Physicians challenge craze for exorbitantly priced TCM fungus

By Huang Jingjing Source:Global Times Published: 2014-7-30 19:58:01

Fungus harvesters dig for cordyceps on the plateau in Haibei Tibetan Autonomous Prefecture in Qinghai Province, June 11, 2013. Photo: CFP



The efficacy of a signature traditional Chinese medicine in curing diseases has recently met with a new round of skepticism.

The ophiocordyceps sinensis, usually known as "cordyceps," is one of the most mysterious and expensive prescriptions among the TCM.

Touted as a "legendary treasure of the East" and a remedy for nearly all diseases, the fungus, which grows mainly in the cold, high-altitude plateaus, grasslands and mountains of West China, has seen its price skyrocket to levels even above that of gold on a per-gram basis.

However, a number of medical experts believe that its supposed benefits have been oversold, saying it is nothing more than a "fungus growing on a dead worm" with no special medicinal value.

Between these two extremes exists a third group of people who believe in the fungus' efficacy in certain situations, but admit that it requires further documentation to be truly convincing.

Despite the debate, powders, tablets and capsules made from cordyceps by pharmaceutical manufacturers from the US, South Korea, Japan and China are sold all over the world.

A search by a reporter for "cordyceps" on amazon.com yielded 427 results, most of which are health supplements.

The benefits listed vary from combating cancer to improving lung and kidney function, fighting fatigue and stress, boosting energy and immune function, and slowing down the aging process.

The most recent edition of the Chinese Pharmacopoeia, an authoritative reference source on traditional Chinese medicine, lists cordyceps as an effective supplement for lungs and kidneys, as well as promoting blood coagulation and reducing phlegm.

The literal translation of cordyceps's Chinese name is "winter worm, summer grass." But it is in fact a sac fungus that parasitizes larvae of ghost moths. The fungus gradually invades the body of the caterpillar, consuming the host's soft tissue and growing downward into the ground, subsequently producing a fruiting body similar to grass in appearance. A complete gestative cycle typically takes three to five years.

Thanks to its "magic" transformation, scarcity, and effects that were recorded in Chinese medical texts as early as 1694, Chinese people place great faith in medicines made from the fungus. In the deadly SARS epidemic of 2003, the fungus, said to be a cure, saw its price jump.

But voices have arisen refuting the power of the "almighty" fungus.

A local shows a cordyceps he found on the plateau in Qinghai. Photo: CFP



Growing skepticism



"In my profession I deal with cancer patients every day. After seeing too many scenes of patients and their families struggling against the disease, over time I've become numb and unemotional. But whenever I see the children of poor families struggling to scrape together money for the 'almighty' cordyceps sinensis for their dying parent, I get heartbroken and angry at people's ignorance, as well as the fraud behind it," said Ji Xiaolong, a well-known physician on cancer, in a post recently widely forwarded online.

Ji, director of biotherapy in cancer at the General Hospital of the Chinese People's Armed Police Forces, originally posted his critique on his blog in 2010, criticizing the fungus' much-hyped anti-cancer properties.

"Any man with a little sense will know it. My views and conclusions on the cordyceps will never change," Ji told the Global Times in an e-mail last week. He has never seen the fungus display any tumor fighting properties in decades of practice and observation.

"There is not sufficient proof of its anti-cancer properties. Although some experimental results in animals did show some effect, this is a long way from a clinical test [on human subjects]," he said.

Ji is not alone in his opposition. Liu Su, a postdoctoral research fellow at Peking University's School of Life Sciences, Fang Zhouzi, a science writer who holds a doctorate in biochemistry, and Yu Xiangdong, a doctor of hematology at Huangshi Central Hospital in Hubei Province famous for his outspoken anti-TCM stances, all made statements attacking businesses that make money by hyping cordyceps' curative powers.

"People's craze for the cordyceps has caused damage to the environment, and cheated a lot of people out of a lot of money. The commercial myths that have been built up around it must be broken," Liu said on his Sina Weibo.

These strong statements have yet to deter popular belief in the drug. The Shenghaixiang Drug Company, based in Nanjing, Jiangsu Province, has sold cordyceps-based products for the past 30 years.

The company's online storefront showed 1,952 transactions during the past month. Its most expensive product sells for 348 yuan ($56) per gram.

"All our cordyceps are transported by air freight from Naqu in Tibet [a region famous for producing cordyceps]. One out of five of our customers are cancer patients. One third of the buyers gave the cordyceps as gifts," said a salesperson.

When asked whether it can treat occasional headaches, the salesperson told the reporter that it was worth a try.

Despite cordyceps' enduring popularity, there have been some signs of skepticism among ordinary people.

One doubter is Zhang Aiyu, a college student in Sichuan University, who was brought up on soups infused with the fungus.

"I haven't seen any great improvement in my immunity. During flu season, I fell ill as easily as others," she told the Global Times. "I'm afraid most people think it works possibly out of psychological effect."

An employee displays newly harvested cordyceps in a TCM store in Wenzhou, Zhejiang Province, on May 15. Photo: CFP



 

Ongoing research



However, some scientists are convinced that there are areas where cordyceps can be useful.

"It's neither a cure-all nor worthless. There are tests that have verified that it can help a lot in preventing fibrosis in the kidney and liver," Wei Jiangchun, a researcher at the Chinese Academy of Science's Institute of Microbiology, told the Global Times.

The institute has researched the biology of cordyceps, but not its function.

According to Wei, as early as in the 1980s Chinese scientists had succeeded in producing an artificial substitute for the active ingredients in cordyceps. "Although [scientists] know about it, markets and consumers are still confused."

Wei added that China's herbal tradition is not backed up by strong scientific research and development.

Cordycepin, or 3'-deoxyadenosine, a derivative of the nucleoside adenosine found in caterpillar fungus, has been tested in countries such as the US for its effectiveness in treating lukemia.

In May 2012, the establishment of a strategic alliance for cordycepin research, study and production was announced in Shanghai, with a total of 28 institutes joining, including Peking University's School of Life Sciences and Tsinghua University's School of Medicine.

At the ceremony, research institutes reported that experiments on mice had shown that the cordycepin does have some effect in curbing the multiplication of pancreas cancer cells, improving longevity for mice with leukemia, and lowering blood fat, according to Shanghai Evening Post.

Since then, though, there has been no news from the alliance.

"Research and tests take a huge sum of money. But some cordyceps companies only care about commercial outcomes and ignore the research, which is a shame," Wei noted.

Wei said that he has great confidence in the fungus, and that he believes that a domestic-made supplement from the fungus he's taken for the past 10 years has helped keep him in good health.

At 82, he looks healthy, with clear eyes and a strong gait.

Artificial substitutes



The huge profits to be made from cordyceps have given rise to a whole digging and trading industries. Though authorities have issued rules restricting digging and prohibiting the use of raw materials in health food production, sales of raw cordyceps and raw cordyceps-derived products remain strong.

Some sellers even substitute other kinds of insect fungus for cordyceps, while others inject the fungus with lead or mercury to increase its weight.

Hao Fengtong, chief physician for occupational diseases at Beijing Chaoyang Hospital wrote on his blog in September 2010 that he had treated a couple from Chongqing for lead poisoning. His conclusion following an investigation was that they had been poisoned by the cordyceps they had taken for years.

It's common for people to cook the cordyceps with soup, to make it into hot tea, or put it in a bottle of high-quality alcohol. However, Wei suggested that contamination concerns make it a better bet just to take finished products.

Chen Yipu, a well-known nephrologist at Beijing Anzhen Hospital, firmly supports the use of artificial cordyceps substitutes.

"I'm pretty disgusted [when I see] advertisements for pills made from natural cordyceps. The products are sold at inflated prices. In addition, the crazy digging could cause environmental damage or even drive this fungus to extinction," Chen told the Global Times. "Why not use the substitute?"

Chen, who used to chair the Chinese Society of Nephrology, has led teams studying and testing fermented powder made from the colonic fungus. "The cellular and animal experiments have both shown that the fungus is a big help in preventing renal interstitial fibrosis," he said. But his teams had conducted only limited clinical tests, he said.

A team he supervises in Anzhen hospital is currently organizing a large clinical randomized controlled trial which will recruit a total of 120 patients.

In addition, a team in Guangzhou Institute of Respiratory Disease has also finished a preliminary study of lung interstitial inflammation and fibrosis in animals, which showed fermented ophiocordyceps sinensis powder to be an effective treatment for the disease.

"The government has earmarked a lot of money for TCM research, but we've done a bad job transforming study results into something productive," a medical expert lamented.


Newspaper headline: A mushrooming debate


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