The Benefits, Side Effects, and Uses of Hericium erinaceus as a Supplement: A Systematic Review

Arya Menon^1*Ayesha Jalal^1*Zara Arshad²Faisal A. Nawaz^2,3Rahul Kashyap^2,4

• ¹Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
• ²Global Remote Scholars Program, New Jersey, United Arab Emirates
• ³Al Amal Psychiatric Hospital, Dubai, United Arab Emirates
• ⁴WellSpan Health, York, United States

Hericium erinaceus (HE), commonly known as Lion’s Mane mushroom, is an edible and medicinal fungus containing bioactive polysaccharides. It holds promising capabilities, including neurodegeneration, anti-tumor, antioxidant, anti-proliferative, and anti-inflammatory effects. The mushroom's bioactive chemical components derived from the fruiting bodies of HE and mycelia (erinacines) show promising neural stimulating activity. This systematic review investigates the existing literature on the clinical use of HE, listing the benefits and side effects on neural stimulation, apoptotic activity, abundance of Short-Chain Fatty Acids (SCFAs) producing microbiota, and function in mood dysregulation to establish a safety profile of the supplement. A systematic literature search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed was searched for relevant, peer-reviewed, published articles ranging from January 2000 to June 2024. A Risk of Quality Bias Assessment was completed for each study to eliminate bias and maintain quality. The systematic review is registered on PROSPERO (ID: CRD42024571250). This review includes results from five randomized controlled trials (RCTs), fifteen laboratory studies, three pilot clinical trials (PCTs), one cohort study, one case report, and one computer analysis. The RCTs and PCTs assessed cognitive improvement in subjects with/without Dementia. Mini-Mental State Examination scores from a RCT and PCT showed a weighted combined mean increase of 1.17 in the intervention group. In vitro laboratory studies pertaining to cancer and cell apoptosis focused on leukemia and gastric cancer cells concluded that the role of isolated erinacine A from the mycelium of HE, which inhibited invasiveness of MKN28 and TSGH 9201 cells and induced activation of caspase pathways. HE increased gut microbiota diversity and SCFAs-producing bacteria, reducing inflammation and protecting gut health. Additionally, HE enhanced pro-BDNF and BDNF production, promoting hippocampal neurogenesis and behavioral improvements and reducing symptoms of depression, anxiety, binge eating, and sleep disorders. HE is effective in neuroprotection, enhancing cognitive function, cancer prevention/alleviation, promoting gut health, and improving symptoms of anxiety and depression. Although commonly unreported, some side effects of HE include stomach discomfort, headache, and allergy reactions.