Lion's mane and medications: what to check

No human study we found has tested lion's mane alongside any medication, so no interaction has been shown, and none has been ruled out. That includes sertraline (Zoloft), escitalopram (Lexapro), levothyroxine, apixaban (Eliquis) and rivaroxaban (Xarelto). If you take any prescription medicine, ask your doctor or pharmacist before starting it.

What the research does and doesn't tell us

Interaction questions need studies that give both products to the same people. We found none for lion's mane. What exists is lab work, and it is not a basis for telling you what happens in your body:

• A compound from lion's mane, hericenone B, inhibited platelet aggregation triggered by collagen in rabbit platelets, and the report says the same occurred in human platelets, in the lab (PMID 20637576).
• A separate lab screen of hot-water extracts from eight edible mushrooms, lion's mane among them, found none changed prothrombin time or INR (PMID 31842490).

Those two do not agree on every measure, they used different preparations, and neither tested a person on a blood thinner. They are the reason to ask, not a finding that lion's mane interacts. Absence of a documented interaction is not the same as having tested for one.

Medicines worth raising with your doctor or pharmacist

• Antidepressants such as sertraline or escitalopram: no study tests lion's mane with them. Do not change or stop a prescribed medicine because of a supplement.
• Blood thinners such as apixaban, rivaroxaban or warfarin: because of the lab platelet work above, mention it before starting.
• Thyroid medicine such as levothyroxine: no study tests lion's mane with it. Levothyroxine has its own instructions on timing relative to food and other products; ask your pharmacist where a supplement fits.
• Diabetes medicines: no human interaction study. Ask first if you take them.
• Any other prescription or over-the-counter medicine, and any upcoming surgery.

Our label

Lion's Mane Mushroom carries this warning: ask a physician before use if you are pregnant or nursing, under 18, on medication or with a medical condition; do not use if allergic to mushrooms. It is 1,000 mg of mushroom powder per two capsules, as low as $18.23 a bottle on subscription.

Questions people ask

Can I take lion's mane with Zoloft or sertraline?

We found no study on it and cannot say it is safe or unsafe. Ask the prescriber or a pharmacist, and keep taking your prescribed medicine as directed.

Lion's mane with Lexapro, or on an antidepressant?

The same answer: untested. Tell your prescriber about every supplement so they can judge it against your history.

Can I take lion's mane with levothyroxine?

Not studied. Ask your pharmacist about timing, because thyroid tablets are usually taken separately from food and other products.

Lion's mane and Eliquis or Xarelto?

Not studied in people. Because of the lab platelet findings above, ask your doctor before combining them.

What are lion's mane drug interactions in general?

None are documented in trials, and none are ruled out. See lion's mane side effects and who should not take lion's mane.