I have never used Maiitake, however, I used a relative Polyporus. Bottom line is I believe many of the mushroom extracts are warming. It is not my experience that our Coriolus PS is warming, however, your patients may be on very warming treatments. Certain drugs or supplements or emotions can contribute to heat as well. If it’s just a matter of tongue/pulse, I would keep patient on the mushrooms. If they get hot flashes or headaches, stop or reduce the mushroom dosage. She might consider CordySeng which is pretty balanced.