Reishi and Ashwagandha Together: What to Know

Quick answer

No trial gave reishi and ashwagandha together. Reishi's one graded finding, an early rise in some immune cell counts, used a purified beta-glucan at 200 mg a day, while ashwagandha's best finding, on stress scores, used 600 mg of extract. Both appear in NIH's liver injury database, reishi as a possible cause and ashwagandha as a likely one.^1,2,3,4

Key facts

Reishi's one graded finding is early and came from a purified beta-glucan at 200 mg a day. Whole reishi at 1.44 to 4 g a day left immune measures unchanged in small trials.^1,5,6
LiverTox says none of reishi's claimed benefits has been shown in properly controlled human trials, and a 2025 pooled analysis rated the certainty of every reishi finding as very low.^3,7
Both are in NIH's liver injury database: reishi as a possible rare cause (category D) and ashwagandha as a likely one (score B), each usually showing up in the first weeks or months of use.^3,4
Reishi products vary: in a US analysis of 19 supplements, the measured triterpenes and polysaccharides matched the label in only 5.⁸
Ganoderic acids from a 3 g reishi dose peaked in the blood about 30 minutes after a fasting dose, and taking it after breakfast gave a lower, later peak.⁹

Two very different evidence profiles

Reishi, also called lingzhi, is a woody, bitter mushroom long used in traditional Chinese medicine. Ashwagandha is the root of a shrub used in Ayurvedic medicine. Both are sold as extracts, and both have a short list of small trials. The difference is how the evidence has been reviewed: ashwagandha has several pooled analyses and an NIH review, though they differ on how firm its stress finding is, while the pooled analysis of reishi rated its own findings as very low certainty.^3,10

A 2025 pooled analysis of 17 randomized trials in 971 people rated the certainty of every reishi finding as very low.⁷

What each is graded for

A purified reishi beta-glucan may raise counts of some immune cells in healthy adults*^1,5,6,11

Early evidence

In a randomized, placebo-controlled trial in healthy adults aged 18 to 55 (157 enrolled, 135 finished), 200 mg a day of a purified reishi beta-glucan for 12 weeks raised counts of several kinds of T cells and natural killer cells more than placebo. It did not measure whether people fell ill less often, and a company paid for it. A trial in young children who ate a yogurt with reishi beta-glucans found a similar rise. Whole reishi did not show this: 1.44 g a day for 4 weeks, and 4 g a day of an extract for 10 days, left immune measures unchanged in small trials.

Amount studied: 200 mg a day of purified reishi beta-glucan, for 12 weeks

Helps the body handle occasional stress, with lower cortisol levels measured in trials*^2,10,12

Moderate evidence

Two placebo-controlled trials of a branded root extract at 600 mg a day (64 adults for 60 days; 60 adults in three groups for 8 weeks) found lower stress questionnaire scores and lower blood cortisol than placebo; in the larger trial cortisol fell 27.9% against 7.9% on placebo. NIH's summary of seven trials (491 adults, all in India) points the same way, but the trials were small and short and the maker supplied the extract.

Amount studied: 600 mg a day of root extract, as 300 mg twice a day, for 8 weeks to 60 days

The two findings are about different things, and the reishi one is narrow. It describes a purified extract of one group of compounds, which is not what most reishi capsules hold. Nothing in either file describes the two taken together.

Absorption and timing

Taken on an empty stomach, ganoderic acids from a 3 g dose of reishi extract appeared in the blood within 5 to 10 minutes and peaked at about 30 minutes. Their levels then halved in under 40 minutes.⁹

Taken straight after breakfast, the same dose gave a lower, later peak of ganoderic acid A with the same total absorbed, but ganoderic acid F stayed too low to measure in most of the 12 men.⁹

Most trials split the daily amount into two 300 mg doses, and several told people to take each dose after food, with water or milk.^2,12,13,14

The reishi study was a single-dose study in 12 healthy men, and it measured how fast two compounds appeared in the blood, not whether they did anything. Ashwagandha has no equivalent absorption study in our files. So the only timing information is how each was dosed: reishi trials ranged from one 200 mg capsule before or with breakfast to several grams a day, and ashwagandha trials split 600 mg into two doses after food. No trial compared times of day for either.^1,2,7,9

Forms, quality and our labels

A purified reishi beta-glucan concentrates one group of compounds. The rise in immune cells seen with it did not appear in small trials of whole reishi at 1.44 to 4 g a day.^1,5,6

When 19 reishi supplements bought in the United States were analyzed, the measured triterpenes and polysaccharides matched the label in only 5.⁸

Reishi and ashwagandha: amounts^{1,2,3,6,10,15}
Item	Amount	Note
Reishi, typical range	500 mg to 3 g a day	Given by NIH's liver database
Reishi, purified beta-glucan	200 mg a day for 12 weeks	One company-funded trial
Reishi, whole preparations in healthy adults	0.72 to 4 g a day for 10 days to 4 weeks	Small trials
Ashwagandha, most trials	600 mg of root extract a day, as two doses	Trials NIH reviewed
Mushroom Complex	266 mg of reishi extract per serving, no beta-glucan figure	Our label
Ashwagandha Complex	600 mg of a branded root extract per serving	Our label

What’s in ours

Ashwagandha Complex: KSM-66 Ashwagandha Extract, 600 mg per serving, from the label

The reishi in Mushroom Complex sits below the low end of the usual range and has no beta-glucan figure on its label, so the graded finding does not describe it. The ashwagandha in Ashwagandha Complex matches the amount most trials used.^1,2,3

The liver, medicines and who should ask first

Reishi and ashwagandha share one kind of caution. Rare cases of liver injury have been reported for each, which is why a person taking both would give a doctor a harder puzzle if liver signs appeared. Reishi cases usually began 1 to 2 months after starting, and ashwagandha cases 2 to 12 weeks after.^3,4

Rare cases of liver injury have been reported, usually 1 to 2 months after starting reishi, with tiredness, nausea, stomach pain, poor appetite, dark urine or yellowing of the skin and eyes. Most people recovered within 1 to 3 months of stopping, but one woman died.³

In two of the reported liver cases, the trouble began after the person switched to a powdered reishi product.³

In five reported cases of liver injury, people had taken 450 to 1,350 mg a day for 1 week to 4 months.¹⁰

Ask your pharmacist or doctor first

NIH says ashwagandha might interact with thyroid hormone medicines, such as levothyroxine. The concern comes from studies in which ashwagandha raised thyroid hormone levels, and from case reports of an overactive thyroid in people taking it.^10,16,17,18

Expected from how the two work, not shown in studies

Reishi has no documented medicine interaction in the official sources we checked. Its cautions come from other findings. A purified reishi extract raised some immune cell counts, and NIH lists immune-suppressing medicines among those ashwagandha might interact with, so anyone on such a medicine should ask about each. A warfarin label says some herbal products add to or lessen its effect and asks for more frequent INR checks when one is started or stopped. In a trial of 40 healthy volunteers, 1.5 g of reishi a day did not change clotting or platelet tests.^1,10,19,20

Ask first if you have liver disease, or have had jaundice or abnormal liver tests.^3,4
Ask first if you take a blood thinner or antiplatelet medicine, immune-suppressing medicines, thyroid hormone or sedatives, or have surgery planned.^10,17,19
Ask first if you are being treated for cancer, or have an autoimmune condition.^1,10
Do not use ashwagandha if you are pregnant or breastfeeding. Reishi has not been studied in either situation, so ask first.^3,17
Do not use reishi if you have had a liver reaction to it, and ask first if you are allergic to mushrooms or molds.³

Stop and see a doctor if you notice yellow skin or eyes, dark urine, itching, nausea, stomach pain or unusual tiredness. These can be signs of liver injury from either supplement.^3,4

Questions people ask

Can I take reishi with ashwagandha?

No trial tested the pair, and the official sources we checked list no medicine interaction for reishi. That is a gap in the research, not reassurance. Both carry rare liver reports, so read the safety section first.^3,4

What is the best time to take reishi and ashwagandha?

No trial compared times of day for either. Two compounds from reishi reach the blood within minutes of a dose on an empty stomach, and a meal slowed and lowered the peak of one of them. Ashwagandha trials usually split 600 mg into two doses taken after food.^2,9

Does the reishi immune finding apply to a mushroom blend?

Not on the evidence. The finding used 200 mg a day of a purified beta-glucan. Whole reishi at 1.44 to 4 g a day left the immune markers measured largely unchanged in small trials.^1,5,6

Is it a concern that both are linked to liver injury?

Yes, as a reason to watch for signs and to tell a doctor about both. The cases are rare, and most people recovered within months of stopping, but a few ashwagandha cases were fatal or needed a transplant, mainly in people who already had liver disease.^3,4

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Sources

*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.

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.