Medicinal mushrooms are in great demand because of their adaptogenic effects and their actions against cancer. They improve the immune system, balance the hormones of the HPA axis, are anti-inflammatory, antioxidant, tonify the heart, protect the liver and soothe the nerves.
Taking them in an effective way is not so easy. Eating medicinal mushrooms like shitake or maitake doesn’t release the medicinal value (except perhaps the Vitamin D.)
If you want to take them as a tea (decoction) you need to simmer them for at least an hour to separate the medicine from the chitin. (Yes mushrooms have chitin, like sea shells.) This is the traditional way used in Chinese medicine. Chris Hobbs suggests keeping a pot warm on the back burner at all times, periodically adding water, astragalus, cinnamon and orange peel so you only need to make it every few weeks. Cooking herbs daily can be a bit much and decoctions only last a few days in the refrigerator but it works and I have used this kind of decoction to make ganoderma coffee.
Tinctures or liquid extracts are portable, let you taste them which makes them more effective than capsules, but are not simple to make. You can’t just soak the mushrooms, either fresh or dried in alcohol. The chitin still locks up the medicine. The most important fractions of the medicine are polysaccharides like beta????-Glucens or Mannogalactoglucan which don’t survive even medium levels of alcohol.
Polysaccharides clump together when exposed to alcohol and become inert. Below 30% the alcohol is not strong enough to percipitate out the polysaccharides. The triterpenes like Ganoderic Acid in reishi are also medicinally important and require a high alcohol percentage to be extracted. So to get the most medicine, you need to follow a two step process and combine them with 25-20% alcohol to make a liquid extract.
For 250 grams, slightly over 1/2 pound of mushrooms you will want to make 1 1/4 liters of liquid extract. It will be 30% grain alcohol or 375 ml and 875 ml of decoction.
The first stage is to decoct the the given weight of dried mushrooms in 
water. You need to simmer below a boil for at least an hour after they rehydrate, longer is better. The bigger the mushroom chunks the longer- Chinese herbal pharmacies sell reishi in thin slices which I usually spin in the Vitamix., but before I had access to those I would chunk as small as possible then run in the Vitamix mid cooking when the mushroom was a little softer. Chaga can be obtained through Mainley Chaga in a coffee grind (but for the medicine decoct it- don’t just run through your coffee maker!) If you wildcraft, slice thinly before the mushroom dries and dry it gill side up in the sun for maximum Vitamin D.
Start with your ground dry mushrooms. Cover with water and let it absorb. Add more water so the mushroom chunks can freely swim. Cover and simmer for an hour or overnight. Strain and squeeze out, measure the decoction in a Pyrex container to see if you have enough, 875 ml in this example, and cook down the decoction to the quantity you need or top up with water. Freeze until the tincture is ready. (Squeeze it out really well.)
Take the strained out marc (which has had most polysaccharides removed) and add Everclear/ grain alcohol to get the triterpenes. For 250 gr mushrooms use 275 mililiters of Everclear. (Because the mushroom pieces will have absorbed water, you need less alcohol than if you were to tincture in alcohol directly and lose the absorbed alcohol.) Store in a dark place for 1-3 months, shaking perodically and strain out really well, squeezing the spongy marc. Mix the finished tincture with the defrosted decoction very slowly, stirring well to get a 30% alcohol level.
(Some just stabilize the decoction with plain 95% grain alcohol but it won’t be as strong. You can also use two batches of mushrooms, one for alcohol and one for decoction in water. You need 7 parts decoction to 3 parts Everclear tincture. It will cost more and you will need more Everclear but it is convenient.)
You can also find Chinese dried granules to rehydrate with warm water, but it won’t have the triterpenes. These can be combined with other Chinese herbs in a formula, although I find granule formulas somewhat less effective than raw herb formulas. (They are convenient however.) And Mushroom Harvest makes a well-done steamed granule that you can put into smoothies. If you purchase tinctures call the company that makes them and find out how they make the tincture- there is a lot of inert or very weak medicinal mushroom tincture out there. You can do better by following these instructions.
