Globe artichoke (Cynara scolymus L.)
Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
Alcachofa, alcaucil, artichaut (French), artichiocco, artichoke, artichoke inulin, artichoke juice, Artischocke (German), artiskok, carciofo, cardo, cardo de comer, cardon d'Espagne, cardoon, chlorogenic acid, Cynara®, Cynara cardunculus, Cynara scolymus L., Cynarae folium, cynarin, cynaroside, French artichoke, garden artichoke, Gemuseartischocke (German), golden artichoke, Hekbilin A®, Hepar SL® forte, inulin, kardone, LI220, Listrocol®, luteolin, Raftiline®, scolymoside, tyosen-azami, Valverde Artischoke bei Verdauungsbeschwerden.
Note: Globe artichoke should not be mistaken for Jerusalem artichoke, which is the tuber of Helianthus tuberosa L. (a species of sunflower).
Globe artichoke (Cynara scolymus) is a species of thistle. The edible part of the plant is the base of the artichoke head in bud, harvested well before any fruit develops. 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.
Cynarin, luteolin, cynardoside (luteolin-7-O-glycoside), scolymoside, and chlorogenic acid are believed to be artichoke's active constituents. The most studied component, cynarin, is concentrated in the leaves.
Artichoke has been used in the treatment of hypercholesterolemia (high cholesterol), alcohol-induced hangover, and for its choleretic (stimulates bile release) and antioxidant properties.
Artichoke extracts are becoming increasingly available in the United States, with public interest and the availability of standardized extracts resulting in efforts to develop more rigorous support for clinical studies exploring the beneficial effects of artichoke.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Choleretic (Stimulates the release of bile)
Globe artichoke leaf extract has been found to increase bile secretion in animal, human and laboratory studies. Additional human study is needed to make a firm recommendation for artichoke as a choleretic.
Preliminary human study suggests that cynarin and artichoke extracts may reduce serum cholesterol and triglyceride levels. However, additional study is needed to a make a strong recommendation.
Artichoke extract has been used and marketed as a hangover remedy. However, there is insufficient available evidence to form a clear conclusion in this area.
Antioxidant properties of artichoke have been noted, although long-term clinical effects in humans are not known. Additional study is needed to make a strong recommendation.
Dyspepsia (upset stomach)
One proposed etiology of non-ulcer dyspepsia is bile duct dyskinesia. Because globe artichoke extract has been studied as a choloretic, it has been hypothesized that it may also function as an antidyspeptic agent. Preliminary evidence supports this hypothesis, although more study is needed to draw a firm recommendation.
Irritable bowel syndrome (IBS)
There is insufficient available evidence to recommend for or against the use of artichoke in relieving the symptoms of irritable bowel syndrome.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Allergies, anemia, antifungal, arthritis, atherosclerosis (hardening of the arteries), bitter tonic, cholelithiasis (stops bile flow), constipation, cystitis (bladder inflammation), diuretic, eczema, emesis (vomiting), gout (foot inflammation), hepatoprotection (liver protection), jaundice, nausea, nephrolithiasis/ urolithiasis (kidney stones), nephrosclerosis (kidney disease), probiotic, peripheral edema, pruritis (severe itching), rheumatic diseases, snakebite.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (over 18 years old)
There is no proven safe or effective dose for artichoke. A typical dosage of standardized artichoke extract is 320-1,800 milligrams daily for six weeks. The expert panel German Commission E recommends 6 grams of the dried herb or its equivalent daily, usually divided into three doses.
Also, 3-8 milliliters of 1:2 liquid extract daily is often recommended in clinical practice, and up to 10 milliliters of pressed juice from fresh leaves and flower buds of the artichoke has been used in clinical trials. The German Commission E has recommended 6 milliliters of tincture (1:5 grams per milliliter) given three times daily.
Doses of globe artichoke containing 250-750 milligrams of cynarin daily, or dried artichoke extract 1,800-1,900 milligrams daily, have been used in clinical trials. However, it is not clear that these are optimal doses.
Doses in the range of 4-9 grams of dried leaves daily are often recommended in clinical practice. The German Commission E has recommended 0.5 gram of a 12:1 (w/w) dried extract given as a single daily dose.
Children (under 18 years old)
There is no proven safe or effective dose for artichoke in children, and use is not recommended.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid in individuals with a known allergy or hypersensitivity to globe artichoke (Cynara scolymus L.), its constituents, or members of the Asteraceae or Compositae family, including chrysanthemums, daisies, marigolds, ragweed, and arnica, due to possible cross-reactivity. Symptoms of allergy may include worsening of asthma, skin rash, anaphylactic shock, dyspnea (difficulty breathing), cough, and chest tightness. While rare, individuals with a known inulin allergy should avoid artichokes and artichoke extracts.
Side Effects and Warnings
Artichoke is likely safe when taken by mouth for short periods of time. The adverse effects associated with artichoke are generally mild and include gastrointestinal symptoms. However, there have been reports of kidney failure and/or toxicity from the use of artichoke leaves. Use cautiously in patients with kidney disease.
Contact dermatitis (rash) and contact urticaria have been noted after application to the skin, with symptoms spontaneously subsiding hours or days after exposure.
Mild flatulence (gas), diarrhea, hunger, redness in the face, increased bile secretion, and nausea have been reported. Use cautiously in patients with cholelithiasis (gallstones) or biliary/bile duct obstruction.
Artichoke extract (Cynarex®) may increase the risk of bleeding, although causality is unclear. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Dyspnea (difficulty breathing), cough, chest tightness, and a severe asthma exacerbation may occur. Severe anaphylactic shock in response to artichoke inulin as an ingredient in commercially available products has also been reported. Individuals with a noted sensitivity to artichokes should consume inulin with caution. While rare, individuals with a known inulin allergy should avoid artichokes and artichoke extracts.
Pregnancy and Breastfeeding
Artichoke is not recommended in pregnant or breastfeeding women due to a lack of available sufficient evidence.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Artichoke may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
There are multiple published reports of cholesterol-lowering effects of artichoke, although the quality of most studies is not sufficient to form a clear conclusion in this area. Artichoke may add to the cholesterol-lowering effects of other agents.
Interactions with Herbs and Dietary Supplements
Artichoke may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
There are multiple published reports of cholesterol-lowering effects of artichoke, although the quality of most studies is not sufficient to form a clear conclusion in this area. Therefore, artichoke may add to the lipid-lowering effects of other agents, such as fish oil, garlic, or niacin.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Betancor-Fernandez A, Perez-Galvez A, Sies H, et al. Screening pharmaceutical preparations containing extracts of turmeric rhizome, artichoke leaf, devil's claw root and garlic or salmon oil for antioxidant capacity. J Pharm Pharmacol 2003;55(7):981-986. View Abstract
Bundy R, Walker AF, Middleton RW, et al. Artichoke leaf extract reduces symptoms of irritable bowel syndrome and improves quality of life in otherwise healthy volunteers suffering from concomitant dyspepsia: a subset analysis. J Altern.Complement Med 2004;10(4):667-669. View Abstract
Franck P, Moneret-Vautrin DA, Morisset M, et al. Anaphylactic reaction to inulin: first identification of specific IgEs to an inulin protein compound. Int Arch Allergy Immunol 2005;136(2):155-158. View Abstract
Holtmann G, Adam B, Haag S, et al. Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial. Aliment.Pharmacol Ther 2003;18(11-12):1099-1105. View Abstract
Jimenez-Escrig A, Dragsted LO, Daneshvar B, et al. In vitro antioxidant activities of edible artichoke (Cynara scolymus L.) and effect on biomarkers of antioxidants in rats. J Agric.Food Chem. 8-27-2003;51(18):5540-5545. View Abstract
Li H, Xia N, Brausch I, Yao Y, et al. Flavonoids from artichoke (Cynara scolymus L.) up-regulate endothelial-type nitric-oxide synthase gene expression in human endothelial cells. J Pharmacol.Exp.Ther. 2004;310(3):926-932. View Abstract
Lopez-Molina, D., Navarro-Martinez, M. D., Rojas-Melgarejo, F., Hiner, A. N., Chazarra, S., and Rodriguez-Lopez, J. N. Molecular properties and prebiotic effect of inulin obtained from artichoke (Cynara scolymus L.). Phytochemistry 2005;66(12):1476-1484. View Abstract
Lupattelli G, Marchesi S, Lombardini R, et al. Artichoke juice improves endothelial function in hyperlipemia. Life Sci 12-31-2004;76(7):775-782. View Abstract
Miralles JC., Garcia-Sells J, Bartolome B, et al. Occupational rhinitis and bronchial asthma due to artichoke (Cynara scolymus). Ann Allergy Asthma Immunol. 2003;91(1):92-95. View Abstract
Pittler MH, White AR, Stevinson C, et al. Effectiveness of artichoke extract in preventing alcohol-induced hangovers: a randomized controlled trial. CMAJ. 12-9-2003;169(12):1269-1273. View Abstract
Valerio F, De Bellis P, Lonigro SL, et al. In vitro and in vivo survival and transit tolerance of potentially probiotic strains carried by artichokes in the gastrointestinal tract. Appl Environ.Microbiol. 2006;72(4):3042-3045. View Abstract
Visioli F, Bogani P, Grande S, et al. Local food and cardioprotection: the role of phytochemicals. Forum Nutr 2006;59:116-129. View Abstract
Wang M, Simon JE, Aviles IF, et al. Analysis of antioxidative phenolic compounds in artichoke (Cynara scolymus L.). J Agric.Food Chem. 1-29-2003;51(3):601-608. View Abstract
Wittemer SM, Ploch M, Windeck T, et al. Bioavailability and pharmacokinetics of caffeoylquinic acids and flavonoids after oral administration of Artichoke leaf extracts in humans. Phytomedicine. 2005;12(1-2):28-38. View Abstract
Zhu XF, Zhang HX, Lo R. Antifungal activity of Cynara scolymus L. extracts. Fitoterapia 2005;76(1):108-111. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017