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 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.1 Their work suggested that the plant does indeed stimulate the kidney and gallbladder. 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 gallbladder 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."2Dyspepsia 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. At least one substantial double-blind study indicates that artichoke leaf is indeed helpful for this condition.13

Another fairly substantial study indicates that artichoke leaf may help lower cholesterol.7

Based on a 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.12

A number of animal studies suggest that artichoke protects the liver from damage by chemical toxins.8 Artichoke's liver-protective effects, however, have never been proven in controlled clinical trials.

What Is the Scientific Evidence for Artichoke?

In a double-blind, placebo-controlled study of 143 people with high cholesterol, artichoke leaf extract significantly improved cholesterol readings.9 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 ratios by 20% vs. 7%. In a subsequent study of 75 otherwise healthy people with high cholesterol, artichoke leaf extract significantly reduced total cholesterol compared to placebo, but it did not affect LDL, HDL, or triglycerides levels.14

Another placebo-controlled study of 44 healthy people failed to find any improvement in cholesterol levels attributable to artichoke leaf.10 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.10 Besides cynarin, a compound in artichoke called luteolin may play a role in reducing cholesterol.11

Dyspepsia

In Europe, vague digestive symptoms are commonly attributed to inadequate flow of bile from the gallbladder. Evidence tells us that artichoke leaf does indeed stimulate the gallbladder.3,4,5 This by itself does not prove artichoke helpful for dyspepsia. In 2003, however, a large (247 participant) double-blind study evaluated artichoke leaf as a treatment for dyspepsia.13 In this carefully conducted 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.6

Dosage

Germany's Commission E recommends 6 g of the dried herb or its equivalent per day, usually divided into 3 doses. Artichoke leaf extracts should be taken according to label instructions.

Warning: People with gallbladder 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 gallbladder contraction, individuals with gallstones or other forms of gallbladder 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 gallbladder contraction could lead to obstruction of ducts or even rupture of the gallbladder.

Finally, 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.