Artichoke has been used in connection with the following conditions:

Rating	Health Concerns
	Indigestion and lack of appetite (digestive aid)
	High cholesterol
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Traditional Use
The artichoke is one of the world’s oldest medicinal plants. The ancient Egyptians placed great value on the plant—it is clearly seen in drawings involving fertility and sacrifice. Moreover, this plant was used by the ancient Greeks and Romans as a digestive aid. In 16th century Europe, the artichoke was favored as a food by royalty. 2

Active Constituents
Artichoke leaves contain a wide number of active constituents, including cynarin, 1,3 dicaffeoylquinic acid, 3-caffeoylquinic acid, and scolymoside. 3 The choleretic (bile stimulating) action of the plant has been well documented in a controlled trial involving a small sample of healthy volunteers. 4 After the administration of 1.92 grams of standardized artichoke extract directly into the duodenum, liver bile flow increased significantly. This choleretic effect has led to the popular use of artichoke extract in Europe for the treatment of mild indigestion—particularly following a meal high in fat. In an uncontrolled clinical trial with 553 people suffering from non-specific digestive disorders (including indigestion), 320–640 mg of a standardized artichoke extract taken three times per day was found to reduce nausea, abdominal pain, constipation, and flatulence in over 70% of the study participants. 5

The standardized extract has also been used to treat high cholesterol and triglycerides. In one preliminary trial 6 and one controlled trial, 7 use of a standardized artichoke extract was found to lower cholesterol and triglycerides significantly when taken in amounts ranging from 900 to 1,920 mg per day. One preliminary trial failed to find any effect. 8

While scientists are not certain how artichoke leaves lower cholesterol, test tube studies have suggested that the action may be due to an inhibition of cholesterol synthesis and/or the increased elimination of cholesterol because of the plant’s choleretic action. 9 In test tube studies, the flavonoids from the artichoke (e.g., luteolin) have been shown to prevent LDL-cholesterol oxidation—an effect that may reduce risk of atherosclerosis. 10

Dosage
The suggested adult amount of the standardized leaf extract is 300–640 mg three times daily for a minimum of six weeks. 11 Alternatively, if a standardized extract is not available, the amount of the crude, dried leaves is 1–4 grams, three times a day. 12

Side Effects
At the recommended amount and according to the German Commission E Monograph, 13 there are no known side effects or drug interactions. The use of artichoke is not recommended for those who are allergic to artichokes and other members of the Compositae (e.g., daisy) family. In addition, those who have any obstruction of the bile duct (e.g., as a result of gallstones) should not employ this plant therapeutically. The plant’s safety during pregnancy and breastfeeding has not been established.

At the time of writing, there were no well-known drug interactions with artichoke.

•  Products
•  References
  1-2.  Brand N. Cynara scolymus L.—The artichoke. Zeitschrift Phytother 1990;11:169–75.
  3.  Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2d ed. New York: John Wiley & Sons, 1996, 42–3.
  4.  Kirchoff R, Beckers CH, Kirchoff GM, et al. Increase of choleresis by means of artichoke extract. Phytomedicine 1994;1:107–15.
  5.  Fintelmann V. Antidyspeptic and lipid-lowering effect of artichoke leaf extract. Zeitschrift fur Allgemeinmed 1996;72(Suppl 2):3–19.
  6.  Fintelmann V. Antidyspeptic and lipid-lowering effect of artichoke leaf extract. Zeitschrift fur Allgemeinmed 1996;72(Suppl 2):3–19.
  7.  Englisch W, Beckers C, Unkauf M, et al. Efficacy of artichoke dry extract in patients with hyperlipoproteinemia. Arzneimittelforschung 2000;50:260–5.
  8.  Heckers H, Dittmar K, Schmahl FW, Huth K. Inefficiency of cynarin as therapeutic regimen in familial type II hyperlipoproteinemia. Atherosclerosis 1977;26:249–53.
  9.  Gebhardt R. New experimental results in the action of artichoke leaf extract. Zeitschrift fur Allgemeinmed 1996;72:20–3.
  10.  Brown JE, Rice-Evans CA. Luteolin rich artichoke extract protects low density lipoprotein from oxidation in vitro. Free Radical Research 1998;29:247–55.
  11.  Fintelmann V. Antidyspeptic and lipid-lowering effect of artichoke leaf extract. Zeitschrift fur Allgemeinmed 1996;72:1–19.
  12.  Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press, 1996, 36.
  13.  Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 84–5.