Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Respond Immune Complex Ingredients & Drug Interactions

by Sundown Organics

Respond Immune Complex label
See full label image
Tablet Or Pill Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Respond Immune Complex against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Respond Immune Complex is a dietary supplement by Sundown Organics with 7 active ingredients. Its ingredients are commonly taken for zinc deficiency, immune support, cold symptoms.Based on those ingredients, 1,278 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin D, organic Reishi Mushroom, Selenium. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Respond Immune Complex by Sundown Organics

Ask about any prescription or over-the-counter medication and we check it for interactions with Respond Immune Complex by Sundown Organics — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Respond Immune Complex by Sundown Organics

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Sep 10, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 7 of its 7 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Respond Immune Complex contains 7 active ingredients. Zinc supports immune function and is effective for zinc deficiency and Wilson disease.

Vitamin D regulates calcium and bone health, and is effective for rickets, osteomalacia, and renal bone disease. Selenium is a trace mineral that supports immune and thyroid function, and is likely effective for selenium deficiency.

Vitamin C (ascorbic acid) is an antioxidant effective for vitamin C deficiency. The product also includes three mushroom extracts — organic reishi, shiitake, and maitake — which have traditionally been used to support immune response, though clinical evidence for specific benefits varies.

The tablet also contains several inactive ingredients: tapioca dextrose, fermentation blend, organic bamboo extract, organic rice extract blend, organic safflower oil, organic oats, maltodextrin, organic sunflower lecithin, organic palm oil, and organic guar gum (a thickening agent).

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: immune support.
  • We looked for evidence on: Acne, Acute bronchitis, Asthma, Atherosclerosis, Atopic dermatitis (eczema), Atopic disease — and 4 related terms.
  • The strongest evidence on file: Zinc is rated "Possibly Effective" for Acne (Natural Medicines).
  • Also on file: Selenium is rated "Possibly Effective" for Autoimmune thyroiditis.
  • Also on file: Vitamin C is rated "Possibly Ineffective" for Acute bronchitis, Atherosclerosis.

The evidence for this product's ingredients is mixed. Zinc is effective for zinc deficiency and likely effective for Wilson disease, and possibly effective for acne, age-related macular degeneration, and diabetes.

Vitamin D is effective for rickets, osteomalacia, renal bone disease, hypoparathyroidism, and familial hypophosphatemia. Selenium is likely effective for selenium deficiency and possibly effective for Kashin-Beck disease and pre-eclampsia, but possibly ineffective for high cholesterol (dyslipidemia).

Vitamin C is effective for vitamin C deficiency and possibly effective for certain types of anemia, cataracts, and exercise-induced respiratory infections. For the mushroom extracts, the evidence we hold is limited.

Reishi mushroom shows insufficient evidence for altitude sickness, Alzheimer's disease, and athletic performance, and is possibly ineffective for high cholesterol. Shiitake and maitake mushrooms also show insufficient evidence for most claimed uses, including cancer-related symptoms and other conditions.

If you're considering this product for a specific health goal, talk with your doctor or pharmacist about whether the evidence supports its use for your situation.

The evidence, ingredient by ingredient Zinc Vitamin D Selenium Vitamin C Reishi Mushroom Shiitake Mushroom Maitake Mushroom

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 7 of the 7 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 7 of 7.
  • General safety write-ups exist for 7 of 7.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Zinc is generally well tolerated at recommended doses, but high doses above 40 mg daily can be harmful. Common side effects include nausea, vomiting, abdominal cramps, diarrhea, and a metallic taste.

Vitamin D is generally safe at recommended amounts, but very high doses over time can cause toxicity with symptoms of high blood calcium (hypercalcemia). Selenium is safe at recommended doses but can be toxic in excess — the upper safe limit is 400 mcg daily.

High doses can cause hair and nail changes, nausea, and rash, and there is concern about increased risk of certain skin cancers. Vitamin C is well tolerated at normal doses, but high doses above 2 grams daily may cause stomach upset, diarrhea, and kidney stones in susceptible people.

Reishi mushroom is generally well tolerated short-term and commonly causes dizziness, dry mouth, nausea, or rash. Shiitake and maitake mushrooms are generally safe as food but carry more caution as concentrated supplements — raw shiitake can cause a skin reaction called shiitake dermatitis, and some people may have allergies or respiratory reactions.

Pregnancy and breastfeeding: the safety data advises against reishi and maitake mushroom during pregnancy and breastfeeding. Vitamin D and selenium are possibly unsafe in pregnancy; vitamin C safety data in pregnancy is mixed.

Zinc's pregnancy rating is inconsistent in the data. Talk with your doctor or pharmacist if you're pregnant or breastfeeding before taking this product.

Side effects, ingredient by ingredient Zinc Vitamin D Selenium Vitamin C Reishi Mushroom Shiitake Mushroom Maitake Mushroom

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 7 of the 7 matched ingredients can interact with medications — Maitake Mushroom, Shiitake Mushroom, Reishi Mushroom, Vitamin D, Zinc, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments; diabetes medications; heart-rhythm medications.
  • For scale: 1,279 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Respond Immune Complex, check with your doctor or pharmacist if you take any blood thinners or antiplatelet drugs (warfarin, aspirin, clopidogrel) — zinc, vitamin D, selenium, and maitake mushroom all interact with them at Moderate severity. Do the same for antibiotics, especially quinolones, tetracyclines, and cephalexin — zinc significantly reduces their absorption.

If you're on heart medications (digoxin, verapamil, diltiazem), blood pressure drugs, or diabetes medications, confirm compatibility first. Anyone on HIV integrase inhibitors, chemotherapy drugs, or immunosuppressants should also check ahead.

Vitamin C and high-dose vitamin D can interfere with chemotherapy effectiveness. No interactions are documented in our data for the inactive ingredients, but that is not a guarantee none exist.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This is a multi-ingredient immune support product best suited for people looking to cover baseline micronutrient needs with mushroom additions. If you take any blood thinners, heart medications, diabetes drugs, blood pressure medications, or chemotherapy, you need to check your specific medications against the tool on this page — the interactions here are real and could affect how your drugs work.

Anyone on antibiotics should time them carefully away from this product. Talk it over with your own doctor or pharmacist before starting, especially if you're pregnant, breastfeeding, or managing a chronic condition.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 7 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 22, 2019.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Respond Immune Complex, straight from the product label.

Brand Sundown Organics
Net contents 30 Tablet(s)
Market status On market
Date entered into DSLD Dec 22, 2019
DSLD ID 212235
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses Nutrient, All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Organic, Gluten Free, Dairy Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Respond Immune Complex by Sundown Organics, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Tablet(s)
Maximum serving Sizes:
1 Tablet(s)
IngredientAmount% DV
Zinc5.5 mg50%
Vitamin D10 mcg50%
Selenium27.5 mcg50%
Vitamin C20 mg22%
organic Reishi Mushroom35 mg--
organic Shiitake Mushroom35 mg--
organic Maitake Mushroom30 mg--

Other ingredients: Tapioca Dextrose, Fermentation Blend, organic Bamboo extract, organic Rice extract Blend, organic Safflower Oil, organic Oats, Maltodextrin, organic Sunflower Lecithin, organic Palm Oil, organic Guar Gum

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

Directions: For adults, take one (1) tablet daily, preferably with a meal.

Once daily

Precautions

As a reminder, discuss the supplements and medications you take with your health care providers.

Contains soy ingredients.

Warning: If you are pregnant, nursing, taking any medications or have any medical condition, consult your doctor before use.

Discontinue use and consult your doctor if any adverse reactions occur.

Keep out of reach of children.

Tamper resistant: Do not use if seal under cap is broken or missing.

Formulation

Nutrients incorporated into a Fermented Blend

Non-GMO No gluten No wheat No milk No lactose No artificial color No artificial flavor No artificial sweetener No preservatives No peanuts No tree nuts No fish Sodium free

Certified Organic by Quality Assurance International

Gluten free Dairy free Non-GMO

Sundown believes in living clean...and being transparent. That's why you won't find genetically modified ingredients, gluten, wheat, dairy, lactose or artificial flavors in any of our products. Now, we're going one step further with our USDA Certified organic Supplements that are 100% free of synthetic dyes. Now there's a clean, organic choice you can feel good about.

USDA Organic

Storage

Store at room temperature and avoid excessive heat.

General Statements

Tree-free carton Made from 100% sugar cane fiber Eliminates Wood-based processes Renewable resource Removes carbon dioxide from the atmosphere

Made in the USA with select ingredients from around the world

Coated paper box US only how2recycle.info

Organic, Clean Nutrition In a world of choice, living your best becomes a collaboration between you...and you. When your well-being is important, living clean is a conscious choice you make.

Seals/Symbols

Quality Assurance International Certified Organic

USDA Organic

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Formula

Stay strong with Vitamin C, D3 and Zinc plus Organic Mushrooms

Stay strong with our Respond Immune Complex containing key immune supporting Vitamins C and D3 along with Selenium and Zinc. Organic mushrooms Reishi, Shiitake and Maitake have been used fr their traditional health properties in Chinese and Japanese cultures for thousands of years.

FDA Statement of Identity

Dietary Supplement

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Respond Immune Complex by Sundown Organics label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Respond Immune Complex label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Respond Immune Complex by Sundown Organics

These are the 7 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Tablet(s) Dosage formTablet Or Pill Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Zinc

Interacts with
67 drugs
5.5 mg per serving Form: Zinc Oxide

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but suppleme...

Zinc monograph & interactions

Vitamin D

Interacts with
715 drugs
10 mcg per serving Form: Cholecalciferol, Vitamin D3

Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people,...

Vitamin D monograph & interactions

Selenium

Interacts with
321 drugs
27.5 mcg per serving Form: Selenium Dioxide

Selenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who...

Selenium monograph & interactions

Vitamin C

Interacts with
207 drugs
20 mg per serving Form: organic Acerola

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for im...

Vitamin C monograph & interactions

Organic Reishi Mushroom

Interacts with
375 drugs
35 mg per serving

Reishi is a traditional Asian mushroom widely used to support the immune system and overall wellness. Human evidence for most of its claimed benefits...

Organic Reishi Mushroom monograph & interactions

Organic Shiitake Mushroom

Interacts with
312 drugs
35 mg per serving

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 b...

Organic Shiitake Mushroom monograph & interactions

Organic Maitake Mushroom

Interacts with
260 drugs
30 mg per serving

Maitake is an edible mushroom long used as food and in traditional Japanese medicine, and it is being studied for possible immune, blood sugar, and bl...

Organic Maitake Mushroom monograph & interactions

Other (inactive) ingredients: Tapioca Dextrose, Fermentation Blend, Organic Bamboo extract, Organic Rice extract Blend, Organic Safflower Oil, Organic Oats, Maltodextrin, Organic Sunflower Lecithin, Organic Palm Oil, Organic Guar Gum. These complete the product’s ingredient list but are not active constituents.

Interaction report

Respond Immune Complex by Sundown Organics Drug Interactions

Want to check YOUR meds against Respond Immune Complex?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,278Drugs
856 Moderate 422 Minor

Ingredients driving the most interactions

Vitamin D 715
organic Reishi Mushroom 375
Selenium 321
organic Shiitake Mushroom 312
organic Maitake Mushroom 260

Individual Drug Interactions

The ingredients in Respond Immune Complex interact with 1,278 drugs. Click any drug to see the details.

7 of the 7 ingredients in Respond Immune Complex interact with drugs. Each result below shows which ingredient is responsible. Vitamin D organic Reishi Mushroom Selenium organic Shiitake Mushroom organic Maitake Mushroom Vitamin C Zinc

Each ingredient & the kinds of drugs it affects

For each ingredient in Respond Immune Complex with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Vitamin D8 drug types · 715 drugs

Aluminum

Vitamin D might increase aluminum absorption and toxicity, but this has only been reported in people with renal failure.
The protein that transports calcium across the intestinal wall can also bind and transport aluminum. This protein is stimulated by vitamin D, which may therefore increase aluminum absorption. This mechanism may contribute to increased aluminum levels and toxicity in people with renal failure, when they take vitamin D and aluminum-containing phosphate binders chronically.

Likelihood Probable Evidence B
Atorvastatin (Lipitor)

Vitamin D might reduce absorption of atorvastatin.
A small, low-quality clinical study shows that taking vitamin D reduces levels of atorvastatin and its active metabolites by up to 55%. However, while atorvastatin levels decreased, total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol levels did not substantially change. Atorvastatin is metabolized in the gut by CYP3A4 enzymes, and researchers theorized that vitamin D might induce CYP3A4, causing reduced levels of atorvastatin. However, this proposed mechanism was not specifically studied.

Likelihood Probable Evidence B
Calcipotriene (Dovonex)

Taking calcipotriene with vitamin D increases the risk for hypercalcemia.
Calcipotriene is a vitamin D analog used topically for psoriasis. It can be absorbed in sufficient amounts to cause systemic effects, including hypercalcemia. Theoretically, combining calcipotriene with vitamin D supplements might increase the risk of hypercalcemia.

Likelihood Probable Evidence D
Digoxin (Lanoxin)

Theoretically, hypercalcemia induced by high-dose vitamin D can increase the risk of arrhythmia from digoxin.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia increases the risk of fatal cardiac arrhythmias with digoxin. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and digoxin concurrently.

Likelihood Possible Evidence D
Diltiazem (Cardizem, Others)

Theoretically, hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of diltiazem for arrhythmia.
High doses of vitamin D can cause hypercalcemia. Hypercalcemia can reduce the effectiveness of verapamil in atrial fibrillation. Theoretically this could also occur with diltiazem. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and diltiazem concurrently.

Likelihood Probable Evidence B
Thiazide Diuretics

Theoretically, taking thiazide diuretics and high-dose vitamin D can increase the risk of hypercalcemia.
Thiazide diuretics decrease urinary calcium excretion, which could lead to hypercalcemia if vitamin D supplements are taken concurrently. This has been reported in people being treated with vitamin D for hypoparathyroidism, and also in elderly people with normal parathyroid function who were taking a thiazide, vitamin D, and calcium-containing antacids daily.

Likelihood Probable Evidence D
Verapamil (Calan, Others)

Hypercalcemia induced by high-dose vitamin D can reduce the therapeutic effects of verapamil for arrhythmia.
Hypercalcemia due to high doses of vitamin D can reduce the effectiveness of verapamil in atrial fibrillation. Avoid vitamin D doses above the tolerable upper intake level (4000 IU daily for adults) and monitor serum calcium levels in people taking vitamin D and verapamil concurrently.

Likelihood Probable Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Vitamin D might induce CYP3A4 enzymes and reduce the bioavailability of CYP3A4 substrates.
There is some concern that vitamin D might induce CYP3A4. In vitro research suggests that vitamin D induces CYP3A4 transcription. Additionally, observational research has found that increased UV light exposure and serum vitamin D levels are associated with decreased serum levels of CYP3A4 substrates such as tacrolimus and sirolimus, while no association between UV light exposure or vitamin D levels and levels of mycophenolic acid, a non-CYP3A4 substrate, was found. A small, low-quality clinical study shows that taking vitamin D reduces levels of the CYP3A4 substrate atorvastatin and its active metabolites by up to 55%; however, the clinical effects of atorvastatin were not reduced. While researchers theorized that vitamin D might induce CYP3A4, this proposed mechanism was not specifically studied.

Likelihood Possible Evidence D
Vitamin D full monograph & interactions

organic Reishi Mushroom3 drug types · 375 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, high doses of reishi mushroom might increase the risk of bleeding.
A dose of 1.5 grams daily of reishi mushroom does not seem to decrease platelet aggregation, but a higher dose of 3 grams daily does.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, reishi mushroom might have additive effects with antidiabetes drugs.
Animal research suggests that reishi mushroom decreases blood sugar. However, in patients with type 2 diabetes, taking reishi mushroom does not reduce fasting glucose levels, and its effects on glycated hemoglobin are inconsistent.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, concurrent use of reishi mushroom with antihypertensive drugs might increase the risk of hypotension.
Reishi mushroom has shown hypotensive activity in animal research. Clinical evidence suggests that reishi mushroom reduces blood pressure in some, but not all, patients with hypertension.

Likelihood Possible Evidence D
organic Reishi Mushroom full monograph & interactions

Selenium6 drug types · 321 drugs

Anticoagulant/Antiplatelet Drugs

Selenium may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Clinical research suggests that taking selenium 10 mcg/kg/day can increase bleeding times by increasing prostacyclin production, which inhibits platelet activity. Other clinical research suggests that taking selenium 75 mcg daily, in combination with ascorbic acid 600 mg, alpha-tocopherol 300 mg, and beta-carotene 27 mg, reduces platelet aggregation.

Likelihood Possible Evidence D
Barbiturates

Theoretically, selenium might prolong the sedating effects of barbiturates.
Laboratory research suggests that selenium can inhibit the hepatic metabolism of barbiturates. Selenium seems to prolong the sedative effect of pentobarbital in animal models.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, selenium supplementation may reduce the effectiveness of immunosuppressant therapy.
In vitro research and preliminary clinical evidence suggests that selenium may stimulate the immune system.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, selenium might interfere with warfarin activity.
Animal research suggests that selenium can increase warfarin activity. Selenium might interact with warfarin by displacing it from albumin binding sites, reducing its metabolism in the liver, or by decreasing production of vitamin K-dependent clotting factors. Selenium can also prolong bleeding times in humans by increasing prostacyclin production, which inhibits platelet activity.

Likelihood Possible Evidence D
Contraceptive Drugs

Contraceptive drugs might increase levels of selenium, although the clinical significance of this effect is unclear.
Some research suggests that oral contraceptives increase serum selenium levels in women taking oral contraceptives; however, other research shows no change in selenium levels. It is suggested that an increase could be due to increased carrier proteins, indicating a redistribution of selenium rather than a change in total body selenium.

Likelihood Possible Evidence B
Niacin

Selenium might reduce the beneficial effects of niacin on high-density lipoprotein (HDL) levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as selenium, or to the combination. It also is not known whether it will occur in other patient populations.

Likelihood Possible Evidence A
Selenium full monograph & interactions

organic Shiitake Mushroom2 drug types · 312 drugs

Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, shiitake mushroom might decrease levels of drugs metabolized by CYP2D6.
In vitro studies suggest that the shiitake mushroom extract AHCC might induce the CYP2D6 enzyme. This effect has not been reported in humans.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, taking shiitake mushroom might decrease the effects of immunosuppressive therapy.
In vitro evidence suggests that shiitake mushroom extracts stimulate immune function.

Likelihood Possible Evidence D
organic Shiitake Mushroom full monograph & interactions

organic Maitake Mushroom3 drug types · 260 drugs

Antidiabetes Drugs

Theoretically, combining maitake mushroom with antidiabetes drugs might increase the risk of hypoglycemia.
Clinical research shows that taking maitake mushroom polysaccharide (MMP) can lower blood glucose levels in patients with types 2 diabetes.

Likelihood Possible Evidence B
Antihypertensive Drugs

Theoretically, combining maitake mushroom with antihypertensive drugs might increase the risk of hypotension.
Animal research shows that maitake mushroom can lower blood pressure.

Likelihood Possible Evidence D
Warfarin (Coumadin)

There is limited evidence that maitake mushroom may increase the anticoagulant effects of warfarin.
In a case report, a patient previously stabilized on warfarin developed an elevated international normalized ratio (INR) of 5.1 after taking maitake mushroom (Grifron-Pro Maitake D-Fraction) 1 drop/kg daily in three divided doses for one week. The elevated INR resolved after holding warfarin for two days, then reducing the dose by 11%. It is thought that the beta-glucan constituent of maitake mushroom might cause warfarin dissociation from proteins, resulting in increased free warfarin levels and increased warfarin effects.

Likelihood Possible Evidence D
organic Maitake Mushroom full monograph & interactions

Vitamin C13 drug types · 207 drugs

Alkylating Agents

Theoretically, antioxidant effects of vitamin C might reduce the effectiveness of alkylating agents.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs that generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Aluminum

Vitamin C can increase the amount of aluminum absorbed from aluminum compounds.
Research in animals and humans shows that vitamin C increases aluminum absorption, theoretically by chelating aluminum and keeping it in solution where it is available for absorption. In people with normal renal function, urinary excretion of aluminum will likely increase, making aluminum retention and toxicity unlikely. Patients with renal failure who take aluminum-containing compounds such as phosphate binders should avoid vitamin C supplements in doses above the recommended dietary allowances.

Likelihood Probable Evidence B
Antitumor Antibiotics

Theoretically, the antioxidant effects of vitamin C might reduce the effectiveness of antitumor antibiotics.
The use of antioxidants like vitamin C during chemotherapy is controversial. There is concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as doxorubicin. In contrast, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that could interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effects, if any, antioxidants such as vitamin C have on chemotherapy.

Likelihood Possible Evidence D
Estrogens

Vitamin C might increase blood levels of estrogens.
Increases in plasma estrogen levels of up to 55% occur under some circumstances when vitamin C is taken concurrently with oral contraceptives or hormone replacement therapy, including topical products. It is suggested that vitamin C prevents oxidation of estrogen in the tissues, regenerates oxidized estrogen, and reduces sulfate conjugation of estrogen in the gut wall. When tissue levels of vitamin C are high, these processes are already maximized and supplemental vitamin C does not have any effect on estrogen levels. Increases in plasma estrogen levels may occur when patients who are deficient in vitamin C take supplements. Monitor these patients for estrogen-related side effects.

Likelihood Probable Evidence B
Fluphenazine (Prolixin)

Theoretically, vitamin C might decrease levels of fluphenazine.
In one patient there was a clinically significant decrease in fluphenazine levels when vitamin C (500 mg twice daily) was started. The mechanism is not known, and there is no further data to confirm this interaction.

Likelihood Possible Evidence D
Indinavir (Crixivan)

Vitamin C can modestly reduce indinavir levels.
One pharmacokinetic study shows that taking vitamin C 1 gram orally once daily along with indinavir 800 mg orally three times daily reduces the area under the concentration-time curve of indinavir by 14%. The mechanism of this interaction is unknown, but it is unlikely to be clinically significant in most patients. The effect of higher doses of vitamin C on indinavir levels is unknown.

Likelihood Probable Evidence B
Levothyroxine (Synthroid, Others)

Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.

Likelihood Probable Evidence B
Warfarin (Coumadin)

High-dose vitamin C might reduce the levels and effectiveness of warfarin.
Vitamin C in high doses may cause diarrhea and possibly reduce warfarin absorption. There are reports of two people who took up to 16 grams daily of vitamin C and had a reduction in prothrombin time. Lower doses of 5-10 grams daily can also reduce warfarin absorption. In many cases, this does not seem to be clinically significant. However, a case of warfarin resistance has been reported for a patient who took vitamin C 500 mg twice daily. Cessation of vitamin C supplementation resulted in a rapid increase in international normalized ratio (INR). Tell patients taking warfarin to avoid taking vitamin C in excessively high doses (greater than 10 grams daily). Lower doses may be safe, but the anticoagulation activity of warfarin should be monitored. Patients who are stabilized on warfarin while taking vitamin C should avoid adjusting vitamin C dosage to prevent the possibility of warfarin resistance.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

High-dose vitamin C might slightly prolong the clearance of acetaminophen.
A small pharmacokinetic study in healthy volunteers shows that taking high-dose vitamin C (3 grams) 1.5 hours after taking acetaminophen 1 gram slightly increases the apparent half-life of acetaminophen from around 2.3 hours to 3.1 hours. Ascorbic acid competitively inhibits sulfate conjugation of acetaminophen. However, to compensate, elimination of acetaminophen glucuronide and unconjugated acetaminophen increases. This effect is not likely to be clinically significant.

Likelihood Probable Evidence B
Aspirin

Acidification of the urine by vitamin C might increase aspirin levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction is not clinically significant.

Likelihood Possible Evidence B
Choline Magnesium Trisalicylate (Trilisate)

Acidification of the urine by vitamin C might increase choline magnesium trisalicylate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams daily of vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.

Likelihood Possible Evidence B
Niacin

Vitamin C might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises HDL cholesterol levels in patients with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50% in patients with coronary disease. It is not known whether this adverse effect is due to a single antioxidant such as vitamin C, or to the combination. It also is not known whether it will occur in other patient populations.

Likelihood Possible Evidence A
Salsalate (Disalcid)

Acidification of the urine by vitamin C might increase salsalate levels.
It has been suggested that acidification of the urine by vitamin C could increase reabsorption of salicylates by the renal tubules, and increase plasma salicylate levels. However, short-term use of up to 6 grams/day vitamin C does not seem to affect urinary pH or salicylate excretion, suggesting this interaction probably is not clinically significant.

Likelihood Possible Evidence B
Vitamin C full monograph & interactions

Zinc10 drug types · 67 drugs

Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy)

Theoretically, zinc might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide should be taken at least 2 hours before or 6 hours after zinc containing products.

Likelihood Probable Evidence D
Cephalexin (Keflex)

Zinc might decrease cephalexin levels by chelating with cephalexin in the gut and preventing its absorption.
A pharmacokinetic study shows that zinc sulfate 250 mg taken concomitantly with cephalexin 500 mg decreases peak levels of cephalexin by 31% and reduces the exposure to cephalexin by 27%. Also, taking zinc sulfate 3 hours before cephalexin decreases peak levels of cephalexin by 11% and reduces the exposure to cephalexin by 18%. By decreasing cephalexin levels, zinc might increase the risk of treatment failure. This effect does not occur when zinc is taken 3 hours after the cephalexin dose. To avoid an interaction, advise patients take zinc sulfate 3 hours after taking cephalexin.

Likelihood Probable Evidence B
Cisplatin (Platinol-Aq)

Theoretically, zinc might interfere with the therapeutic effects of cisplatin.
Animal research suggests that zinc stimulates tumor cell production of the protein metallothionein, which binds and inactivates cisplatin. It is not known whether zinc supplements or high dietary zinc intake can cause clinically significant interference with cisplatin therapy. Cisplatin might also increase zinc excretion.

Likelihood Possible Evidence D
Integrase Inhibitors

Theoretically, taking zinc along with integrase inhibitors might decrease the levels and clinical effects of these drugs.
Zinc is a divalent cation. Pharmacokinetic studies have shown that other divalent cations such as calcium and iron can decrease blood levels of the integrase inhibitor dolutegravir through chelation.

Likelihood Possible Evidence D
Penicillamine (Cuprimine, Depen)

Zinc might reduce the levels and clinical effects of penicillamine.
By forming an insoluble complex with penicillamine, zinc interferes with penicillamine absorption and activity. Zinc supplements reduce the efficacy of low-dose penicillamine (0.5-1 gram/day), but do not seem to affect higher doses (1-2.75 gram/day), provided dosing times are separated. Advise patients to take zinc and penicillamine at least 2 hours apart.

Likelihood Probable Evidence B
Quinolone Antibiotics

Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.

Likelihood Probable Evidence B
Ritonavir (Norvir)

Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.

Likelihood Probable Evidence B
Tetracycline Antibiotics

Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.

Likelihood Probable Evidence B
Amiloride (Midamor)

Amiloride can modestly reduce zinc excretion and increase zinc levels.
Clinical research shows that amiloride can reduce urinary zinc excretion, especially at doses of 10 mg per day or more. This zinc-sparing effect can help to counteract zinc losses caused by thiazide diuretics, but it is unlikely to cause zinc toxicity at usual amiloride doses. The other potassium-sparing diuretics, spironolactone (Aldactone) and triamterene (Dyrenium), do not seem to have a zinc-sparing effect.

Likelihood Probable Evidence B
Atazanavir (Reyataz)

Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.

Likelihood Probable Evidence B
Zinc full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Respond Immune Complex, from the product label.

Sundown Organics

See all Sundown Organics products
Name
Rexall Sundown, Inc.
City
Boca Raton
State
FL
ZipCode
33487
Phone Number
1-888-848-2435
Web Address
www.sundownorganics.com
Pharmacist Counseling Corner

Respond Immune Complex by Sundown Organics: Common Questions

Does Respond Immune Complex by Sundown Organics interact with any medications?
Yes. Based on its ingredients, Respond Immune Complex has a known interaction with 1,278 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Respond Immune Complex contains 7 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Does this product have fillers?
Yes. The tablet contains several inactive ingredients including tapioca dextrose, maltodextrin, fermentation blend, and plant extracts (bamboo, rice, oats, safflower oil, sunflower lecithin, palm oil, and guar gum). These serve as binders, thickeners, and carriers to hold the active ingredients together.
Can I take this if I'm pregnant or breastfeeding?
The safety data advises against reishi and maitake mushroom during pregnancy and breastfeeding due to insufficient data. Vitamin D and selenium are possibly unsafe in pregnancy. Zinc and vitamin C have mixed or unclear pregnancy ratings. You should not take this without talking to your doctor or pharmacist first — they can give personalized advice based on your situation.
What's the difference between the mushrooms in this product?
Reishi, shiitake, and maitake are three different medicinal mushrooms included here for immune support. Reishi is traditionally used for relaxation; shiitake is eaten as food and may support immune function; maitake has been studied for blood sugar and immune effects. None have strong clinical evidence for specific uses in the data we hold.
Is this safe to take long-term?
The safety data notes that reishi mushroom is generally well tolerated short-term but its long-term safety is not well studied. Zinc and selenium can accumulate at high doses over time and cause toxicity. Vitamin D toxicity can develop from excessive doses taken over extended periods. If you're thinking about taking this for months or longer, check with your doctor or pharmacist about whether it's right for you.
Can this help with immune support or colds?
Vitamin C is possibly effective for exercise-induced respiratory infections. Zinc is possibly effective for acne and other conditions listed. The mushroom ingredients are traditionally used for immune support, but clinical evidence for preventing or treating colds is not established in the data we hold. Talk with your doctor about whether this product makes sense for your specific health goal.
What's the most common side effect?
Zinc most commonly causes nausea, vomiting, diarrhea, and a metallic taste — especially at doses above recommended amounts. Vitamin C can cause stomach upset and diarrhea at high doses. The mushrooms commonly cause nausea, dizziness, or stomach upset. If you experience any bothersome effects, stop taking it and talk with your pharmacist.

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

Not sure if Respond Immune Complex is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Respond Immune Complex label
Go deeper

The Full Monographs Behind Respond Immune Complex’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Zinc

Interacts with 67 drugs

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a defici...

Read the full Zinc monograph → Herb & supplement monograph

Vitamin D

Interacts with 715 drugs

Vitamin D is a fat-soluble vitamin that helps your body absorb calcium and is important for healthy bones, muscles, and immune function. Many people, especially those with low sun exposure,...

Read the full Vitamin D monograph → Herb & supplement monograph

Selenium

Interacts with 321 drugs

Selenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who eat a varied diet get enough, and supple...

Read the full Selenium monograph → Herb & supplement monograph

Vitamin C

Interacts with 207 drugs

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an...

Read the full Vitamin C monograph → Herb & supplement monograph

Reishi Mushroom

Interacts with 375 drugs

Reishi is a traditional Asian mushroom widely used to support the immune system and overall wellness. Human evidence for most of its claimed benefits is limited or low-quality, so it should...

Read the full Reishi Mushroom monograph → Herb & supplement monograph

Shiitake Mushroom

Interacts with 312 drugs

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 al...

Read the full Shiitake Mushroom monograph → Herb & supplement monograph

Maitake Mushroom

Interacts with 260 drugs

Maitake is an edible mushroom long used as food and in traditional Japanese medicine, and it is being studied for possible immune, blood sugar, and blood pressure effects. The human evidence...

Read the full Maitake Mushroom monograph →
Sources

Sources & How We Checked

Respond Immune Complex's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 293 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Zinc 88 references
  1. Barceloux DG. Zinc. J Toxicol Clin Toxicol 1999;37:279-92.
  2. Eby GA, Davis DR, Halcomb WW. Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study. Antimicrob Agents Chemother 1984;25:20-4. DOI
  3. Smith DS, Helzner EC, Nuttall CE Jr, et al. Failure of zinc gluconate in treatment of acute upper respiratory tract infections. Antimicrob Agents Chemother 1989;33:646-8. PubMed
  4. Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
  5. Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
  6. Kugelmas M. Preliminary observation: oral zinc sulfate replacement is effective in treating muscle cramps in cirrhotic patients. J Am Coll Nutr 2000;19:13-5. PubMed
  7. Hebel SK, ed. Drug Facts and Comparisons. 52nd ed. St. Louis: Facts and Comparisons, 1998.
  8. Chan S, Gerson B, Subramaniam S. The role of copper, molybdenum, selenium, and zinc in nutrition and health. Clin Lab Med 1998;18:673-85. DOI
  9. Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents. J Am Coll Nutr 1993;12:26-30. PubMed
  10. Fosmire GJ. Zinc toxicity. Am J Clin Nutr 1990;51:225-7.
  11. Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
  12. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  13. Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14. PubMed
  14. Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
  15. Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial. Ear Nose Throat J 2000;79:778-82.. DOI
  16. Simkin PA. Oral zinc sulphate in rheumatoid arthritis. Lancet 1976;2:539-42. PubMed
  17. Wray D. A double-blind trial of systemic zinc sulfate in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;53:469-72. PubMed
  18. Douglas RM, Miles HB, Moore BW, et al. Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory tract infections in Australian adults. Antimicrob Agents Chemother 1987;31:1263-5. PubMed
  19. Lagiou P, Wuu J, Trichopoulou A, et al. Diet and benign prostatic hyperplasia: a study in Greece. Urology 1999;54:284-90. PubMed
  20. Ewing CI, Gibbs AC, Ashcroft C, David TJ. Failure of oral zinc supplementation in atopic eczema. Eur J Clin Nutr 1991;45:507-10.
  21. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  22. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss. AREDS report no. 8. Arch Oph
  23. Greenberg JE, Lynn M, Kirsner RS, et al. Mucocutaneous pigmented macule as a result of zinc deposition. J Cutan Pathol 2002;29:613-5. PubMed
  24. Godfrey HR, Godfrey NJ, Godfrey JC, Riley D. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med 2001;7:49-56.
  25. Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of experimental rhinovirus colds. Clin Infect Dis 2001;33:1865-70. PubMed
  26. Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med 2001;111:103-8. PubMed
  27. Mossad SB. Effect of zincum gluconicum nasal gel on the duration and symptom severity of the common cold in otherwise healthy adults. QJM 2003;96:35-43. DOI
  28. Leitzmann MF, Stampfer MJ, Wu K, et al. Zinc supplement use and risk of prostate cancer. J Natl Cancer Inst 2003;95:1004-7.. PubMed
  29. Jafek BW, Linschoten M, Murrow BW. Zicam Induced Anosmia. American Rhinologic Society 49th Annual Fall Scientific Meeting abstract. Orlando, Florida. September 20, 2003. http://app.american-rhinologic.org/programs/2003ARSFallProgram071503.pdf (Accessed 24
  30. Uebayashi H, Hatanaka T, Kanemura F, Tonosaki K. Acute anosmia in the mouse: behavioral discrimination among the four basic taste substances. Physiol Behav 2001;72:291-6.. PubMed
  31. Barrett S. Zicam Marketers Sued. United States District Court Western District of Michigan Southern Division, Filed October 14, 2003, Case No. 4:03CV0146.
  32. Bilici M, Yildirim F, Kandil S, et al. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry 2004;28:181-90.. PubMed
  33. Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
  34. Mery C, Delrieu F, Ghozlan R, et al. Controlled trial of D-penicillamine in rheumatoid arthritis. Dose effect and the role of zinc. Scand J Rheumatol 1976;5:241-7. PubMed
  35. Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
  36. Kondo Y, Yamagata K, Satoh M, et al. Optimal administration schedule of cisplatin for bladder tumor with minimal induction of metallothionein. J Urol 2003;170:2467-70. PubMed
  37. Doz F, Berens ME, Deschepper CF, et al. Experimental basis for increasing the therapeutic index of cis-diamminedicarboxylatocyclobutaneplatinum(II) in brain tumor therapy by a high-zinc diet. Cancer Chemother Pharmacol 1992;29:219-26.
  38. Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
  39. Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
  40. Leary WP, Reyes AJ, Van der Byl K. Urinary magnesium and zinc excretion after two different single doses of amiloride in healthy adults. Curr Ther Res 1983;34:205-16.
  41. McBride K, Slotnick B, Margolis FL. Does intranasal application of zinc sulfate produce anosmia in the mouse? An olfactometric and anatomical study. Chem Senses 2003;28:659-70. PubMed
  42. Burd GD. Morphological study of the effects of intranasal zinc sulfate irrigation on the mouse olfactory epithelium and olfactory bulb. Microsc Res Tech 1993;24:195-213. PubMed
  43. Ducray A, Bondier JR, Michel G, et al. Recovery following peripheral destruction of olfactory neurons in young and adult mice. Eur J Neurosci 2002;15:1907-17. PubMed
  44. Mayer AD, Rosenblatt JS. Peripheral olfactory deafferentation of the primary olfactory system in rats using ZnSO4 nasal spray with special reference to maternal behavior. Physiol Behav 1993;53:587-92. PubMed
  45. DeCook CA, Hirsch AR. Anosmia due to inhalational zinc: a case report (abstract). Chem Senses 2000;25:659.
  46. Tisdall FF, Brown A, Defries RD. Persistent anosmia following zinc sulfate nasal spraying. JPed 1938;18:60-2. DOI
  47. Lawson KA, Wright ME, Subar A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. J Natl Cancer Inst 2007;99:754-64. PubMed
  48. Public Health Advisory. Loss of sense of smell with intranasal cold remedies containing zinc. U.S. Food and Drug Administration, June 16, 2009. Available at: http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm166059.htm (Accessed 16 June 2009)
  49. Dooren JC. FDA warns against use of Zicam. The Wall Street Journal, June 16, 2009. Available at: http://online.wsj.com/article/SB124516778692319231.html#mod=djemHL?mg=com-wsj (Accessed 16 June 2009).
  50. Alexander TH, Davidson TM. Intranasal zinc and anosmia: the zinc-induced anosmia syndrome. Laryngoscope 2006;116:217-20.
  51. Health Canada / GlaxoSmithKline Consumer Healthcare. Association of long-term, excessive use of zinc-containing Poli-Grip products with myeloneuropathy and blood dyscrasias. February 18, 2010. Available at: http://hc-sc.gc.ca/dhp-mps/alt_formats/pdf/medef
  52. GlaxoSmithKline Consumer Advisory. GlaxoSmithKline (GSK) warns about a potential health risk associated with long-term, excessive use of GSK's zinc-containing denture adhesives Super Polygrip Original, Ultra Fresh and Extra Care. February 18, 2010. Availa
  53. Science M, Johnstone J, Roth DE, et al. Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. CMAJ 2012;184:E551-61. PubMed
  54. Castilla-Higuero, L., Romero-Gomez, M., Suarez, E., and Castro, M. Acute hepatitis after starting zinc therapy in a patient with presymptomatic Wilson's disease. Hepatology 2000;32(4 Pt 1):877. PubMed
  55. Sharquie, K. E., Najim, R. A., Farjou, I. B., and Al Timimi, D. J. Oral zinc sulphate in the treatment of acute cutaneous leishmaniasis. Clin.Exp.Dermatol. 2001;26(1):21-26. PubMed
  56. Dreno, B., Moyse, D., Alirezai, M., Amblard, P., Auffret, N., Beylot, C., Bodokh, I., Chivot, M., Daniel, F., Humbert, P., Meynadier, J., and Poli, F. Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of
  57. Moore, R. Bleeding gastric erosion after oral zinc sulphate. Br.Med J 3-25-1978;1(6115):754. PubMed
  58. Jafek, B. W., Linschoten, M. R., and Murrow, B. W. Anosmia after intranasal zinc gluconate use. Am J Rhinol. 2004;18(3):137-141. DOI
  59. Simonart, T. and de, Maertelaer, V. Systemic treatments for cutaneous warts: a systematic review. J Dermatolog.Treat. 2012;23(1):72-77. PubMed
  60. Cochran, R. J., Tucker, S. B., and Flannigan, S. A. Topical zinc therapy for acne vulgaris. Int.J Dermatol. 1985;24(3):188-190. DOI
  61. Morgan, A. A. Bleeding gastric erosion after oral zinc sulphate. Br.Med.J. 5-13-1978;1(6122):1283-1284. PubMed
  62. Murphy, J. V. Intoxication following ingestion of elemental zinc. JAMA 6-22-1970;212(12):2119-2120.
  63. Lang, C. J., Rabas-Kolominsky, P., Engelhardt, A., Kobras, G., and Konig, H. J. Fatal deterioration of Wilson's disease after institution of oral zinc therapy. Arch Neurol. 1993;50(10):1007-1008. PubMed
  64. Fjellner, B. Drug-induced lupus erythematosus aggravated by oral zinc therapy. Acta Derm.Venereol. 1979;59(4):368-370. DOI
  65. Varas Lorenzo, M. J. Zinc acexamate and ranitidine in the short- and mid-term management of gastroduodenal ulcers. Curr Ther Res 21986;39:19-29.
  66. Bosch, F. and Jimenez, E. Post-marketing surveillance of zinc acexamate in peptic ulcer treatment. Clin Trials J 1990;27:301-312.
  67. DeCook, C. A. and Hirsch, A. R. Anosmia due to inhalational zinc: a case report (abstract). Chem Senses 2000;25:659.
  68. Crown LA, May JA. Zinc toxicity: denture adhesives, bone marrow failure and polyneuropathy. Tenn Med. 2012 Feb;105(2):39-40, 42.
  69. Dadamio J, Van Tournout M, Teughels W, Dekeyser C, Coucke W, Quirynen M. Efficacy of different mouthrinse formulations in reducing oral malodour: a randomized clinical trial. J Clin Periodontol. 2013 May;40(5):505-13. PubMed
  70. Moyle G, Else L, Jackson A, Back D, Yapa MH, Seymour N, Ringner-Nackter L, Karolia Z, Gazzard B, Boffito M. Coadministration of atazanavir-ritonavir and zinc sulfate: impact on hyperbilirubinemia and pharmacokinetics. Antimicrob Agents Chemother. 2013 Aug PubMed
  71. Zittel S, Ufer F, Gerloff C, Münchau A, Rosenkranz M. Severe myelopathy after denture cream use--is copper deficiency or excess zinc the cause? Clin Neurol Neurosurg. 2014 Jun;121:17-8. PubMed
  72. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
  73. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents: Drug Interactions between Integrase Inhibitors and Other Drugs. AIDSinfo. July 14, 2016. Available at: https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescen
  74. Ding Y, Jia YY, Li F, et al. The effect of staggered administration of zinc sulfate on the pharmacokinetics of oral cephalexin. Br J Clin Pharmacol. 2012 Mar;73(3):422-7. PubMed
  75. Fallah R, Sabbaghzadegan S, Karbasi SA, Binesh F. Efficacy of zinc sulfate supplement on febrile seizure recurrence prevention in children with normal serum zinc level: A randomised clinical trial. Nutrition. 2015;31(11-12):1358-61. PubMed
  76. Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2016;12:CD005436. PubMed
  77. Mahmoud AM, Al-Alem U, Dabbous F, et al. Zinc intake and risk of prostate cancer: Case-control study and meta-analysis. PLoS One. 2016;11(11):e0165956. PubMed
  78. Nagraj SK, George RP, Shetty N, Levenson D, Ferraiolo DM, Shrestha A. Interventions for managing taste disturbances. Cochrane Database Syst Rev. 2017 Dec 20;12(12):CD010470. PubMed
  79. Yee BE, Richards P, Sui JY, Marsch AF. Serum zinc levels and efficacy of zinc treatment in acne vulgaris: A systematic review and meta-analysis. Dermatol Ther. 2020:e14252. PubMed
  80. Janyajirawong R, Vilaichone RK, Sethasine S. Efficacy of zinc supplement in minimal hepatic encephalopathy: A prospective, randomized controlled study (Zinc-MHE Trial). Asian Pac J Cancer Prev 2021;22(9):2879-2887. PubMed
  81. Nakano M, Nakamura Y, Miyazaki A, Takahashi J. Zinc pharmacotherapy for elderly osteoporotic patients with zinc deficiency in a clinical setting. Nutrients 2021;13(6):1814. PubMed
  82. Tolino E, Skroza N, Mambrin A, et al. An open-label study comparing oral zinc to lymecycline in the treatment of acne vulgaris. J Clin Aesthet Dermatol 2021;14(5):56-58.
  83. Hunter J, Arentz S, Goldenberg J, et al. Zinc for the prevention or treatment of acute viral respiratory tract infections in adults: a rapid systematic review and meta-analysis of randomised controlled trials. BMJ Open. 2021;11(11):e047474. PubMed
  84. Yamazaki K, Kageyama H, Fujiyama T, Ito T, Urano S, Honda T. A case of systemic contact dermatitis due to zinc supplements. Int J Dermatol 2022. PubMed
  85. Magham K, Han J, Eilbert W, Bunney EB. Severe copper deficiency anemia caused by zinc supplement use. Am J Emerg Med 2023;72:222. PubMed
  86. Sivakumar RR, Chinnaiah Govindareddy D, Sahoo J, Bobby Z, Chinnakali P. Effect of daily zinc supplementation for 12 weeks on serum thyroid auto-antibody levels in children and adolescents with autoimmune thyroiditis - a randomized controlled trial. J Pedi PubMed
  87. AlDhasee O, AlMalki H, AlKharashi N, AlJeraisy N, Al Deeb M. Acute zinc sulfate overdose: clinical presentation and management. BMJ Case Rep 2025;18(1):e263899. PubMed
  88. US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.

See these in context on the Zinc monograph →

Vitamin D 26 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Tatro DS, ed. Drug Interactions Facts. Facts and Comparisons Inc., St. Louis, MO. 1999.
  3. Koutkia P, Chen TC, Holick MF. Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med 2001;345:66-7. PubMed
  4. Bar-Or D, Yoel G. Calcium and calciferol antagonize effect of verapamil in atrial fibrillation. Br Med J 1981;282:1585-6.
  5. Demontis R, Leflon A, Fournier A, et al. 1 alpha(OH) vitamin D3 increases plasma aluminum in hemodialyzed patients taking AI(OH)3. Clin Nephrol 1986;26:146-9.
  6. Crowe M, Wollner L, Griffiths RA. Hypercalcemia following vitamin D and thiazide therapy in the elderly. Practitioner 1984;228:312-3.
  7. Parfitt AM. Thiazide-induced hypercalcemia in vitamin D-treated hypoparathyroidism. Ann Intern Med 1972;77:557-63. PubMed
  8. Thiazide diuretics and the risk of osteoporosis. Pharmacist's Letter/Prescriber's Letter 2003;19(11):191105.
  9. Moon J. The role of vitamin D in toxic metal absorption. J Am Coll Nutr 1994;13:559-64.
  10. Demontis R, Reissi D, Noel C, et al. Indirect clinical evidence that 1alphaOH vitamin D<SUB>3</SUB> increases the intestinal absorption of aluminum. Clin Nephrol 1989;31:123-7.
  11. Adler AJ, Berlyne GM. Duodenal aluminum absorption in the rat: effect of vitamin D. Am J Physiol 1985;249:G209-13. PubMed
  12. Schwartz JB. Effects of vitamin D supplementation in atorvastatin-treated patients: A new drug interaction with an unexpected consequence. Clin Pharmacol Ther 2009;85:198-203. PubMed
  13. Dietary reference intakes for calcium and vitamin D. Institute of Medicine, November 30, 2010. Available at: http://www.iom.edu/~/media/Files/Report%20Files/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/Vitamin%20D%20and%20Calcium%202010%20Repo
  14. Cox KA, Dunn MA. Aluminum toxicity alters the regulation of calbindin-D28k protein and mRNA expression in chick intestine. J Nutr 2001;131:2007-13. PubMed
  15. Escribano, J., Balaguer, A., Pagone, F., Feliu, A., and Roque, I. Figuls. Pharmacological interventions for preventing complications in idiopathic hypercalciuria. Cochrane.Database.Syst.Rev. 2009;(1):CD004754. PubMed
  16. Carlton, S., Clopton, D., and Cappuzzo, K. A. Vitamin D deficiency: appropriate replenishment therapies and the effects of vitamin D toxicity. Consult Pharm 2010;25(3):171-177. PubMed
  17. Wang, H., Xia, N., Yang, Y., and Peng, D. Q. Influence of vitamin D supplementation on plasma lipid profiles: a meta-analysis of randomized controlled trials. Lipids Health Dis. 2012;11:42. PubMed
  18. Turner AN, Carr Reese P, Fields KS, Anderson J, Ervin M, Davis JA, Fichorova RN, Roberts MW, Klebanoff MA, Jackson RD. A blinded, randomized controlled trial of high-dose vitamin D supplementation to reduce recurrence of bacterial vaginosis. Am J Obstet G PubMed
  19. Weiner M, Epstein FH. Signs and symptoms of electrolyte disorders. Yale J Biol Med. 1970;43(2):76-109.
  20. Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017 Mar 28;317(12):1234-1243. PubMed
  21. Roth DE, Leung M, Mesfin E, Qamar H, Watterworth J, Papp E. Vitamin D supplementation during pregnancy: state of the evidence from a systematic review of randomised trials. BMJ. 2017;359:j5237. PubMed
  22. Murai IH, Fernandes AL, Sales LP, et al. Effect of a single high dose of vitamin D3 on hospital length of stay in patients with moderate to severe COVID-19: A randomized clinical trial. JAMA. 2021.
  23. Wang Z, Schuetz EG, Xu Y, Thummel KE. Interplay between vitamin D and the drug metabolizing enzyme CYP3A4. J Steroid Biochem Mol Biol 2013;136:54-8. PubMed
  24. Doyle D, Browne U, Brickley A, Murphy D. Vitamin D-induced hypercalcaemia and acute kidney injury in sarcoidosis. BMJ Case Rep 2023;16(1):e250580. PubMed
  25. Williamson A, Martineau AR, Sheikh A, Jolliffe D, Griffiths CJ. Vitamin D for the management of asthma. Cochrane Database Syst Rev 2023;2(2):CD011511. PubMed
  26. Kinesya E, Santoso D, Gde Arya N, et al. Vitamin D as adjuvant therapy for diabetic foot ulcers: Systematic review and meta-analysis approach. Clin Nutr ESPEN 2023;54:137-143. PubMed

See these in context on the Vitamin D monograph →

Selenium 36 references
  1. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
  2. Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
  3. Trafikowska U, Zachara BA, Wiacek M, et al. Selenium supply and glutathione peroxidase activity in breastfed Polish infants. Acta Paediatr 1996;85:1143-5. PubMed
  4. Duffield-Lillico AJ, Slate EH, Reid ME, et al. Selenium supplementation and secondary prevention of nonmelanoma skin cancer in a randomized trial. J Natl Cancer Inst 2003;95:1477-81.. PubMed
  5. Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
  6. Schiavon R, Freeman GE, Guidi GC, et al. Selenium enhances prostacyclin production by cultured endothelial cells: possible explanation for increased bleeding times in volunteers taking selenium as a dietary supplement. Thromb Res 1984;34:389-96. PubMed
  7. Davila JC, Edds GT, Osuna O, Simpson CF. Modification of the effects of aflatoxin B1 and warfarin in young pigs given selenium. Am J Vet Res 1983;44:1877-83. DOI
  8. Heese HD, Lawrence MA, Dempster WS, Pocock F. Reference concentrations of serum selenium and manganese in healthy nulliparas. S Afr Med J 1988;73:163-5.
  9. Lloyd B, Lloyd RS, Clayton BE. Effect of smoking, alcohol and other factors on the selenium status of a healthy population. J Epidemiol Commun Health 1983;37:213-7. PubMed
  10. Capel ID, Jenner M, Williams DC, et al. The effect of prolonged oral contraceptive steroid use on erythrocyte glutathione peroxidase activity. J Steroid Biochem 1981;14:729-32. PubMed
  11. Contempre B, Dumont JE, Ngo B, et al. Effect of selenium supplementation in hypothyroid subjects of an iodine and selenium deficient area: the possible danger of indiscriminate supplementation of iodine-deficient subjects with selenium. J Clin Endocrinol PubMed
  12. Hofbauer LC, Spitzweg C, Magerstadt RA, Heufelder AE. Selenium-induced thyroid dysfunction. Postgrad Med J 1997;73:103-4. PubMed
  13. Debski B, Milner JA. Dietary selenium supplementation prolongs pentobarbital induced hypnosis. J Nutr Biochem 2004;15:548-53. PubMed
  14. Ishikawa M, Sasaki M, Koiwai K, et al. Inhibition of hepatic mixed-function oxidase enzymes in mice by acute and chronic treatment with selenium. J Pharmacobiodyn 1992;15:377-85. PubMed
  15. Lippmann SM, Klein EA, Goodman PJ, et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the selenium and vitamin E cancer prevention trial (SELECT). JAMA 2009;301:39-51. DOI
  16. Reid SM, Middleton P, Cossich MC, Crowther CA. Interventions for clinical and subclinical hypothyroidism in pregnancy. Cochrane Database Syst Rev 2010;(7):CD007752. PubMed
  17. Vinceti, M., Wei, E. T., Malagoli, C., Bergomi, M., and Vivoli, G. Adverse health effects of selenium in humans. Rev.Environ.Health 2001;16(4):233-251. PubMed
  18. Abrams, C. K., Siram, S. M., Galsim, C., Johnson-Hamilton, H., Munford, F. L., and Mezghebe, H. Selenium deficiency in long-term total parenteral nutrition. Nutr Clin Pract 1992;7(4):175-178. PubMed
  19. Spiller, H. A. and Pfiefer, E. Two fatal cases of selenium toxicity. Forensic Sci Int 8-24-2007;171(1):67-72. PubMed
  20. Negro, R., Greco, G., Mangieri, T., Pezzarossa, A., Dazzi, D., and Hassan, H. The influence of selenium supplementation on postpartum thyroid status in pregnant women with thyroid peroxidase autoantibodies. J Clin Endocrinol.Metab 2007;92(4):1263-1268. PubMed
  21. Alexander, J. Selenium. Novartis.Found.Symp 2007;282:143-149.
  22. Salonen, J. T., Salonen, R., Seppanen, K., Rinta-Kiikka, S., Kuukka, M., Korpela, H., Alfthan, G., Kantola, M., and Schalch, W. Effects of antioxidant supplementation on platelet function: a randomized pair-matched, placebo-controlled, double-blind trial
  23. Kupka, R., Mugusi, F., Aboud, S., Msamanga, G. I., Finkelstein, J. L., Spiegelman, D., and Fawzi, W. W. Randomized, double-blind, placebo-controlled trial of selenium supplements among HIV-infected pregnant women in Tanzania: effects on maternal and chil
  24. Kamble, P., Mohsin, N., Jha, A., Date, A., Upadhaya, A., Mohammad, E., Khalil, M., Pakkyara, A., and Budruddin, M. Selenium intoxication with selenite broth resulting in acute renal failure and severe gastritis. Saudi.J Kidney Dis.Transpl. 2009;20(1):106
  25. Peretz, A., Neve, J., Desmedt, J., Duchateau, J., Dramaix, M., and Famaey, J. P. Lymphocyte response is enhanced by supplementation of elderly subjects with selenium-enriched yeast. Am.J Clin.Nutr. 1991;53(5):1323-1328. PubMed
  26. Kumpulainen, J., Salmenpera, L., Siimes, M. A., Koivistoinen, P., and Perheentupa, J. Selenium status of exclusively breast-fed infants as influenced by maternal organic or inorganic selenium supplementation. Am.J Clin.Nutr. 1985;42(5):829-835. PubMed
  27. Han, L. and Zhou, S. M. Selenium supplement in the prevention of pregnancy induced hypertension. Chin Med J (Engl) 1994;107(11):870-871.
  28. Kiremidjian-Schumacher, L., Roy, M., Wishe, H. I., Cohen, M. W., and Stotzky, G. Supplementation with selenium and human immune cell functions. II. Effect on cytotoxic lymphocytes and natural killer cells. Biol.Trace Elem.Res. 1994;41(1-2):115-127. PubMed
  29. Srivastava, A. K., Gupta, B. N., Bihari, V., and Gaur, J. S. Generalized hair loss and selenium exposure. Vet.Hum.Toxicol. 1995;37(5):468-469.
  30. Sudfeld CR, Aboud S, Kupka R, et al. Effect of selenium supplementation on HIV-1 RNA detection in breast milk of Tanzanian women. Nutrition 2014;30(9):1081-4. PubMed
  31. Rees K, Hartley L, Day C, et al. Selenium supplementation for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev 2013;1:CD009671. PubMed
  32. Thompson PA, Ashbeck EL, Roe DJ, et al. Selenium Supplementation for Prevention of Colorectal Adenomas and Risk of Associated Type 2 Diabetes. J Natl Cancer Inst. 2016;108(12). PubMed
  33. Wichman J, Winther KH, Bonnema SJ, Hegedüs L. Selenium supplementation significantly reduces thyroid autoantibody levels in patients with chronic autoimmune thyroiditis: a systematic review and meta-analysis. Thyroid 2016;26(12):1681-92. PubMed
  34. Vinceti M, Filippini T, Rothman KJ. Selenium exposure and the risk of type 2 diabetes: a systematic review and meta-analysis. Eur J Epidemiol. 2018 Sep;33(9):789-810. Epub 2018 Jul 5. Review. PubMed
  35. Fallah S, Sani FV, Firoozrai M. Effect of contraceptive pill on the selenium and zinc status of healthy subjects. Contraception. 2009;80(1):40-3. PubMed
  36. Malpas CB, Vivash L, Genc S, et al. A Phase IIa Randomized Control Trial of VEL015 (Sodium Selenate) in Mild-Moderate Alzheimer's Disease. J Alzheimers Dis. 2016;54(1):223-232. PubMed

See these in context on the Selenium monograph →

Vitamin C 51 references
  1. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Back DJ, Breckenridge AM, MacIver M, et al. Interaction of ethinyloestradiol with ascorbic acid in man. Br Med J (Clin Res Ed) 1981;282:1516.
  3. Morris JC, Beeley L, Ballantine N. Interaction of ethinyloestradiol with ascorbic acid in man [letter]. Br Med J (Clin Res Ed) 1981;283:503.
  4. Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
  5. Dwyer JH, Merz NB, Shirocre AM, et al. Progression of early atherosclerosis and intake of vitamin C and vitamin E from supplements and food. The Los Angeles Atherosclerosis Study. 41st Annual Conference on Cardiovascular Disease Epidemiology and Prevent
  6. Levine M, Rumsey SC, Daruwala R, et al. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1415-23. PubMed
  7. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  8. Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
  9. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
  10. Houston JB, Levy G. Drug biotransformation interactions in man VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:1218-21. PubMed
  11. Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
  12. Rosenthal G. Interaction of ascorbic acid and warfarin. JAMA 1971;215:1671. DOI
  13. Hume R, Johnstone JM, Weyers E. Interaction of ascorbic acid and warfarin. JAMA 1972;219:1479. DOI
  14. Smith EC, Skalski RJ, Johnson GC, Rossi GV. Interaction of ascorbic acid and warfarin. JAMA 1972;221:1166. DOI
  15. Traxer O, Huet B, Poindexter J, et al. Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 2003;170:397-401.. PubMed
  16. Domingo JL, Gomez M, Llobet JM, Richart C. Effect of ascorbic acid on gastrointestinal aluminum absorption (letter). Lancet 1991;338:1467.
  17. Domingo JL, Gomez M, Llobet JM, Corbella J. Influence of some dietary constituents on aluminum absorption and retention in rats. Kidney Int 1991;39:598-601. PubMed
  18. Partridge NA, Regnier FE, White JL, Hem SL. Influence of dietary constituents on intestinal absorption of aluminum. Kidney Int 1989;35:1413-7. PubMed
  19. Mc Leod DC, Nahata MC. Inefficacy of ascorbic acid as a urinary acidifier (letter). N Engl J Med 1977;296:1413. DOI
  20. Hansten PD, Hayton WL. Effect of antacid and ascorbic acid on serum salicylate concentration. J Clin Pharmacol 1980;20:326-31. PubMed
  21. Dysken MW, Cumming RJ, Channon RA, Davis JM. Drug interaction between ascorbic acid and fluphenazine. JAMA 1979;241:2008. DOI
  22. Vihtamaki T, Parantainen J, Koivisto AM, et al. Oral ascorbic acid increases plasma oestradiol during postmenopausal hormone replacement therapy. Maturitas 2002;42:129-35. PubMed
  23. Slain D, Amsden JR, Khakoo RA, et al. Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Pharmacotherapy 2005;25:165-70. PubMed
  24. Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
  25. Feetam CL, Leach RH, Meynell MJ. Lack of a clinically important interaction between warfarin and ascorbic acid. Toxicol Appl Pharmacol 1975;31:544-7. PubMed
  26. Weintraub M, Griner PF. Warfarin and ascorbic acid: lack of evidence for a drug interaction. Toxicol Appl Pharmacol 1974;28:53-6. PubMed
  27. Lee DH, Folsom AR, Harnack L, et al. Does supplemental vitamin C increase cardiovascular disease risk in women with diabetes? Am J Clin Nutr 2004;80:1194-200. PubMed
  28. Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 2004;15:3225-32. PubMed
  29. Ward NC, Hodgson JM, Croft KD, et al. The combination of vitamin C and grape-seed polyphenols increases blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens 2005;23:427-34.. PubMed
  30. Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
  31. Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
  32. Fairweather-Tait S, Hickson K, McGaw B, et al. Orange juice enhances aluminium absorption from antacid preparation. Eur J Clin Nutr. 1994;48(1):71-3.
  33. Gruenwald, J., Graubaum, H. J., Busch, R., and Bentley, C. Safety and tolerance of ester-C compared with regular ascorbic acid. Adv.Ther. 2006;23(1):171-178.
  34. Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
  35. Einerson, B., Nathorn, C., Kitiyakara, C., Sirada, M., and Thamlikitkul, V. The efficacy of ascorbic acid in suboptimal responsive anemic hemodialysis patients receiving erythropoietin: a meta-analysis. J Med.Assoc.Thai. 2011;94 Suppl 1:S134-S146.
  36. Li, G., Li, L., Yu, C., and Chen, L. Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis. Br.J Nutr 2011;106(11):1632-1637.
  37. Chen X, Shen L, Gu X, et al. High-dose supplementation with vitamin C--induced pediatric urolithiasis: the first case report in a child and literature review. Urology. 2014;84(4):922-4. PubMed
  38. Sattar A, Willman JE, Kolluri R. Possible warfarin resistance due to interaction with ascorbic acid: case report and literature review. Am J Health Syst Pharm. 2013;70(9):782-6. PubMed
  39. Yaich S, Chaabouni Y, Charfeddine K, et al. Secondary oxalosis due to excess vitamin C intake: a cause of graft loss in a renal transplant recipient. Saudi J Kidney Dis Transpl. 2014;25(1):113-6. PubMed
  40. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. PubMed
  41. Rumbold A, Ota E, Nagata C, Shahrook S, Crowther CA. Vitamin C supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004072. PubMed
  42. Seo MS, Kim JK, Shim JY. High-dose vitamin C promotes regression of multiple pulmonary metastases originating from hepatocellular carcinoma. Yonsei Med J. 2015;56(5):1449-52. PubMed
  43. Skelin M, Lucijanic T, Amidzic Klaric D, et al. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review. Clin Ther. 2017 Feb;39(2):378-403. PubMed
  44. Jiang K, Tang K, Liu H, Xu H, Ye Z, Chen Z. Ascorbic acid supplements and kidney stones incidence among men and women: a systematic review and meta-analysis. Urol J. 2019;16(2):115-120.
  45. Thomas S, Patel D, Bittel B, et al. Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial. JAMA Netw Open. 2 PubMed
  46. Giffen MA, McLemore JL. Hyperoxalosis Secondary to Intravenous Vitamin C Administration as a Non-Allopathic Treatment for Cancer. Acad Forensic Pathol 2019;9(1-2):118-126. PubMed
  47. Maike A, Sturgill D, Gallan A. Oxalate Nephropathy in a Renal Transplant Recipient After Receiving High Dose Ascorbic Acid. Am J Med Sci 2021. PubMed
  48. Shen ZY, Chen YR, Wang MC, Chang SS. High-dose vitamin C-induced acute oxalate nephropathy in a renal transplant recipient: a case report and literature review. Asian J Surg 2022. PubMed
  49. Yanase F, Spano S, Maeda A, et al. Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial. Crit Care 2023;27(1):371. PubMed
  50. Sharma Y, Sumanadasa S, Shahi R, et al. Efficacy and safety of vitamin C supplementation in the treatment of community-acquired pneumonia: a systematic review and meta-analysis with trial sequential analysis. Sci Rep 2024;14(1):11846. PubMed
  51. Pejcic AV, Petrovic NZ, Djordjic MD, Milosavljevic MN. Vitamin C Levels in Pregnant Women and the Efficacy of Vitamin C Supplements in Preventing Premature Rupture of Membranes: A Systematic Review and Meta-Analysis. Balkan Med J 2024;41(4):248-260. PubMed

See these in context on the Vitamin C monograph →

Reishi Mushroom 17 references
  1. McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
  2. Tao J, Feng KY. Experimental and clinical studies on inhibitory effect of ganoderma lucidum on platelet aggregation. J Tongji Med Univ 1990;10:240-3. PubMed
  3. Singh AB, Gupta SK, Pereira BM, Prakash D. Sensitization to Ganoderma lucidum in patients with respiratory allergy in India. Clin Exp Allergy 1995;25:440-7.
  4. Lee SY, Rhee HM. Cardiovascular effects of mycelium extract of Ganoderma lucidum: inhibition of sympathetic outflow as a mechanism of its hypotensive action. Chem Pharm Bull (Tokyo) 1990;38:1359-64. PubMed
  5. Kwok Y, Ng KFJ, Li, CCF, et al. A prospective, randomized, double-blind, placebo-controlled study of the platelet and global hemostatic effects of Ganoderma lucidum (Ling-Zhi) in healthy volunteers. Anesth Analg 2005;101:423-6. PubMed
  6. Wanmuang, H., Leopairut, J., Kositchaiwat, C., Wananukul, W., and Bunyaratvej, S. Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder. J Med Assoc Thai. 2007;90(1):179-181.
  7. Seto, S. W., Lam, T. Y., Tam, H. L., Au, A. L., Chan, S. W., Wu, J. H., Yu, P. H., Leung, G. P., Ngai, S. M., Yeung, J. H., Leung, P. S., Lee, S. M., and Kwan, Y. W. Novel hypoglycemic effects of Ganoderma lucidum water-extract in obese/diabetic (+db/+db
  8. Chu, T. T., Benzie, I. F., Lam, C. W., Fok, B. S., Lee, K. K., and Tomlinson, B. Study of potential cardioprotective effects of Ganoderma lucidum (Lingzhi): results of a controlled human intervention trial. Br.J.Nutr. 2012;107(7):1017-1027.
  9. Jin, X., Ruiz, Beguerie J., Sze, D. M., and Chan, G. C. Ganoderma lucidum (Reishi mushroom) for cancer treatment. Cochrane.Database.Syst.Rev. 2012;6:CD007731.
  10. Kabir, Y., Kimura, S., and Tamura, T. Dietary effect of Ganoderma lucidum mushroom on blood pressure and lipid levels in spontaneously hypertensive rats (SHR). J Nutr Sci Vitaminol.(Tokyo) 1988;34(4):433-438. PubMed
  11. Kanmatsuse, K., Kajiwara, N., Hayashi, K., Shimogaichi, S., Fukinbara, I., Ishikawa, H., and Tamura, T. [Studies on Ganoderma lucidum. I. Efficacy against hypertension and side effects]. Yakugaku Zasshi 1985;105(10):942-947. PubMed
  12. Gao, Y., Lan, J., Dai, X., Ye, J., and Zhou, S. A Phase I/II Study of Ling Zhi Mushroom Ganoderma lucidum(W.Curt: Fr.) Lloyd (Aphyllophoromycetideae) Extract in Patients with Type II Diabetes Mellitus. International Journal of Medicinal Mushrooms 2004;6. DOI
  13. Jin H, Zhang G, Cao X, and et al. Treatment of hypertension by linzhi combined with hypotensor and its effects on arterial, arteriolar and capillary pressure and microcirculation. In: Niimi H, Xiu RJ, Sawada T, and et al. Microcirculatory Approach to Asi
  14. Klupp NL, Chang D, Hawke F, Kiat H, Cao H, Grant SJ, Bensoussan A. Ganoderma lucidum mushroom for the treatment of cardiovascular risk factors. Cochrane Database Syst Rev. 2015 Feb 17;2:CD007259. PubMed
  15. Zhao H, Zhang Q, Zhao L, Huang X, Wang J, Kang X. Spore Powder of Ganoderma lucidum Improves Cancer-Related Fatigue in Breast Cancer Patients Undergoing Endocrine Therapy: A Pilot Clinical Trial. Evid Based Complement Alternat Med. 2012;2012:809614.
  16. Pazzi F, Adsuar JC, Domínguez-Muñoz FJ, García-Gordillo MA, Gusi N, Collado-Mateo D. Ganoderma lucidum effects on mood and health-related quality of life in women with fibromyalgia. Healthcare (Basel) 2020;8(4):520. PubMed
  17. Kogure T, Koiwai A, Fukushi D, et al. Hypereosinophilia with hepatic nodule formation caused by Ganoderma lucidum. Intern Med 2021;60(24):3897-3903.

See these in context on the Reishi Mushroom monograph →

Shiitake Mushroom 67 references
  1. Hitosugi M, Kitamura O, Takatsu A, Yoshino Y. Autopsy case of duodenal obstruction from impacted mushroom. J Gastroenterol 1998;33:562-5. PubMed
  2. Hanada K, Hashimoto I. Flagellate mushroom (Shiitake) dermatitis and photosensitivity. Dermatol 1998;197:255-7. PubMed
  3. Levy AM, Kita H, Phillips SF, et al. Eosinophilia and gastrointestinal symptoms after ingestion of shiitake mushrooms. J Allergy Clin Immunol 1998;101:613-20. PubMed
  4. Murakami M, Kawabe K, Hosoi Y, et al. Decreased pulmonary perfusion in hypersensitivity pneumonitis caused by Shiitake mushroom spores. J Intern Med 1997;241:85-8. PubMed
  5. Matsui S, Nakazawa T, Umegae Y, Mori M. Hypersensitivity pneumonitis induced by Shiitake mushroom spores. Intern Med 1992;31:1204-6.
  6. Nakamura T. Shiitake (Lentinus edodes) dermatitis. Contact Dermatitis 1992;27:65-70.
  7. Ueda A, Obama K, Aoyama K, et al. Allergic contact dermatitis in shiitake (Lentinus edodes (Berk) Sing) growers. Contact Dermatitis 1992;26:228-33.
  8. 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.
  9. 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
  10. 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
  11. 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
  12. Spierings, E. L., Fujii, H., Sun, B., and Walshe, T. A Phase I study of the safety of the nutritional supplement, active hexose correlated compound, AHCC, in healthy volunteers. J Nutr Sci Vitaminol.(Tokyo) 2007;53(6):536-539. PubMed
  13. 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
  14. Ritz, B. W. Supplementation with active hexose correlated compound increases survival following infectious challenge in mice. Nutr.Rev. 2008;66(9):526-531. PubMed
  15. 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
  16. Mach, C. M., Fugii, H., Wakame, K., and Smith, J. Evaluation of active hexose correlated compound hepatic metabolism and potential for drug interactions with chemotherapy agents. J Soc Integr.Oncol. 2008;6(3):105-109.
  17. 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
  18. Sumiyoshi, Y., Hashine, K., Kakehi, Y., Yoshimura, K., Satou, T., Kuruma, H., Namiki, S., and Shinohara, N. Dietary administration of mushroom mycelium extracts in patients with early stage prostate cancers managed expectantly: a phase II study. Jpn.J Cl PubMed
  19. 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.
  20. 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.
  21. 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
  22. 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
  23. 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.
  24. 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.
  25. Thaiudom, S., Piyaniran, W., and Chutaputthi, A. A study of the efficacy of Active Hexose Correlated Compound (AHCC) in the treatment of chronic Hepatitis C patients at Phramongkutklao Hospital. The Medical News (Thailand) 2010;325:13-16.
  26. Smith, J. A., Hunter, R. J., Fujii, H., Wakame, K., and Wolf, J. Defining Synergistic Activity ofthe Combination of Active Hexose Correlated Compound (AHCC) with Liposomal Doxorubicin (Doxil). Presented at the 18th International Congress on Nutrition and
  27. 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
  28. Fujiwara, K., Sato, T., Yonei, T., Genba, K., Nogami, N., and Yamadori, I. [A case of chronic hypersensitivity pneumonitis induced by shiitake mushroom spores]. Nihon Kokyuki.Gakkai Zasshi 2000;38(12):908-913.
  29. Lippert, U., Martin, V., Schwertfeger, C., Junghans, V., Ellinghaus, B., and Fuchs, T. Shiitake dermatitis. Br.J Dermatol. 2003;148(1):178-179.
  30. 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
  31. Curnow, P. and Tam, M. Contact dermatitis to Shiitake mushroom. Australas.J.Dermatol. 2003;44(2):155-157. PubMed
  32. Mak, R. K. and Wakelin, S. H. Shiitake dermatitis: the first case reported from a European country. Br J Dermatol 2006;154(4):800-801. PubMed
  33. Sastre, J., Ibanez, M. D., Lopez, M., and Lehrer, S. B. Respiratory and immunological reactions among Shiitake (Lentinus edodes) mushroom workers. Clin.Exp.Allergy 1990;20(1):13-19.
  34. 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
  35. Ade R, Sukut C, Wiser HJ, Shockman S, Buescher L. Shiitake dermatitis demonstrating Köebner phenomenon. Int J Dermatol. 2015;54(5):e179-81.
  36. Adler MJ, Larsen WG. Clinical variability of shiitake dermatitis. J Am Acad Dermatol. 2012 Oct;67(4):e140-1. PubMed
  37. Adriano AR, Acosta ML, Azulay DR, Quiroz CD, Talarico SR. Shiitake dermatitis: the first case reported in Brazil. An Bras Dermatol. 2013 May-Jun;88(3):417-9. PubMed
  38. Ampere A, Delhaes L, Soots J, Bart F, Wallaert B. Hypersensitivity pneumonitis induced by Shiitake mushroom spores. Med Mycol. 2012 Aug;50(6):654-7. PubMed
  39. Baran W, Batycka-Baran A, Maj J, Szepietowski JC. Shiitake dermatitis - now also in Poland. Acta Derm Venereol. 2015 Jan;95(1):102-3. PubMed
  40. Boels D, Landreau A, Bruneau C, et al. Shiitake dermatitis recorded by French Poison Control Centers - new case series with clinical observations. Clin Toxicol (Phila). 2014 Jul;52(6):625-8. PubMed
  41. Chu EY, Anand D, Dawn A, Elenitsas R, Adler DJ. Shiitake dermatitis: a report of 3 cases and review of the literature. Cutis. 2013 Jun;91(6):287-90.
  42. Corazza M, Zauli S, Ricci M, et al. Shiitake dermatitis: toxic or allergic reaction? J Eur Acad Dermatol Venereol. 2015 Jul;29(7):1449-51. PubMed
  43. Czarnecka AB, Kreft B, Marsch WCh. Flagellate dermatitis after consumption of Shiitake mushrooms. Postepy Dermatol Alergol. 2014 Jun;31(3):187-90. PubMed
  44. 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.
  45. Hamer SE, Kulkarni K, Cohen SN. Shiitake dermatitis with oral ulceration and pustules. Clin Exp Dermatol. 2015 Apr;40(3):332-3. PubMed
  46. Hiernickel C, Metz S, Elsner P. Shiitake dermatitis: an impressive case report. J Dtsch Dermatol Ges. 2015 May;13(5):455-6. PubMed
  47. Karanovic S, George S, Topham E. Don't miss shiitake dermatitis: a case report. Br J Gen Pract. 2014 Aug;64(625):426-7. PubMed
  48. Kopp T, Mastan P, Mothes N, Tzaneva S, Stingl G, Tanew A. Systemic allergic contact dermatitis due to consumption of raw shiitake mushroom. Clin Exp Dermatol. 2009 Dec;34(8):e910-3. PubMed
  49. Lingström P, Zaura E, Hassan H, et al. The anticaries effect of a food extract (shiitake) in a short-term clinical study. J Biomed Biotechnol. 2012;2012:217164. PubMed
  50. Loo HV, Oon HH. Flagellate dermatitis following consumption of shiitake mushroom. Dermatol Reports. 2011 Oct 5;3(2):e21. PubMed
  51. Luber AJ, Ackerman LS. Flagellate shiitake mushroom dermatitis. Dermatol Online J. 2015 Aug 15;21(8). pii: 13030/qt7rm57553. DOI
  52. Mendonça CN, Silva PM, Avelleira JC, Nishimori FS, Cassia Fde F. Shiitake dermatitis. An Bras Dermatol. 2015 Mar-Apr;90(2):276-8.
  53. Netchiporouk E, Pehr K, Ben-Shoshan M, Billick RC, Sasseville D, Singer M. Pustular flagellate dermatitis after consumption of shiitake mushrooms. JAAD Case Rep. 2015 May 2;1(3):117-9. PubMed
  54. Nguyen AH, Gonzaga MI, Lim VM, Adler MJ, Mitkov MV, Cappel MA. Clinical features of shiitake dermatitis: a systematic review. Int J Dermatol. 2017 Jun;56(6):610-616. PubMed
  55. Poppe LM, Anders D, Kneitz H, Bröcker EB, Benoit S. Flagellate dermatitis caused by shiitake mushrooms. An Bras Dermatol. 2012 May-Jun;87(3):463-5. PubMed
  56. Pravettoni V, Primavesi L, Piantanida M. Shiitake mushroom (Lentinus edodes): a poorly known allergen in Western countries responsible for severe work-related asthma. Int J Occup Med Environ Health. 2014 Oct;27(5):871-4. PubMed
  57. Ricar J, Pizinger K, Cetkovska P. Shiitake dermatitis: a distinctive clinical entity. Int J Dermatol. 2013 Dec;52(12):1620-1. PubMed
  58. Shozushima M, Ohata K, Nonaka K, Matsuhashi N. Shiitake mushroom-induced ileus managed using double-balloon enteroscopy. Endoscopy. 2013;45 Suppl 2 UCTN:E437. PubMed
  59. Uslu U, Linkner RV. Shiitake mushroom dermatitis. Cutis. 2015 May;95(5):E11-2.
  60. Wang AS, Barr KL, Jagdeo J. Shiitake mushroom-induced flagellate erythema: A striking case and review of the literature. Dermatol Online J. 2013 Apr 15;19(4):5. DOI
  61. Tan J, Yuan K, Zuo J, et al. Two cases of small bowel obstruction due to a shiitake mushroom. Gastroenterol Rep (Oxf) 2019;7(4):298-300. doi: 10.1093/gastro/gox028. PubMed
  62. Boels D, Greillet C, Langrand J, et al. Shiitake dermatitis: experience of the Poison Control Centre Network in France from 2014 to 2019. Clin Toxicol (Phila) 2022. PubMed
  63. Miyagishima D, Inoue M, Kinjo K, et al. A case of bowel obstruction due to shiitake mushrooms: Diagnostic features on computed tomography. Intern Med 2022. PubMed
  64. Soga K, Mukai H, Kitae H. Management of shiitake mushroom-induced ileus using balloon enteroscopy. Dig Endosc 2022;34(4):e58-e59. PubMed
  65. Ma JY, Liu JW. Shiitake flagellate dermatitis. Mayo Clin Proc 2022;97(12):2192-2193. PubMed
  66. Booms A, Rashid Z, Al-Rubaie V, Bal A. Shiitake dermatitis: a case report of a rare mushroom-induced dermatitis in the United States. Int J Dermatol 2022. PubMed
  67. Sudy E, Urbina F. Shiitake dermatitis: clinical forms of presentation. Int J Dermatol 2023. PubMed

See these in context on the Shiitake Mushroom monograph →

Maitake Mushroom 8 references
  1. Kabir Y, Kimura S. Dietary mushrooms reduce blood pressure in spontaneously hypertensive rats (SHR). J Nutr Sci Vitaminol (Tokyo) 1989;35:91-4. PubMed
  2. Kabir Y, Yamaguchi M, Kimura S. Effect of shiitake (Lentinus edodes) and maitake (Grifola frondosa) mushrooms on blood pressure and plasma lipids of spontaneously hypertensive rats. J Nutr Sci Vitaminol (Tokyo) 1987;33:341-6. PubMed
  3. Konno S, Tortorelis DG, Fullerton SA, et al. A possible hypoglycaemic effect of maitake mushroom on Type 2 diabetic patients. Diabet Med 2001;18:1010. PubMed
  4. Chen JT, Tominaga K, Sato Y, et al. Maitake mushroom (Grifola frondosa) extract induces ovulation in patients with polycystic ovary syndrome: a possible monotherapy and a combination therapy after failure with first-line clomiphene citrate. J Altern Compl
  5. Hanselin MR, Vande Griend JP, Linnebur SA. INR elevation with maitake extract in combination with warfarin. Ann Pharmacother 2010;44:223-4. PubMed
  6. Talpur, N. A., Echard, B. W., Fan, A. Y., Jaffari, O., Bagchi, D., and Preuss, H. G. Antihypertensive and metabolic effects of whole Maitake mushroom powder and its fractions in two rat strains. Mol.Cell Biochem. 2002;237(1-2):129-136. PubMed
  7. Deng, G., Lin, H., Seidman, A., Fornier, M., D'Andrea, G., Wesa, K., Yeung, S., Cunningham-Rundles, S., Vickers, A. J., and Cassileth, B. A phase I/II trial of a polysaccharide extract from Grifola frondosa (Maitake mushroom) in breast cancer patients: i
  8. Wesa KM, Cunningham-Rundles S, Klimek VM, et al. Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study. Cancer Immunol Immunother 2015;64(2):237-47. PubMed

See these in context on the Maitake Mushroom monograph →

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
Supplement interaction checker › Check any supplement or product against your medications Drug–drug interactions › Check two or more of your medications against each other Browse medications A–Z › Every drug we've checked against herbs & supplements NDC & pricing lookup › Find a drug’s NDCs, packaging and costs Ask a pharmacist › Free, personal answer from our licensed team