Herbs & Supplements:
Artichoke
Cynara scolymus
Principal Proposed Uses
•
Dyspepsia (Indigestion)
Other Proposed Uses
•
High Cholesterol, Liver Protection
The artichoke is one of the oldest cultivated plants.1 It was first grown in Ethiopia and then made its way to southern Europe via Egypt. Its image is found on ancient Egyptian tablets and sacrificial altars. The ancient Greeks and Romans considered it a valuable digestive aid and reserved what was then a rare plant for consumption in elite circles. In sixteenth-century Europe, the artichoke was also considered a "noble" vegetable meant for consumption by the royal and the rich.
In traditional European medicine, the leaves of the artichoke (not the flower buds, which are the parts commonly cooked and eaten as a vegetable) were used as a diuretic to stimulate the kidneys and as a "choleretic" to stimulate the flow of bile from the liver and gall bladder. (Bile is a yellowish-brown fluid manufactured in the liver and stored in the gall bladder; it consists of numerous substances, including several that play a significant role in digestion.)
In the first half of the twentieth century, French scientists began modern research into these traditional medicinal uses of the artichoke plant.2 Their work suggested that the plant does indeed stimulate the kidney and gall bladder. Mid-century, Italian scientists isolated a compound from artichoke leaf called cynarin, which appeared to duplicate many of the effects of whole artichoke. Synthetic cynarin preparations were used as a drug to stimulate the liver and gall bladder and to treat elevated cholesterol from the 1950s to the 1980s; competition from newer pharmaceuticals has since eclipsed the use of cynarin.
What Is Artichoke Used for Today?
Artichoke leaf (as opposed to cynarin) continues to be used in many countries.
Germany's Commission E has authorized its use for "dyspeptic problems."3Dyspepsia is a rather vague term that corresponds to the common word "indigestion," indicating a variety of digestive problems including discomfort in the stomach, bloating, lack of appetite, nausea, and mild diarrhea or constipation.
In Europe, dyspepsia is commonly attributed to inadequate flow of bile from the gall bladder, which is why artichoke leaf is used as a treatment for this condition. Evidence tells us that artichoke leaf does indeed stimulate the gall bladder.4,5,6 However, there is little real proof that gall bladder dysfunction is actually the cause of dyspepsia, and individuals whose gall bladder has been removed are not particularly likely to suffer from digestive distress. There is no solid evidence that artichoke leaf taken by itself improves dyspepsia. The only evidence we do have comes from open studies and a trial of a combination herbal treatment containing artichoke leaf. 7
Better evidence suggests that artichoke leaf may help lower cholesterol.8
A number of animal studies suggest that artichoke protects the liver from damage by chemical toxins.9 Artichoke's liver-protective effects have never, however, been proven in controlled clinical trials.
What Is the Scientific Evidence for Artichoke?
High Cholesterol
According to a double-blind placebo-controlled study of 143 individuals with elevated cholesterol, artichoke leaf extract significantly improved cholesterol readings.10 Total cholesterol fell by 18.5% as compared to 8.6% in the placebo group; LDL cholesterol by 23% vs. 6; and LDL to HDL ratio decreased by 20% vs. 7%.
An earlier double-blind placebo-controlled study of 44 healthy individuals failed to find any improvement in cholesterol levels attributable to artichoke leaf.11 The researchers note, however, that study participants, on average, started the trial with lower than normal cholesterol levels (due to a statistical accident); improvement, therefore, couldn't be expected!
Artichoke leaf may work by interfering with cholesterol synthesis.12 Besides cynarin, a compound in artichoke called luteolin may play a role in reducing cholesterol.13
Dosage
Germany's Commission E recommends 6 g of the dried herb or its equivalent per day, usually divided into 3 doses.
Warning: Individuals with gall bladder disease should use artichoke only under medical supervision (see Safety Issues below).
Safety Issues
Artichoke leaf has not been associated with significant side effects in studies so far, but full safety testing has not been completed. For this reason, it should not be used by pregnant or nursing women. Safety in young children or in people with severe liver or kidney disease has also not been established.
In addition, because artichoke leaf is believed to stimulate gall bladder contraction, individuals with gallstones or other forms of gall bladder disease could be put at risk by using this herb. Such individuals should use artichoke leaf only under the supervision of a physician. It is possible that increased gall bladder contraction could lead to obstruction of ducts or even rupture of the gall bladder.
Individuals with known allergies to artichokes or related plants in the Asteraceae family, such as arnica or chrysanthemums, should avoid using artichoke or cynarin preparations.
View References
Last reviewed March 2002 by Medical Review Board
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