This study aims to evaluate the effects of Tiger Milk Mushroom (TMM) supplementation on physical performance and overall wellbeing in physically active adults. Tiger Milk Mushroom (Lignosus rhinocerus) is a medicinal mushroom traditionally used in Southeast Asia for promoting health and vitality. Previous laboratory and clinical studies have suggested that Tiger Milk Mushroom possesses antioxidant, anti-inflammatory, and immunomodulatory properties that may support physical function, exercise recovery, and overall health. In this randomized, double-blind, placebo-controlled trial, 60 physically active adults aged 18 years and above will be randomly assigned to receive either Tiger Milk Mushroom supplementation or a matching placebo for 12 weeks. Participants in the intervention group will consume one capsule of Tiger Milk Mushroom twice daily, while participants in the placebo group will consume matching placebo capsules following the same schedule. Assessments will be conducted at baseline, week 6, and week 12. The study will evaluate physical performance through measurements of muscle strength, heart rate, self-paced walking performance, perceived exertion, and aerobic capacity (VO₂max). Blood samples will be collected to assess biomarkers related to cardiovascular endurance, exercise recovery, inflammation, and general health, including cortisol, total iron-binding capacity, creatine kinase, interleukin-2, and interleukin-6. Participants' stress levels and overall wellbeing will also be assessed using validated questionnaires. The purpose of this study is to determine whether Tiger Milk Mushroom supplementation can support physical performance, exercise capacity, recovery, and overall wellbeing in physically active adults.
Physical performance is an important determinant of overall health, functional capacity, and quality of life. Optimal physical performance depends on multiple physiological factors, including muscular strength, cardiovascular endurance, recovery capacity, and the regulation of inflammation and oxidative stress. During physical exertion, increased metabolic activity leads to the production of reactive oxygen species (ROS) and inflammatory mediators, which may contribute to muscle fatigue, impaired recovery, reduced exercise capacity, and decreased physical performance. Therefore, interventions capable of reducing oxidative stress and inflammation may offer benefits in enhancing physical performance and exercise recovery. Lignosus rhinocerus, commonly known as Tiger Milk Mushroom (TMM), is a medicinal mushroom belonging to the Polyporaceae family and has been traditionally used in Southeast Asia and China for promoting general health and treating various ailments. The sclerotium of TMM contains numerous bioactive compounds, including polysaccharides, glycoproteins, phenolic compounds, and triterpenoids, which have been reported to possess antioxidant, anti-inflammatory, antimicrobial, immunomodulatory, and neuroprotective properties. Previous in vitro and animal studies have demonstrated that TMM can suppress the production of pro-inflammatory cytokines, including tumour necrosis factor-alpha (TNF-α), and protect cells against oxidative damage. These biological activities suggest a potential role for TMM in improving exercise performance and recovery. Oxidative stress and exercise-induced inflammation are recognised contributors to muscle fatigue, reduced endurance, and impaired physical performance. Studies have shown that dietary interventions with antioxidant and anti-inflammatory properties may enhance muscle function, improve aerobic capacity, and accelerate post-exercise recovery. Given the documented antioxidant and anti-inflammatory activities of TMM, supplementation with TMM may help attenuate exercise-induced physiological stress, preserve muscle function, and enhance overall physical performance. Although several studies have investigated the pharmacological properties of TMM and its effects on respiratory health, immunity, and antioxidant status, clinical evidence regarding its efficacy in improving physical performance remains limited. A previous randomized controlled trial reported beneficial effects of TMM supplementation combined with resistance training on muscular strength, aerobic fitness, anaerobic performance, and immune parameters in young adults. However, further studies are required to better understand the effects of TMM supplementation on physical performance, cardiovascular endurance, exercise recovery, inflammatory responses, and perceived wellbeing in healthy individuals. Therefore, this study aims to evaluate the effects of Tiger Milk Mushroom supplementation on physical performance among healthy adults by assessing muscle strength, cardiovascular endurance, exercise-related inflammatory markers, stress levels, and overall wellbeing.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE
Enrollment
65
Participants received Tiger Milk Mushroom (Lignosus rhinocerus) capsules containing 300 mg of TMM extract per capsule. Participants consumed one capsule orally twice daily for 12 weeks.
Participants received matching placebo capsules identical in appearance to the active supplement. Participants consumed one capsule orally twice daily for 12 weeks.
UCSI University
Cheras, Kuala Lumpur, Malaysia
Change in Maximal Oxygen Uptake (VO₂max)
Change in estimated maximal oxygen uptake (VO₂max), an indicator of aerobic capacity and cardiovascular endurance. VO₂max was estimated using the Rockport One-Mile Walk Test based on walk completion time, post-exercise heart rate, age, sex, and body weight.
Time frame: Baseline, Week 6, and Week 12
Change in Isometric Muscle Strength
Muscle strength (kgf) of the elbow flexors, wrist extensors, shoulder abductors, hip flexors, knee extensors, and foot dorsiflexors was measured using a handheld muscle assessment dynamometer. Higher values indicate greater muscle strength (better outcome).
Time frame: Baseline, Week 6, and Week 12
Change in Rating of Perceived Exertion (RPE)
Rate of perceived exertion (RPE) was assessed using the Borg Category-Ratio 10 (CR10) Scale, with scores ranging from 0 to 10, where 0 indicates no exertion and 10 indicates maximal exertion. Lower scores indicate lower perceived exertion (better outcome), whereas higher scores indicate greater perceived exertion (worse outcome).
Time frame: Baseline, Week 6, and Week 12
Change in Total Iron Binding Capacity (TIBC)
Total iron-binding capacity (TIBC) (mg/L) was measured using an enzyme-linked immunosorbent assay (ELISA). TIBC was assessed as an indicator of iron-binding capacity and oxygen transport potential. Higher values indicate greater iron-binding capacity.
Time frame: Baseline, and Week 12
Change in Serum Cortisol Levels
Salivary cortisol concentration (ng/mL) was measured using an enzyme-linked immunosorbent assay (ELISA). Lower concentrations indicate lower physiological stress (better outcome).
Time frame: Baseline, Week 6, and Week 12
Change in Creatine Kinase Levels
Serum creatine kinase (CK) concentration (U/L) was measured using an enzyme-linked immunosorbent assay (ELISA). CK concentration was assessed as a biomarker of exercise-induced muscle damage. Lower CK concentrations indicate reduced muscle damage (better outcome).
Time frame: Baseline, and Week 12
Changes in Lactate Levels
Blood lactate concentration (mg/dL) was measured using an enzyme-linked immunosorbent assay (ELISA). Lower concentrations indicate reduced metabolic fatigue and improved exercise recovery (better outcome).
Time frame: Baseline and week 12
Change in Inflammatory Levels
Serum interleukin-2 (IL-2) and interleukin-6 (IL-6) concentrations (pg/mL) were measured using enzyme-linked immunosorbent assays (ELISA) to assess immune and inflammatory responses following Tiger Milk Mushroom supplementation.
Time frame: Baseline, and Week 12
Change in Perceived Stress Scale (PSS-10) Score
Perceived Stress Scale-10 (PSS-10) score. The PSS-10 consists of 10 items scored on a 5-point Likert scale (0-4), with a total score ranging from 0 to 40. Higher scores indicate greater perceived stress (worse outcome), whereas lower scores indicate lower perceived stress (better outcome).
Time frame: Baseline, Week 6, and Week 12
Change in Visual Analogue Scale (VAS) Score on Physical Fitness
Visual Analogue Scale (VAS) for Exercise Performance: Participants rated their overall perceived exercise performance using a 10-point Visual Analogue Scale (VAS). Scores range from 1 to 10, with 1 indicating the poorest perceived exercise performance and 10 indicating the best perceived exercise performance. Higher scores indicate better perceived exercise performance (better outcome).
Time frame: Baseline, Week 6, and Week 12
Red Blood Cell Count
Red blood cell (RBC) count (×10⁶/µL) measured using an automated hematology analyzer. RBC count was assessed to evaluate the hematological safety of Tiger Milk Mushroom supplementation.
Time frame: Baseline and Week 12
White Blood Cell Count
White blood cell (WBC) count (×10³/µL) measured using an automated hematology analyzer. WBC count was assessed to evaluate the hematological safety of Tiger Milk Mushroom supplementation.
Time frame: Baseline and Week 12
Platelet Count
Platelet count (×10³/µL) measured using an automated hematology analyzer. Platelet count was assessed to evaluate the hematological safety of Tiger Milk Mushroom supplementation.
Time frame: Baseline and Week 12
Hepatic Function
Hepatic function was assessed by measuring serum alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT) activities (U/L) using an automated clinical chemistry analyzer. These parameters were evaluated to assess the hepatic safety of Tiger Milk Mushroom supplementation.
Time frame: Baseline and week 12
Blood Urea Nitrogen (BUN) Concentration
Blood urea nitrogen (BUN) concentration (mmol/L) measured using an automated clinical chemistry analyzer. BUN concentration was assessed to evaluate renal safety following Tiger Milk Mushroom supplementation.
Time frame: Baseline and week 12
Serum Creatinine Concentration
Serum creatinine concentration (µmol/L) measured using an automated clinical chemistry analyzer. Serum creatinine concentration was assessed to evaluate renal safety following Tiger Milk Mushroom supplementation.
Time frame: Baseline and week 12
Estimated Glomerular Filtration Rate (eGFR)
Estimated glomerular filtration rate (eGFR) (mL/min/1.73 m²) calculated from serum creatinine using a validated equation and reported by the clinical laboratory. eGFR was assessed to evaluate renal function and the renal safety of Tiger Milk Mushroom supplementation.
Time frame: Baseline and week 12
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