LI Chak Sum 20058397d The High Price Tag of Cordyceps Does Not Worth The Price Cordyceps, scientifically known as Ophiocordyceps sinensis, belong to the Ophiocordycipitaceae family. The fungus of cordyceps is parasitic in nature. It attacks, infects and devours a host, typically the larva or caterpillar stage of a specific ghost moth. Inside the caterpillar, the fungus grows into a fruiting body which looks like a piece of grass, and then it releases spores for reproduction. The spore germinates and produces hyphae, which then grows inside the insect internally and turns into mycelium. Afterwards, mycelium will fully consume the caterpillar and cordyceps are produced. Cordyceps are generally found from the elevations of 3000m to 5000m, on the Tibetan Plateau and the Himalayas. Thus, there is a myth that cordyceps only grow in extreme weather and geographical conditions. However, this is not entirely true. The reason why natural and wild cordyceps are generally found on these extreme geographical conditions is because the specific larvae of moths which cordyceps fungus parasitizes is within the family Hepialidae and could only be found in these locations. As technology advances, cordyceps can already be artificially produced, further proving that extreme conditions are not needed. However, the growth of cordyceps still needs some specific conditions. First, it requires an atmospheric temperature of 21 degree Celsius or below. Second, it has to grow on mineral- rich soil. Third, a rarefied atmosphere is required. Therefore, artificial production of cordyceps is still costly. The use of cordyceps has a deep and rich history. The first evidence of Cordyceps usage as a medicine can be traced back to around 101 B.C. in The Classic Herbal of the Divine Plowman (“Sheng Nung Bon Cas Chien”). While in China, the first written record of the Cordyceps fungus was in the year AD 620, during the Tang Dynasty.[1] In the narrative, cordyceps are described as a magical creature, which undergoes a miraculous transformation every year. It changes from animal to plant in summer, and from plant back to animal in winter. In ancient China, cordyceps were considered as a folk medicine which could strengthen the body. Although their actual effects were not revealed, they were still so valuable that only the emperor’s family could have access to them and take them. It was as late as 1757, when the first evidence-based and objective research in the Ben Cao Congxin (New Compilation of Materia Medica) written by Wu-Yiluo suggested the medical value of Cordyceps fungus. [2] Using the perspective of Chinese medicine, cordyceps are considered as a plant which has a sweet taste and is warm in nature, and it enters the “Lung” and “Kidney” meridian. Cordyceps would protect the lungs, improve the kidneys as well as invigorate Yin-Yang. In the west, he knowledge and recognition of cordyceps came in the eighteen century, when a French Jesuit priest, Perennin Jean Baptiste duHalde, brought back a specimen and shared his experience of being invited as a guest at an emperor-ruled China.[3] In the modern society, the popularity of cordyceps had gone sky-rocket as our great and mighty Chinese runners stormed the World Outdoor Track and Field Championships held in Germany in the August of 1993. The Chinese Olympic women’s running team won multiple championships and broke 3 world records which had been on stack for decades. As rumours of drug use speculated, it was revealed that the natural cordyceps was their secret weapons. Taking them regularly after each training session, it was claimed that they could enhance the runners’ metabolism, and relax and open up their upper respiratory tract. Having such a shocking and unprecedented effect, cordyceps gained its fame as an omnipotent medicine. Being so popular worldwide, cordyceps are always being in pursuit. Due to the limited supply globally, cordyceps are extremely expensive and are considered as “soft gold”. Its price has once gone to a highest of USD $20,000 to $40,000 per kilogram, which in other words, is around USD $6.77 per piece. Cordyceps are undoubtedly expensive. However, do they truly worth such a high price tag? Cordyceps certainly have some therapeutic values, but do these mild effects worth so much money? Apart from the uncertain therapeutic values, it is also said that cordyceps can actually be replaced by other alternatives. Besides, safety concerns have arisen concerning the issue of pollution from heavy metals. These problems are proving that cordyceps do not worth the high price tag. Cordyceps have a couple of therapeutic values. It may boost exercise performance, help manage Type 2 diabetes, and produce anti-aging and anti-tumour effects. Yet, these effects are either not significantly valuable or even not scientifically proven to be beneficial to human beings. First of all, Cordyceps may increase the production of the molecule adenosine triphosphate (ATP) in an individual, thus it can boost the exercise performance. ATP is an essential component to deliver energy to somatic muscles. Multiple experiments have suggested that the cordyceps can improve and enhance oxygen usage in our body, especially when we are having vigorous exercise.[4] In a study involving 30 healthy older adults riding a static bike. It is examined that the participants receiving 3 grams of Cordyceps (CS-4) per day for 6 weeks would have a 7% increase in VO2 max while the placebo does not show significant difference. As VO2 max is the maximum rate of consumption of oxygen gas measured during intense exercises. It can provide a quantitative value of endurance and fitness level, meaning that a higher VO2 value indicates a better exercise performance. However, this effect of Cordyceps may only be applicable to people with limited exercises. This is because a research has found that cordyceps cannot further enhance trained athletes’ exercise performances.[5] From this, it can be concluded that taking cordyceps may be beneficial to elderlies or patients with severe chronic diseases, whose mobility and range of motion are limited due to impaired body functions. Yet, cordyceps may not help the mass majority in general. Second, cordyceps may help manage Type 2 diabetes. Researchers have found that cordyceps have a particular type of sugar which may alleviate diabetes. Diabetes is a body dysfunction which occurs when the pancreas cannot produce and secrete insulin, or the liver cannot respond to insulin, which is used to transport glucose. Thus, in diabetes patients, their blood sugar level remains high after meals. When there is too much glucose in blood for a long period of time, serious health problems will be resulted. It is thought that cordyceps can imitate the action of insulin, thus it helps to keep blood sugar levels within a healthy range. There are studies of the effect of cordyceps on diabetic mice, and it has been shown that cordyceps can decrease blood sugar levels.[6] It is also suggested that cordyceps may help prevent kidney disease. 22 studies, involving 1,746 patients with chronic kidney dysfunction, have been conducted. The participants who had taken Cordyceps during rehabilitation period would have better kidney function afterwards.[7] However, the authors of the review described the experiments as of low quality and poor reliability. Thus, it could not be concluded that cordyceps can help improve kidney function in chronic kidney disease patients. On the other hand, the effect of cordyceps on diabetes human patients is unknown as the studies are on rats only. Lastly, cordyceps may have anti-aging and anti-tumour properties. On one hand, it is thought that cordyceps can reduce muscle fatigue and boost body strength. On the other hand, evidence have shown that cordyceps may lower the growth rate of human cancer cells, including lung, skin, liver and colon cancers. Regarding the anti-aging properties, it is believed that as cordyceps contain antioxidant, which can produce anti-aging effect. Antioxidants would neutralize free radicals in body cells, thus it can fight and slow down cell damage due to aging and disease. Several studies have been conducted, and it is found that feeding cordyceps to aged mice would increase their antioxidant content, allowing the mice to have improvement in memory and sexual function.[8] Besides, a study has found that infant mice that have taken cordyceps would live a longer life for about 1 to 3 months than those which have not.[9]. However, it cannot be concluded that cordyceps would exert the same anti-aging effects on human beings, On the other hand, cordyceps is also thought to be able to reduce the growth rate of tumours. It is believed that the cordyceps fungi may exert anti-tumour effects. In test-tube studies, cordyceps samples are examined and they could inhibit the growth of human cancer cells.[10] It is also revealed that cordyceps have antitumour effects on melanoma, lung cancer and lymphoma.[11] Cordyceps may also reverse the side effects caused by cancer therapy. However, the effects of cordyceps on the growth of tumour on living humans are still unknown, thus it could be ineffective after all. The claimed therapeutic values of cordyceps certainly do not worth the high price tag. This is because there are numerous alternative TCMs, which can pose the same positive effects, available on the market at a much lower price. Currently, the price of cordyceps is around 5000-30000 HKD for 38 grams. On the other hand, alternatives like Short-horned Epimedium Herb and Sichuan Fritillary, which could also supplement kidney and dispel wind-damp, are only around 10 HKD and 60-200 HKD respectively. Besides, cordyceps may not be safe for usage due to pollution. Because of industrialisation and urbanisation, a large amount of heavy metals are produced as waste. When these wastes are not treated properly, they would be discharged into rivers and streams and contaminate the soil. The cordyceps would absorb these wastes and become contaminated. When the cordyceps are consumed, the heavy metal wastes inside would enter the human body and accumulate, causing inflammation and cancer. In conclusion, cordyceps sinensis does not worth the high price tags due to limited therapeutic values, availability of alternative TCMs and possible health risks due to heavy metal pollution. The high price tag should only be a result of marketing strategy which is used to appeal to customers. 1. Hung Chang Kee(1999), Brief history of Chinese medicine in The Pharmacology of Chinese herbs, 2nd edition, CRC press, Florida, 1999, pp -9-21 2. Karma chos ‘phel. bDud rtsi sman gyi ‘khrungs dpe legs bshad nor bu’i phreng mdzes. Lhasa: Bodljongs mi dmangs dpe skrun khang; 1993. [Karma Chopel. Beautiful Rosary of Precious and ElegantTeachings: a Materia Medica on the Medicines which are Elixir of Immortality. Lhasa: Tibetan PeoplePress; 1993. 3. Chen SZ, Chu JZ. [NMR and IR studies on the character-ization of cordycepin and 2’deoxyadenosine.] Zhongguo Kangshengsu Zaxhi. 1996;21:9–12 (in Chinese) 4. Xu YF. Effect of Polysaccharide from Cordyceps militaris (Ascomycetes) on Physical Fatigue Induced by Forced Swimming. Int J Med Mushrooms. 2016;18(12):10831092. doi:10.1615/IntJMedMushrooms.v18.i12.30 5. Parcell, A. C., Smith, J. M., Schulthies, S. S., Myrer, J. W., & Fellingham, G. (2004). Cordyceps Sinensis (CordyMax Cs-4) supplementation does not improve endurance exercise performance. International journal of sport nutrition and exercise metabolism, 14(2), 236–242. https://doi.org/10.1123/ijsnem.14.2.236 6. Lo, H. C., Tu, S. T., Lin, K. C., & Lin, S. C. (2004). The anti-hyperglycemic activity of the fruiting body of Cordyceps in diabetic rats induced by nicotinamide and streptozotocin. Life sciences, 74(23), 2897–2908. https://doi.org/10.1016/j.lfs.2003.11.003 7. Zhang, H. W., Lin, Z. X., Tung, Y. S., Kwan, T. H., Mok, C. K., Leung, C., & Chan, L. S. (2014). Cordyceps sinensis (a traditional Chinese medicine) for treating chronic kidney disease. The Cochrane database of systematic reviews, (12), CD008353. https://doi.org/10.1002/14651858.CD008353.pub2 8. Li, X. T., Li, H. C., Li, C. B., Dou, D. Q., & Gao, M. B. (2010). Protective effects on mitochondria and anti-aging activity of polysaccharides from cultivated fruiting bodies of Cordyceps militaris. The American journal of Chinese medicine, 38(6), 1093–1106. https://doi.org/10.1142/S0192415X10008494 9. Ning, Z. T., Jamie, L. B., Yan, Z., Scott, B. F., Zi, M. W., Tomas, A. P., Mark, B., Jia, S. Z. (2011). The lifespan‐extending effect of Cordyceps sinensis Cs‐4 in normal mice and its molecular mechanisms. The FASEB Journal, S1(52) 10. Lee, H. H., Lee, S., Lee, K., Shin, Y. S., Kang, H., & Cho, H. (2015). Anti-cancer effect of Cordyceps militaris in human colorectal carcinoma RKO cells via cell cycle arrest and mitochondrial apoptosis. Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences, 23(1), 35. https://doi.org/10.1186/s40199-015-0117-6 11. Yamaguchi, N., Yoshida, J., Ren, L. J., Chen, H., Miyazawa, Y., Fujii, Y., Huang, Y. X., Takamura, S., Suzuki, S., & Koshimura, S. (1990). Augmentation of various immune reactivities of tumor-bearing hosts with an extract of Cordyceps sinensis. Biotherapy (Dordrecht, Netherlands), 2(3), 199–205. https://doi.org/10.1007/BF02173520