Are turkey tail mushroom supplements safe to use with chemotherapy, such as Temozolomide (temozolomide)?

From the Guidelines

Turkey tail mushroom supplements can be considered for use alongside chemotherapy like temozolomide, but only under the guidance of an oncologist due to potential interactions and variable supplement quality. When considering the use of turkey tail mushroom supplements with chemotherapy, it's crucial to prioritize the patient's safety and the efficacy of the cancer treatment. The current evidence does not directly address the interaction between turkey tail mushrooms and temozolomide, as seen in the study on cannabis and cannabinoids in adults with cancer 1, which highlights the potential for drug-drug interactions but does not provide specific guidance on mushroom supplements. Key points to consider include:

• The potential for supplements to interact with chemotherapy drugs, affecting their metabolism and efficacy, as noted with cannabis and cannabinoids interacting with cytochrome P450 enzymes 1.
• The variable quality and purity of supplements, which can impact their safety and effectiveness.
• The need for individualized advice from an oncologist, considering the patient's specific health situation, the type of cancer, and the chemotherapy regimen.
• The importance of choosing supplements from reputable manufacturers that conduct third-party testing to ensure quality and purity. Given the lack of direct evidence on turkey tail mushroom supplements and temozolomide, and considering the principles of minimizing potential drug interactions and maximizing treatment efficacy and safety, consultation with an oncologist is essential before starting any supplement regimen. This approach prioritizes the patient's morbidity, mortality, and quality of life outcomes.

From the Research

Turkey Tail Mushroom Supplements and Chemotherapy

• The use of turkey tail mushroom supplements in conjunction with chemotherapy, such as temozolomide, has been studied in various contexts 2, 3.
• A 2022 study published in The Cochrane database of systematic reviews found that adjunctive treatment with Coriolus versicolor (Trametes versicolor or 'Turkey Tail') mushroom and its extracts may have a small effect on improved survival at five years compared with no adjunctive care, but the evidence was of low certainty 2.
• The same study found very low-certainty evidence of little to no effect of adjunctive treatment with Coriolus on withdrawal from treatment due to adverse events, and uncertain effects on adverse events including neutropenia, oral cavity disorders, nausea, diarrhea, and fatigue 2.

Mechanisms and Interactions

• A 2019 study published in BMC complementary and alternative medicine found that the mycelium of the Trametes versicolor (Turkey tail) mushroom and its fermented substrate each show potent and complementary immune activating properties in vitro, which may be relevant to its potential interactions with chemotherapy 3.
• A 2024 study published in Heliyon discussed the mechanisms of resistance to temozolomide in glioblastoma, including DNA repair processes and abnormal cell signaling pathways, but did not specifically address the use of turkey tail mushroom supplements in this context 4.

Bioactive Compounds and Antioxidant Activity

• A 2020 study published in the International journal of medicinal mushrooms found that Trametes versicolor contains various bioactive compounds, including phenolic compounds, free amino acids, vitamins, and fatty acids, which may contribute to its potential health benefits 5.
• The antioxidant activity of Trametes versicolor may also be relevant to its potential interactions with chemotherapy, although this has not been specifically studied in the context of temozolomide 5.