Is it safe for an older female in her 70s to take L-Threonate with Lion's Mane (Hericium erinaceus) as supplements together?

Safety of L-Threonate with Lion's Mane in Older Women

Yes, taking L-Threonate with Lion's Mane appears safe for an older female in her 70s, though the evidence for benefit is limited and these supplements add to medication burden without proven preventive benefits in this age group.

Key Safety Considerations

General Supplement Use in Elderly

• Herbal supplements are not FDA-regulated and have actual drug interaction concerns, add to medication burden and expense, with poor to no evidence of pharmacological benefit 1
• Multiple vitamin and mineral supplements add complexity and cost to medication regimens without evidence of preventive benefits including mortality, cardiovascular disease, cancer, or cognitive function in community-dwelling older adults 1
• In elderly patients, supplements should be evaluated for deprescribing as they contribute to polypharmacy without substantiated benefit 1

Specific Safety Profile: Lion's Mane (Hericium erinaceus)

Documented Safety Data:

• Lion's Mane appears safe and inexpensive when consumed in powder or capsule form 2
• One case of anaphylaxis has been reported after consuming fresh Lion's Mane mushroom 2
• Potential side effects include stomach discomfort, headache, and allergic reactions, though these are commonly unreported 3
• Four weeks of supplementation at 10g daily showed no adverse effects in healthy adults 4
• No significant safety concerns emerged in randomized controlled trials evaluating cognitive effects 5, 3

Evidence for Efficacy:

• Currently insufficient information to support use for treating neurodegenerative conditions 2
• No significant overall improvement in cognitive performance or mood in healthy younger adults after acute dosing 5
• Four weeks of supplementation showed no impact on metabolic flexibility or cognition in college-age participants 4

Specific Safety Profile: L-Threonate (L-Threonine)

Documented Safety Data:

• A no-observed-adverse-effect-level (NOAEL) of 12g/day was established in healthy adult males 6
• Supplementation up to 12g daily for 4 weeks showed no significant adverse effects on anthropometric parameters, blood pressure, heart rate, or most biochemical markers 6
• Minor non-specific increases in plasma aspartate aminotransferase and creatine kinase occurred at 9g/day but not at 12g/day 6
• Moderate and mild adverse events occurred randomly and resolved during the supplementation period despite continued use 6

Critical Caveats for This Age Group

Polypharmacy Concerns

• Elderly patients in their 70s require careful medication review to identify drug-drug interactions, drug-disease interactions, and high-risk medications 1
• Each additional supplement increases regimen complexity, potentially affecting adherence to essential medications 1
• Supplements should be evaluated alongside all other medications for potential interactions 1

When Supplements ARE Appropriate in Elderly

• Daily multivitamin supplementation may be appropriate for older adults with reduced energy intake (less than 1500 kcal/day) 1, 7, 8
• Calcium intake of at least 1,200 mg daily is recommended for all older adults 1, 7, 8
• Vitamin D supplementation at 600 IU daily is recommended 7, 8
• Vitamin B12 supplementation should be strongly considered given high prevalence of deficiency 7, 8

Specific Monitoring Recommendations

• Monitor for allergic reactions, particularly if consuming fresh Lion's Mane 2, 3
• Watch for gastrointestinal symptoms (stomach discomfort) 3
• Assess for headaches or other neurological symptoms 3
• Evaluate whether the supplements are interfering with appetite or intake of nutritious foods 1
• Review total medication and supplement burden at each visit 1

Practical Algorithm for Decision-Making

Step 1: Assess Necessity

• Is there a documented deficiency or specific indication? If no, reconsider use 1, 7
• Are evidence-based supplements (vitamin D, calcium, B12) already being taken? 7, 8

Step 2: Evaluate Medication Burden

• Count total daily medications and supplements 1
• If polypharmacy exists (≥5 medications), prioritize deprescribing non-essential supplements 1

Step 3: Screen for Contraindications

• History of mushroom allergies (absolute contraindication to Lion's Mane) 2, 3
• Active gastrointestinal disease (relative caution) 3
• Liver disease (monitor if using L-Threonate due to potential transaminase elevation) 6

Step 4: If Proceeding with Use

• Start with lower doses than studied in younger adults 6
• Monitor for gastrointestinal symptoms, headache, or allergic reactions 3
• Reassess benefit after 4-8 weeks; discontinue if no perceived benefit 1
• Ensure supplements do not interfere with intake of nutritious foods 1

Important Pitfalls to Avoid

• Do not assume supplements are harmless simply because they are "natural" - they contribute to medication burden and have documented side effects 1
• Do not continue supplements indefinitely without reassessing benefit - elderly patients should have regular medication reviews including supplements 1
• Do not prioritize supplements over evidence-based medications - focus on maintaining functional status and quality of life with proven interventions 1
• Do not use supplements as substitutes for adequate nutrition - dietary intake should be prioritized over supplementation 1