo-controlled trial in 20 healthy adults found a Cordyceps militaris beverage (2.85 mg cordycepin/day, 8 weeks) significantly increased NK cell activity (men at 4 weeks p=0.049; women at 8 weeks p=0.023) and reduced inflammatory cytokines (IL-1beta, IL-6).
RCT
Dewi 2024
✓ PubMed
Randomized double-blind placebo-controlled crossover trial (n=14 young adults, 1 g pre-exercise) showed Cordyceps accelerated CD34+ stem cell recruitment to skeletal muscle to 3 h post-exercise (+51%, p=0.002) and produced ~four-fold Pax7+ cell expansion (p=0.01) after high-intensity interval exercise.
randomized controlled trial
Savioli 2022
✓ Full text
Randomized double-blind placebo-controlled trial in 30 amateur marathoners taking 2 g/day Cordyceps sinensis for 12 weeks lowered submaximal heart rate at 8 weeks and improved aerobic performance at 12 weeks.
toxicology/safety analysis
Liu 2022 (arsenic speciation)
✓ PubMed
HPLC-ICP-MS analysis of dry and fresh cultivated Cordyceps products found high total arsenic but predominantly low-toxicity organic species with only trace inorganic arsenic, with risk assessment indicating limited hazard at typical intake.
RCT
Chen 2010 (Cs-4 RCT, older adults)
✓ PubMed
Randomized, double-blind, placebo-controlled trial in 20 healthy older adults: Cs-4 (Cordyceps sinensis) 333 mg 3x/day for 12 weeks significantly increased metabolic/ventilatory threshold (+10.5%) versus no change with placebo, indicating improved exercise capacity.
government
LiverTox (NIH) 2024
✓ Full text
NIH LiverTox monograph assigns Cordyceps a likelihood score of 'E' (unlikely cause of liver injury), noting extracts are generally well tolerated with no reported aminotransferase elevations or clinically apparent hepatotoxicity, apart from a single unconfirmed case of hepatoportal sclerosis that resolved on discontinuation.
Study
Chen 2010
✓ Full text
Improved aerobic performance markers in older adults.
Study
Earnest 2004
✓ PubMed
No ergogenic benefit in trained cyclists.
Preclinical
Immune studies
✓ PubMed
Polysaccharides modulate immune cells in preclinical models.