Artichoke as a dietary supplement

DEFINITION: Natural plant product consumed as a dietary supplement for specific health benefits.

PRINCIPAL PROPOSED USES: Dyspepsia, high cholesterol

OTHER PROPOSED USE: Liver protection

Overview

The artichoke is one of the oldest cultivated plants. It was first grown in Ethiopia and brought 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 gallbladder. (Bile is a yellowish-brown fluid manufactured in the liver and stored in the gallbladder; 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. Their work suggested that the plant does indeed stimulate the kidney and gallbladder. Midcentury, 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 to stimulate the liver and gallbladder and treat elevated cholesterol from the 1950s to the 1980s. Competition from newer pharmaceuticals has since eclipsed the use of cynarin.

Uses and Applications

Artichoke leaf (as opposed to cynarin) continues to be used in many countries. Germany’s Commission E authorized its use for “dyspeptic problems.” Dyspepsia is a rather vague term that corresponds to the common word “indigestion,” indicating various digestive problems, including discomfort in the stomach, bloating, lack of appetite, nausea, and mild diarrhea or constipation. One substantial double-blind study suggests that artichoke leaf is indeed helpful for this condition. Several substantial studies, as well as reviews of multiple studies, indicate that artichoke leaf may help lower cholesterol.

Based on the general notion that artichoke leaf is good for the liver, it has become a popular treatment for alcohol-induced hangovers. However, a small, double-blind, placebo-controlled study failed to find it more effective than placebo.

Several animal studies suggest that artichoke protects the liver from damage by chemical toxins. However, artichoke’s liver-protective effects have not been proven in controlled clinical trials.

Artichoke has also been recommended to help regulate blood pressure, control blood sugar, ease the symptoms of irritable bowel syndrome, and reduce the appearance of aging when applied topically. These results have been documented through scientific studies.

Scientific Evidence

High cholesterol. Artichoke leaf extract significantly improved cholesterol readings in a double-blind, placebo-controlled study of 143 people with high cholesterol. Total cholesterol fell by 18.5 percent compared with 8.6 percent in the placebo group, LDL (low-density lipoprotein, also referred to as bad cholesterol) cholesterol fell by 23 percent versus 6 percent, and LDL-to-HDL (high-density lipoprotein, also referred to as good cholesterol) ratios fell by 20 percent versus 7 percent. In a subsequent study of seventy-five otherwise healthy people with high cholesterol, artichoke leaf extract significantly reduced total cholesterol compared with placebo. Still, it did not affect LDL, HDL, or triglyceride levels.

Another placebo-controlled study involving forty-four healthy people failed to find any improvement in cholesterol levels attributable to artichoke leaf. 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, could not be expected.

Artichoke leaf may work by interfering with cholesterol synthesis. In addition to cynarin, a compound in artichoke called luteolin may play a role in reducing cholesterol.

Dyspepsia. In Europe, vague digestive symptoms are commonly attributed to inadequate bile flow from the gallbladder. Evidence shows that artichoke leaf does indeed stimulate the gallbladder. This by itself does not prove artichoke is helpful for dyspepsia. Despite this, a large (247-participant) double-blind study evaluated artichoke leaf as a treatment for dyspepsia. In this study, artichoke leaf extract proved significantly more effective than placebo for alleviating digestive symptoms. A previous study of an herbal combination containing artichoke leaf also found benefits.

Scientific studies have also been performed throughout the twenty-first century that confirm artichoke effectiveness in treating high blood pressure, regulating blood sugar, improving cholesterol levels, easing irritable bowel syndrome, and providing valuable anticancer properties.

Dosage

Germany’s Commission E recommends 6 grams of the dried herb or its equivalent per day, usually divided into three doses. Artichoke leaf extracts should be taken according to label instructions. People with gallbladder disease should use artichoke only under medical supervision.

Safety Issues

Studies have not associated artichoke leaf with significant side effects, 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 people with severe liver or kidney disease has also not been established.

In addition, because artichoke leaf is believed to stimulate gallbladder contraction, persons with gallstones or other forms of gallbladder disease could be put at risk by using this herb. Such persons should use artichoke leaf only under the supervision of a physician. It is possible that increased gallbladder contraction could lead to obstruction of ducts or even rupture of the gallbladder. Finally, persons with known allergies to artichokes or related plants in the Asteraceae family, such as arnica or chrysanthemums, should avoid using artichoke or cynarin preparations.

Bibliography

"Artichoke." Drugs.com, 17 Feb. 2023, www.drugs.com/npc/artichoke.html. Accessed 20 Aug. 2023.

Brown, Mary J. "Top 8 Health Benefits of Artichokes and Artichoke Extract." Healthline, 23 Mar. 2023, www.healthline.com/nutrition/artichoke-benefits. Accessed 20 Aug. 2023.

Bundy, R., et al. "Artichoke Leaf Extract (Cynara scolymus) Reduces Plasma Cholesterol in Otherwise Healthy Hypercholesterolemic Adults." Phytomedicine, vol. 15, 2008, pp. 668-675.

Holtmann, G., et al. "Efficacy of Artichoke Leaf Extract in the Treatment of Patients with Functional Dyspepsia." Alimentary Pharmacology and Therapeutics, vol. 18, 2003, pp. 1099-1105.

Mahboubi, Mohaddese. "Cynara scolymus (Artichoke) and its Efficacy in Management of Obesity." Bulletin of Faculty of Pharmacy, Cairo University, vol. 56, no. 2, Dec. 2018, pp. 115-120, doi.org/10.1016/j.bfopcu.2018.10.003.

Moradi, Mozhgan, et al. "Effects of Artichoke on Blood Pressure: A Systematic Review and Meta-Analysis." Complementary Therapies in Medicine, vol. 57, 2021, p. 102668, doi:10.1016/j.ctim.2021.102668. Accessed 3 Sept. 2024.

Richter, Amy, and Katherine Marengo. "Top 8 Health Benefits of Artichokes and Artichoke Extract." Healthline, 23 Mar. 2023, www.healthline.com/nutrition/artichoke-benefits. Accessed 3 Sept. 2024.

Shahinfar, Hossein, et al. "Effects of Artichoke Leaf Extract Supplementation or Artichoke Juice Consumption on Lipid Profile: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials." Phytotherapy Research, vol. 35, no. 12, 2021, pp. 6607-6623, doi:10.1002/ptr.7247. Accessed 3 Sept. 2024.