on October 06, 2026
From Tradition to Modern Research
For millennia, medicinal mushrooms have held a special place in Asian therapeutic traditions. Not only as food, but as biologically complex organisms capable of producing polysaccharides, triterpenes, sterols, polyphenols, and numerous other secondary metabolites.
Modern pharmacological research has begun to investigate the biological basis of many of these traditional applications. This has given rise to mycotherapy, a field of research that studies the interactions between mushroom components and the body's biological systems.
The most extensively studied areas include the immune system, carbohydrate and lipid metabolism, oxidative stress, inflammation, and certain cellular processes involved in tumor proliferation.
The urinary tract also represents an interesting field of research.
The kidneys, bladder, prostate, and urinary tract form a system in which fluid balance, osmotic pressure, hormonal regulation, inflammation, and immune response are closely interconnected.
In this context, some medicinal mushrooms, particularly Polyporus umbellatus and Ganoderma lucidum, have attracted research attention for different but potentially complementary mechanisms.
However, it is important to distinguish from the outset between three levels of evidence: traditional use, experimental research, and clinical demonstration. Activity observed in a cell culture or in a laboratory animal does not equate to therapeutic efficacy in humans.
Polyporus umbellatus: When Research Meets Diuresis Regulation
Polyporus umbellatus is a mushroom traditionally used in Eastern medicine, especially in relation to fluid retention, reduced urine output, and certain urinary tract disorders.
Today, the main scientific interest lies in its possible diuretic activity, that is, its ability to promote the elimination of water through urine.
One of the most interesting experimental studies examined the aqueous extract of Polyporus umbellatus sclerotia in normal rats. The treatment resulted in a significant increase in urine production and the excretion of sodium and chloride, along with changes in the renal expression of certain proteins involved in water regulation.
Among these, aquaporins are of particular interest—membrane proteins that regulate the passage of water through cells.
The kidney has a sophisticated system for controlling urine concentration. Water is continuously filtered, reabsorbed, and regulated again according to the body's needs. Altering even one step in this process can significantly change urine volume.
In the experimental model, Polyporus umbellatus reduced the expression of AQP2 and the V2 receptor of the antidiuretic hormone, suggesting a possible involvement of the vasopressin-V2R-AQP2 axis in its diuretic activity.
This is a biologically interesting result, but it must be interpreted correctly: the available research is preclinical and does not demonstrate that Polyporus umbellatus can be used in humans as an equivalent to a diuretic medication.
Ergone, Aquaporins, and Hydro-Electrolyte Balance
Polyporus umbellatus contains numerous bioactive molecules. Among those studied are sterols, polysaccharides, and compounds belonging to the ergostane family.
Ergone has been proposed as one of the components responsible for the diuretic activity observed experimentally. Its action has been linked to the regulation of sodium-potassium balance and the renal systems responsible for controlling water.
Other components, including ergosterol and D-mannitol, have also been studied in relation to the mushroom's pharmacological properties.
The most interesting finding, however, is not just the increase in urine volume. It is the way in which this increase appears to occur.
In the animal model, the extract increased the excretion of sodium, potassium, and chloride, while the changes in AQP2 and V2R suggest an effect on water reabsorption mechanisms.
This observation supports the hypothesis that some molecules in Polyporus may interact with physiological systems normally involved in regulating body fluid volume.
However, the key word remains hypothesis.
Clinical studies in humans are needed to determine whether these mechanisms actually translate into a clinically relevant benefit.
Ganoderma lucidum and Lower Urinary Tract Disorders
While the main interest in Polyporus is related to diuresis, for Ganoderma lucidum, also known as Reishi, the most interesting findings come from research on male lower urinary tract symptoms, referred to in scientific literature by the acronym LUTS, Lower Urinary Tract Symptoms.
As people age, symptoms such as increased urinary frequency, urgency, difficulty starting urination, reduced stream, and a feeling of incomplete bladder emptying become common.
These symptoms may be associated with different urological conditions and, in men, often overlap with benign prostatic hyperplasia.
An initial randomized, double-blind, placebo-controlled study evaluated a Ganoderma lucidum extract in men over 50 with urinary symptoms. The treatment was well tolerated, and an improvement in the IPSS score, used to quantify the severity of urinary symptoms, was observed. However, no significant changes were found in maximum urinary flow, post-void residual volume, prostate volume, or PSA.
Another randomized study evaluated 88 men with mild or moderate urinary symptoms who were treated for 12 weeks with either 6 mg daily of Ganoderma extract or a placebo. In this case too, an improvement in the IPSS compared to the placebo was observed, while no significant changes were found in urinary flow, post-void residual volume, prostate volume, PSA, or testosterone.
This result is probably one of the most interesting clinical findings available in the field of mycotherapy applied to the lower urinary tract.
But caution is also necessary here.
Improving a symptom score does not demonstrate a reduction in prostatic hyperplasia, nor does it replace a urological evaluation.
Ganoderma and the Prostate: From 5-Alpha-Reductase to Experimental Research
Another area of research concerns the possible interference of Ganoderma lucidum with androgen metabolism.
5-alpha-reductase converts testosterone into dihydrotestosterone, or DHT, an androgen particularly important in prostate physiology.
Experimental studies have shown that Ganoderma lucidum extracts can inhibit 5-alpha-reductase activity and interfere with testosterone-induced prostate growth in animal models.
Other experiments have identified specific triterpenes, including ganoderol B, capable of interfering with androgen signaling and the proliferation of prostate cells in experimental models.
A subsequent study on rats with testosterone-induced prostatic hyperplasia also showed a reduction in the increase of the prostate weight/body weight ratio and changes in certain biological parameters, including PSA.
These results are interesting from a pharmacological perspective because they suggest a possible interaction between mushroom components and androgen metabolism.
However, they do not authorize defining Ganoderma lucidum as a treatment for benign prostatic hyperplasia.
The difference between antiandrogenic action in the laboratory, reduction of prostate growth in an animal model, and clinical benefit in humans is substantial.
Grifola frondosa and Prostate Research
Grifola frondosa, also known as Maitake, has also been studied for its polysaccharide content and other bioactive molecules.
The available research consists mainly of experimental studies and a growing body of literature on its immunomodulatory, metabolic, and antioxidant properties.
However, in the field of prostate health and oncology, it is necessary to avoid direct comparisons with established pharmacological treatments when adequate clinical studies are not available.
In particular, claims that Grifola is “10 or 20 times more effective” than Serenoa repens cannot be considered scientifically proven in the absence of adequate comparative clinical studies.
The value of mycotherapeutic research therefore does not lie in the simplistic replacement of a treatment with a mushroom, but in the possibility of identifying new molecules, new biological targets, and new complementary strategies to be subjected to clinical verification.
Bladder, Immunity, and Inflammation
The health of the urinary tract does not depend exclusively on the amount of urine produced.
The urinary mucosa is, in fact, a true biological barrier, continuously exposed to microorganisms, metabolites, and variations in the chemical environment.
The local and systemic immune system therefore plays an important role in responding to these challenges.
Polysaccharides, beta-glucans, and triterpenes found in various medicinal mushrooms have been studied precisely for their ability to modulate certain immune cells and inflammatory signaling pathways.
This explains the interest in Ganoderma, Grifola, Polyporus, and other mushrooms in research on infections and inflammatory diseases.
However, this does not mean that a mushroom can be considered an antibiotic or antifungal treatment.
In the case of cystitis, recurrent urinary tract infections, fever, lower back pain, blood in the urine, or persistent urinary symptoms, diagnosing the cause remains fundamental and requires an adequate clinical evaluation.
Incontinence and Bladder Function Control
Urinary incontinence also represents a field in which interesting hypotheses have been formulated about the possible action of certain medicinal mushrooms.
Continence control depends on the interaction between the detrusor muscle, sphincters, pelvic floor, autonomic nervous system, and central control.
For this reason, substances capable of modulating muscle tone or the neuromuscular response have been considered in experimental research.
Cordyceps and Ganoderma have been associated in the literature with possible effects on muscle function and the regulation of certain physiological processes.
However, there is insufficient clinical evidence to state that these mushrooms are treatments for urinary incontinence or that they can replace medications specifically prescribed for this condition.
For now, their potential role must be considered within the scope of biological research, not as a replacement therapy.
Mycotherapy and Oncology: An Evolving Field of Research
One of the most extensively studied areas of mycotherapy is oncology.
Interest arises from the presence in medicinal mushrooms of polysaccharides, beta-glucans, triterpenes, and other molecules capable, in experimental models, of interacting with the immune system, cell proliferation, apoptosis, autophagy, and certain intracellular signaling pathways.
However, the concept of integrated oncology must be interpreted correctly.
It does not mean replacing surgery, radiotherapy, chemotherapy, immunotherapy, or other cancer therapies with natural products.
Rather, it means studying whether certain natural compounds could, in the future and on the basis of adequate clinical evidence, become part of supportive strategies compatible with conventional treatments.
Polyporus and Bladder Cancer: A Preclinical Signal
Particularly interesting is the research published in 2024 on the polysaccharides of Polyporus umbellatus.
In an experimental model, a homogeneous polysaccharide derived from Polyporus reduced the proliferation of bladder carcinoma cells when they were cultured together with macrophages.
The effect was associated with the induction of autophagy and the modulation of the PI3K/Akt/mTOR pathway, one of the fundamental intracellular systems in the regulation of cell growth and metabolism.
The data is interesting because it suggests that the action of the polysaccharide may not depend exclusively on a direct effect on the tumor cell, but also on communication between tumor cells and immune cells.
It is a particularly stimulating biological model.
But it remains a preclinical model.
It does not prove that Polyporus umbellatus can cure bladder cancer in humans, reduce recurrence, or replace oncological therapy.
To reach these conclusions, controlled clinical studies would be necessary, with standardized dosages, characterized preparations, and specific oncological endpoints.
Diuresis and urinary calculi: a hypothesis to be verified
The traditional association of Polyporus umbellatus with diuresis has also led to the hypothesis of a possible interest in urinary calculi.
From a physiological point of view, an increase in urine production can contribute to the dilution of substances that participate in the formation of calculi. But this general principle does not mean that a diuretic mushroom is automatically able to prevent the formation of calculi.
Currently, it is not possible to state, based on the available evidence, that Polyporus umbellatus prevents kidney stones or prevents the precipitation of calcium salts in urine.
The relationship between diuresis, urinary composition, citrate, oxalate, calcium, uric acid, and pH is much more complex.
For this reason, the possible role of Polyporus in the prevention of calculi remains a pathophysiological hypothesis to be submitted to clinical studies, not a demonstrated therapeutic efficacy.
An interest that goes beyond the urinary tract
Research on medicinal mushrooms does not exclusively concern the urinary system.
Polyporus umbellatus, for example, has also been studied for the presence of molecules such as acetosyringone and polyporusterones A and B, isolated and experimentally evaluated for their possible activity on hair growth.
In this case too, the data belongs to experimental research and does not equate to the demonstration of cosmetic or therapeutic efficacy in humans.
However, it is significant because it shows a common characteristic of mycomedicine: a single organism can contain numerous molecules capable of interacting with different biological targets.
It is precisely this complexity that makes medicinal mushrooms interesting for modern pharmacology, but at the same time makes the standardization of extracts essential.
The standardization problem
One of the main obstacles to the development of scientific mycomedicine is represented by the great variability of the preparations.
The composition of a mushroom can change depending on the species, the part used, the cultivation substrate, the environmental conditions, the extraction method, and the final concentration of bioactive principles.
Simply saying “Ganoderma lucidum” or “Polyporus umbellatus” is therefore not sufficient to know what quantity of polysaccharides, triterpenes, sterols, or other molecules is actually present in a product.
This aspect is particularly important when comparing different scientific studies.
An extract used in one clinical study cannot automatically be considered equivalent to any other product containing the same species of mushroom.
Standardization, chemical characterization, and quality control therefore represent essential conditions to transform a traditional interest into reproducible pharmacological research.
From the molecule to man: the true path of research
The history of medicinal mushrooms shows a scientifically fascinating path.
First comes traditional observation.
Then the identification of molecules.
Next come cellular studies, animal experiments, the identification of biological mechanisms, and, finally, clinical studies in humans.
Only this last step allows us to establish whether a biological effect really translates into a benefit for the patient.
In the case of medicinal mushrooms studied for urinary health, the current picture is therefore complex.
Polyporus umbellatus presents interesting experimental data on diuresis and the regulation of some renal systems, but clinical evidence in humans is still insufficient.
Ganoderma lucidum has more interesting clinical data in male lower urinary tract disorders, with improvements in IPSS observed in randomized studies, but without demonstrating a reduction in prostate volume or an objective improvement in urinary flow.
The antiandrogenic and prostate effects are supported mainly by cellular and animal studies.
Oncological research on Polyporus and other mushrooms is promising in terms of cellular mechanisms, but remains predominantly preclinical. The 2024 study on bladder carcinoma represents a significant example of this phase of research.
A new frontier of natural medicine
Mycomedicine must not be interpreted either as a simple tradition lacking biological basis or as a therapeutic shortcut capable of replacing conventional medicine.
It is more correct to consider it as an interdisciplinary field of research, in which ethnobotany, pharmacology, immunology, cell biology, and clinical medicine can meet.
The kidney and urinary tract represent a particularly interesting field because many physiological processes are regulated by interconnected systems: water balance, electrolytes, hormones, immunity, inflammation, metabolism, and neuromuscular control.
Polyporus umbellatus and Ganoderma lucidum show, through different mechanisms, how complex this interaction can be.
The future of research will probably be determined by the ability to move from generic extracts to characterized molecules, reproducible dosages, reliable biomarkers, and well-designed clinical studies.
It is in this transition that mycomedicine will be able to demonstrate its real scientific value.
Not everything that is traditional is automatically effective. But not everything that comes from tradition must be excluded from research.
True scientific medicine is born precisely from the ability to transform an observation into a hypothesis, a hypothesis into a mechanism, and a mechanism into clinical verification.
For medicinal mushrooms, this evolution is still ongoing.
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Bibliographic references
- Zhang G, Zeng X, Han L, Wei JA, Huang H. Diuretic activity and renal medulla AQP1, AQP2, AQP3, V2R expression of aqueous extract of Polyporus umbellatus sclerotia in normal rats. J Ethnopharmacol. 2010;128(2):433-437. doi:10.1016/j.jep.2010.01.032.
- Camilleri E, Blundell R, Baral B, et al. Unveiling the full spectrum of maitake mushrooms: A comprehensive review of their medicinal, therapeutic, nutraceutical, and cosmetic potential. Heliyon. 2024;10(9). doi:10.1016/j.heliyon.2024.e30254.
- Fujita R, Liu J, Shimizu K, et al. Antiandrogenic activities of Ganoderma lucidum. J Ethnopharmacol. 2005;102:107-112. doi:10.1016/j.jep.2005.05.041.
- Nahata A, Dixit VK. Ganoderma lucidum is an inhibitor of testosterone-induced prostatic hyperplasia in rats. Andrologia. 2012;44 Suppl 1:160-174. doi:10.1111/j.1439-0272.2010.1155.x.
- Noguchi M, Kakuma T, Tomiyasu K, et al. Effect of an extract of Ganoderma lucidum in men with lower urinary tract symptoms: a double-blind, placebo-controlled randomized and dose-ranging study. Asian J Androl. 2008;10(4):651-658. doi:10.1111/j.1745-7262.2008.00336.x.
- Ishida H, Inaoka Y, Shibatani J, Fukushima M, Tsuji K. Studies on active principles in herbs used for hair treatment. II. Isolation of hair regrowth substances, acetosyringone and polyporusterones A and B, from Polyporus umbellatus Fries. Biol Pharm Bull. 1999;22(11):1189-1192. doi:10.1248/bpb.22.1189.
- Luo S, Huang X, Li S, et al. Homogeneous Polyporus polysaccharide exerts anti-bladder cancer effects via autophagy induction. Pharm Biol. 2024;62(1):214-221. doi:10.1080/13880209.2024.2316195.
