Intraoperative Bleeding Associated with Preoperative Use of Ganoderma lucidum Supplements


Reishi mushroom, also known as Ganoderma lucidum, is a type of edible medicinal fungi that is found throughout Asia. Recent research has shown that it may also have antiplatelet activity that is similar to aspirin. Likewise simvastatin has been shown to inhibit platelet aggregation. In addition, montelukast has anecdotally related to one case of acquired thrombopathia and may interfere with platelet aggregation. We report a case of intraoperative hemorrhage with laparoscopic trocar placement and dissection in a patient concomitantly taking Ganoderma lucidum supplements, simvastatin and montelukast. The hemorrhage only responded to a transfusion of platelets. We believe this is the first report associating Ganoderma lucidum products with an intraoperative hemorrhage. We recommend that patients who are on simvastatin, montelukast or an anticoagulant should refrain from taking Ganoderma lucidum products for seven days prior to surgery.

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Shulman, S. , Sharma, S. , Cracchiolo, B. , Shubhangi, K. and Sifonios, A. (2014) Intraoperative Bleeding Associated with Preoperative Use of Ganoderma lucidum Supplements. Open Journal of Anesthesiology, 4, 119-122. doi: 10.4236/ojanes.2014.46018.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] White, L.B. and Foster, S. (2000) The Herbal Drugstore: The Best Natural Alternatives to Over-the-Counter and Prescription Medicines! Rodale, Emmaus, xiii, 610p.
[2] Tao, J. and Feng, K.Y. (1990) Experimental and Clinical Studies on Inhibitory Effect of Ganoderma lucidum on Platelet Aggregation. Journal of Tongji Medical University (Tong ji yi ke da xue xue bao), 10, 240-243.
[3] Lee, Y.M, Chen, W.F., Chou, D.S., Jayakumar, T., Hou, S.Y., Lee, J.J., et al. (2010) Cyclic Nucleotides and MitogenActivated Protein Kinases: Regulation of Simvastatin in Platelet Activation. Journal of Biomedical Science, 17, 45.
[4] Duchemin, J., Lion, F., Arnaud, B., Nicot, C., Blouch, M.T. and Abgrall, J.F. (2004) Acquired Thrombopathia Related to Montelukast Therapy. Thrombosis and Haemostasis, 91, 1247-1248.
[5] Zjawiony, J.K. (2004) Biologically Active Compounds from Aphyllophorales (Polypore) Fungi. Journal of Natural Products, 67, 300-310.
[6] Wan, F. and Huang, D. (1992) Anti-Inflammatory and Analgesic Actions of Artificial and Fermentative Ganoderma sinense (AFGS). China Journal of Chinese Materia Medica (Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi), 17, 619-622, 640.
[7] Niedermeyer, T.H., Lindequist, U., Mentel, R., Gordes, D., Schmidt, E., Thurow, K., et al. (2005) Antiviral Terpenoid Constituents of Ganoderma pfeifferi. Journal of Natural Products, 68, 1728-1731.
[8] Chang, H.T., Cheng, Y.H., Wu, C.L., Chang, S.T., Chang, T.T. and Su, Y.C. (2008) Antifungal Activity of Essential Oil and Its Constituents from Calocedrus macrolepis var. formosana Florin Leaf against Plant Pathogenic Fungi. Bioresource Technology, 99, 6266-6270.
[9] Wang, S.H., Liang, C.J., Weng, Y.W., Chen, Y.H., Hsu, H.Y., Chien, H.F., et al. (2012) Ganoderma lucidum Polysaccharides Prevent Platelet-Derived Growth Factor-Stimulated Smooth Muscle Cell Proliferation in Vitro and Neointimal Hyperplasia in the Endothelial-Denuded Artery in Vivo. Journal of Cellular Physiology, 227, 3063-3071.
[10] Kino, K., Mizumoto, K., Sone, T., Yamaji, T., Watanabe, J., Yamashita, A., et al. (1990) An Immunomodulating Protein, Ling Zhi-8 (LZ-8) Prevents Insulitis in Non-Obese Diabetic Mice. Diabetologia, 33, 713-718.
[11] Ni, T., Hu, Y., Sun, L., Chen, X., Zhong, J., Ma, H., et al. (2007) Oral Route of Mini-Proinsulin-Expressing Ganoderma lucidum Decreases Blood Glucose Level in Streptozocin-Induced Diabetic Rats. International Journal of Molecular Medicine, 20, 45-51.
[12] Van der Hem, L.G., Van der Vliet, J.A., Bocken, C.F., Kino, K., Hoitsma, A.J. and Tax, W.J. (1995) Ling Zhi-8: Studies of a New Immunomodulating Agent. Transplantation, 60, 438-443.
[13] Xiao, C., Wu, Q.P., Cai, W., Tan, J.B., Yang, X.B. and Zhang, J.M. (2012) Hypoglycemic Effects of Ganoderma lucidum Polysaccharides in Type 2 Diabetic mice. Archives of Pharmacal Research, 35, 1793-1801.
[14] Cao, L.Z. and Lin, Z.B. (2003) Comparison of the Effects of Polysaccharides from Wood-Cultured and Bag-Cultured Ganoderma lucidum on Murine Spleen Lymphocyte Proliferation in Vitro. Acta Pharmaceutica Sinica (Yao xue xue bao), 38, 92-97.
[15] Chang, S.T. and Wasser, S.P. (2012) The Role of Culinary-Medicinal Mushrooms on Human Welfare with a Pyramid Model for Human Health. International Journal of Medicinal Mushrooms, 14, 95-134.
[16] Sanodiya, B.S., Thakur, G.S., Baghel, R.K., Prasad, G.B. and Bisen, P.S. (2009) Ganoderma lucidum: A Potent Pharmacological Macrofungus. Current Pharmaceutical Biotechnology, 10, 717-742.
[17] Benzie, I.F.F. and Wachtel-Galor, S. (2011) Herbal Medicine: Biomolecular and Clinical Aspects. 2nd Edition, CRC Press, Boca Raton, xxi, 473p.
[18] Kwok, Y., Ng, K.F., Li, C.C., Lam, C.C. and Man, R.Y. (2005) A Prospective, Randomized, Double-Blind, Placebo-Controlled Study of the Platelet and Global Hemostatic Effects of Ganoderma lucidum (Ling-Zhi) in Healthy Volunteers. Anesthesia and Analgesia, 101, 423-426, Table of Contents.
[19] Tsen, L.C., Segal, S., Pothier, M. and Bader, A.M. (2000) Alternative Medicine Use in Presurgical Patients. Anesthesiology, 93, 148-151.
[20] Leung, J.M., Dzankic, S., Manku, K. and Yuan, S. (2001) The Prevalence and Predictors of the Use of Alternative Medicine in Presurgical Patients in Five California Hospitals. Anesthesia and Analgesia, 93, 1062-1068.

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