Drugs A - Z
Globe artichoke (Cynara scolymus L.)
Generic Name: Artichoke
CategoryHerbs & Supplements
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 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.
EvidenceDISCLAIMER: 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.
TraditionWARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. 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 healthcare provider. There may be other proposed uses that are not listed below.
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.
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.
SafetyDISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
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 & Breastfeeding
Artichoke is not recommended in pregnant or breastfeeding women due to a lack of available sufficient evidence.
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 & 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, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Heather Boon, B.Sc.Phm, PhD (University of Toronto); Ashley Brigham, PharmD (Northeastern University); Joan Engebretson, DrPH, RN (University of Texas); Nicole Giese, MS (Natural Standard Research Collaboration); Ernest B. Hawkins, MS, BSPharm (Health Education Resources, Inc.); Charles Holmes, MD (Harvard Medical School); Michael Smith, M.R.PharmS, ND (Canadian College of Naturopathic Medicine); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration); Heeja Yoon, PharmD (Drake University).
BibliographyDISCLAIMER: 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.
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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.