Drug & supplement interaction

Shiitake Mushroom + Tocilizumab

Tocilizumab brand name: Actemra.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Shiitake Mushroom has a moderate interaction with Tocilizumab. Theoretically, taking shiitake mushroom might decrease the effects of immunosuppressive therapy.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Shiitake Mushroom and Tocilizumab

Here is the interaction we found between these two, with the evidence behind it.

Moderate

IMMUNOSUPPRESSANTS

Why this applies to Tocilizumab

Tocilizumab falls under IMMUNOSUPPRESSANTS — the group Shiitake Mushroom interacts with.

Theoretically, taking shiitake mushroom might decrease the effects of immunosuppressive therapy.
In vitro evidence suggests that shiitake mushroom extracts stimulate immune function.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thinking behind this pairing. Tocilizumab (Actemra) works by calming down an overactive immune system to help with conditions like rheumatoid arthritis or giant cell arteritis. Concentrated shiitake extracts, on the other hand, contain beta-glucans like lentinan that may nudge the immune system in the opposite direction, toward more activity. So in theory, a strong shiitake supplement could work against what your medication is trying to do, possibly making it a bit less effective.

I want to be honest though: this concern comes only from lab studies, not from real people taking both together, so it's a soft, theoretical worry. Eating shiitake as food in a meal is very unlikely to matter. If you're considering a concentrated shiitake supplement, just run it by your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Burikhanov, R. B., Wakame, K., Igarashi, Y., Wang, S., and Matsuzaki, S. Suppressive effect of active hexose correlated compound (AHCC) on thymic apoptosis induced by dexamethasone in the rat. Endocr.Regul. 2000;34(4):181-188.
  2. Gao, Y., Zhang, D., Sun, B., Fujii, H., Kosuna, K., and Yin, Z. Active hexose correlated compound enhances tumor surveillance through regulating both innate and adaptive immune responses. Cancer Immunol.Immunother. 2006;55(10):1258-1266. PubMed
  3. Ritz, B. W., Nogusa, S., Ackerman, E. A., and Gardner, E. M. Supplementation with active hexose correlated compound increases the innate immune response of young mice to primary influenza infection. J Nutr. 2006;136(11):2868-2873. PubMed
  4. Aviles, H., O'Donnell, P., Sun, B., and Sonnenfeld, G. Active hexose correlated compound (AHCC) enhances resistance to infection in a mouse model of surgical wound infection. Surg.Infect.(Larchmt.) 2006;7(6):527-535. PubMed
  5. Aviles, H., O'Donnell, P., Orshal, J., Fujii, H., Sun, B., and Sonnenfeld, G. Active hexose correlated compound activates immune function to decrease bacterial load in a murine model of intramuscular infection. Am J Surg. 2008;195(4):537-545. PubMed
  6. Ritz, B. W. Supplementation with active hexose correlated compound increases survival following infectious challenge in mice. Nutr.Rev. 2008;66(9):526-531. PubMed
  7. Terakawa, N., Matsui, Y., Satoi, S., Yanagimoto, H., Takahashi, K., Yamamoto, T., Yamao, J., Takai, S., Kwon, A. H., and Kamiyama, Y. Immunological effect of active hexose correlated compound (AHCC) in healthy volunteers: a double-blind, placebo-controll
  8. Wang, S., Welte, T., Fang, H., Chang, G. J., Born, W. K., O'Brien, R. L., Sun, B., Fujii, H., Kosuna, K., and Wang, T. Oral administration of active hexose correlated compound enhances host resistance to West Nile encephalitis in mice. J Nutr. 2009;139(3 PubMed
  9. Yin, Z., Fujii, H., and Walshe, T. Effects of active hexose correlated compound on frequency of CD4+ and CD8+ T cells producing interferon-gamma and/or tumor necrosis factor-alpha in healthy adults. Hum.Immunol. 2010;71(12):1187-1190.
  10. Lee, W. W., Lee, N., Fujii, H., and Kang, I. Active Hexose Correlated Compound promotes T helper (Th) 17 and 1 cell responses via inducing IL-1beta production from monocytes in humans. Cell Immunol. 2012;275(1-2):19-23.
  11. Daddaoua, A., Martinez-Plata, E., Ortega-Gonzalez, M., Ocon, B., Aranda, C. J., Zarzuelo, A., Suarez, M. D., de Medina, F. S., and Martinez-Augustin, O. The nutritional supplement Active Hexose Correlated Compound (AHCC) has direct immunomodulatory actio
  12. Roman, B. E., Beli, E., Duriancik, D. M., and Gardner, E. M. Short-term supplementation with active hexose correlated compound improves the antibody response to influenza B vaccine. Nutr Res. 2013;33(1):12-17. PubMed
  13. Uno, K., Kosuna, K., Sun, B., Fujii, H., Wakame, K., Chikumaru, S., Hosokawa, G., and Ueda, Y. Active Hexose Correlated Compound (AHCC) Improves Immunological Parameters and Performance Status of Patients with Solid Tumors. Biotherapy 2000;14(3):303-309.
  14. Ghoneum, M., Wimbley, M., Salem, F., McKlain, A., Attallah, N., and Gill, G. Immunomodulatory and anticancer effects of active hexose correlated compound (AHCC). Int J Immunother 1995;11:23-28.
  15. Sia, G. M. and Candlish, J. K. Effects of shiitake (Lentinus edodes) extract on human neutrophils and the U937 monocytic cell line. Phytother.Res. 1999;13(2):133-137. DOI
  16. Lobanok, A. G., Babitskaia, V. G., Plenina, L. V., Puchkova, T. A., and Osadchaia, O. V. [Composition and biological activity of submerged mycelium of the xylotrophic basidiomycete Lentinus edodes]. Prikl.Biokhim.Mikrobiol. 2003;39(1):69-73. DOI
  17. Liu, M., Li, J., Kong, F., Lin, J., and Gao, Y. Induction of immunomodulating cytokines by a new polysaccharide-peptide complex from culture mycelia of Lentinus edodes. Immunopharmacology 1998;40(3):187-198. PubMed
  18. Dai X, Stanilka JM, Rowe CA, et al. Consuming Lentinula edodes (Shiitake) Mushrooms Daily Improves Human Immunity: A Randomized Dietary Intervention in Healthy Young Adults. J Am Coll Nutr. 2015;34(6):478-87.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Shiitake Mushroom Also Interacts With Other Medications

Shiitake Mushroom has 311 moderate known drug interactions in our database — the Tocilizumab one above is one of them. If you take anything else, check it against the full list below.

Moderate 311 No known interaction 2,519 (incl. Tocilizumab)
Taking anything else?

Check Another of Your Medications Against Shiitake Mushroom

Covers the 2,830 medications we’ve checked against Shiitake Mushroom. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Tocilizumab

This page covers Shiitake Mushroom only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tocilizumab page lists 89 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Beer (major), Siberian Cocklebur (major), Wine (major), Active Hexose Correlated Compound (ahcc) (moderate) and Alfalfa (moderate).

By severity: 3 major · 85 moderate · 1 minor.

From our pharmacist’s overview on the Tocilizumab page

“Tocilizumab (Actemra) calms an overactive immune system in conditions like rheumatoid arthritis, and it is also known to strain the liver, which is exactly where its supplement interactions concentrate. This page deserves genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Tocilizumab interaction page

One more smart check

Taking Shiitake Mushroom as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,613 real supplement products containing Shiitake Mushroom, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Shiitake Mushroom. Your product may carry other ingredients that interact with Tocilizumab too, on top of Shiitake Mushroom — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Shiitake Mushroom and Tocilizumab Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Shiitake Mushroom
Top 25%

#178 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tocilizumab
Top half

#1,195 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Shiitake Mushroom

What is Shiitake Mushroom?

  • Immune support
  • General wellness and nutrition
  • Cholesterol and heart health
  • Adjunct in cancer care (lentinan, AHCC)
  • Antioxidant support

Shiitake is a popular edible mushroom that is nutritious and safe to eat as food for most people. Some of its extracts (like lentinan and AHCC) have been studied as immune support, mainly alongside cancer treatment, but evidence for most supplement uses is limited. Talk with your pharmacist or doctor before using concentrated shiitake supplements.

Read the full Shiitake Mushroom monograph & all interactions
Medication

About Tocilizumab Injection

What Is Tocilizumab Injection Used For?

Brand name: Actemra

Tocilizumab injection is used to treat several serious inflammatory and immune-related conditions. Actemra (tocilizumab) is indicated for moderately to severely active rheumatoid arthritis in adults who haven't responded well to other disease-modifying drugs, giant cell arteritis in adults, systemic sclerosis-associated interstitial lung disease (SSc-ILD) to slow lung function decline, polyarticular and systemic juvenile idiopathic arthritis in patients 2 years and older, and severe or life-threatening cytokine release syndrome (CRS) caused by CAR T-cell therapy in adults and children 2 and older.

Actemra is also approved for hospitalized adults and children aged 2 and older with COVID-19 who are on corticosteroids and need supplemental oxygen or mechanical breathing support. Not every brand or route is approved for every use — your prescriber will choose the right form for your specific condition.

See full Tocilizumab Injection drug information
Keep checking

Other Drugs & Shiitake Mushroom

Browse every other medication we’ve checked against Shiitake Mushroom — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
311Moderate
0Minor
2,518No known interaction
311 Moderate 2,518 No interaction
Moderate

311 interactions

Showing 60 of 311 moderate interactions — see all 311 on the Shiitake Mushroom page.

No interaction 2,518 drugs checked — show the list

We also checked Shiitake Mushroom against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,518 medications checked with no known interaction — see the full Shiitake Mushroom list.

See the full Shiitake Mushroom interactions page
See every supplement checked against Tocilizumab, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Shiitake Mushroom monograph › Uses, safety, and every drug interaction in one place Tocilizumab supplement interactions › Every supplement checked against Tocilizumab, ranked by severity Tocilizumab Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Shiitake Mushroom and Tocilizumab Together: Common Questions

Can you take Shiitake Mushroom with Tocilizumab?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Shiitake Mushroom and Tocilizumab interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tocilizumab and Shiitake Mushroom?

Our pharmacists answer your medication & supplement questions — free.

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.