Artichoke leaf extract benefit, side effects
Health supplement used for cholesterol, IBS, and other medical conditions
April 11 2017 by Ray Sahelian, M.D.

Artichoke leaf extract is widely used alone or in association with other herbs for embittering alcoholic and soft drinks and to prepare herbal teas or herbal medicinal products. Some of the research is listed below. It appears that this supplement has many health benefits, including lowering of cholesterol levels.

Clinical uses and benefit
Artichoke leaf extract has been tested in gastritis, heartburn, also known as dyspepsia. It has also been tested in irritable bowel syndrome and those with high cholesterol levels. I am not aware of it being of benefit in weight loss. Diet Rx works much better for the purpose of appetite suppression.

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Artichoke leaf extract 500mg, 60 capsules
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Recommendations, dosage, how much to take: One two artichoke capsules 1 to 3 times daily or as recommended by your health care provider. If you buy Artichoke leaf extract supplement you can take it with any meal.

Q. Can you tell me if artichoke leaf extract supplements should be taken before or after meals?
   A. Right before or with meals are good options.

Review article
Plant Foods Hum Nutrition. 2015. Pharmacological Studies of Artichoke Leaf Extract and Their Health Benefits. Artichoke leaf extract has been shown to have antioxidant, choleretic, liver protective, bile-enhancing and lipid-lowering effects, which corresponded with its historical use. Ongoing research seems to indicate that artichoke has medicinal qualities. Most significant appears to be its beneficial effect on the liver. In animal studies, extracts of the roots and leaves of artichoke have demonstrated an ability to protect the liver, with possibly even to help liver cells regenerate. Although research is not yet conclusive, scientists are optimistic that its long-standing use in humans for digestive and bowel problems is justified. It may also play a role in lowering cholesterol and thus help to prevent heart disease.

Artichoke for cholesterol reduction, does it lower blood lipids?
Int J Food Sci Nutr. 2013. Beneficial effects of artichoke leaf extract supplementation on increasing HDL-cholesterol in subjects with primary mild hypercholesterolaemia: a double-blind, randomized, placebo-controlled trial. The aim of this study was to evaluate the effects of artichoke leaf extract (ALE) supplementation (250 mg, 2 b.i.d.) on the lipid pattern. Results indicate that ALE could play a relevant role in the management of mild high cholesterol levels, favouring in particular the increase in HDL-C, besides decreasing total cholesterol and LDL-cholesterol.

In a study of 140 people with high blood cholesterol levels, supplementing with a daily artichoke extract of 450 mg was found to lower the cholesterol level by 18 per cent. Artichoke contains luteolin and other beneficial flavonoids and compounds.

Phytomedicine, 2008. Artichoke leaf extract (Cynara scolymus) reduces plasma cholesterol in otherwise healthy hypercholesterolemic adults: a randomised double-blind placebo controlled trial.  Bundy Rafe, et al. An artichoke leaf extract from the globe artichoke plant can reduce cholesterol in otherwise healthy individuals with moderately raised levels. Dr Rafe Bundy, who led the study, gave 75 volunteers four capsules, or 1,280 mg, of an artichoke leaf extract, or matched placebo, each day for 12 weeks. Artichoke leaf extract consumption reduced total plasma cholesterol by an average of 4% and increased in the control group by an average of 2%. No significant differences between groups were observed for LDL cholesterol, HDL cholesterol or triglyceride levels. Globe artichokes have been used traditionally in Europe to improve digestive and urinary tract health.

Cochrane Database Syst Rev. 2002. Artichoke leaf extract for treating hypercholesterolemia. Artichoke leaf extract, which is available as an over-the-counter herbal remedy, has been implicated in lowering cholesterol levels. Whether Artichoke leaf extract is truly efficacious for this indication, however, is still a matter of debate. To assess the evidence of Artichoke leaf extract versus placebo or reference medication for treating hypercholesterolemia defined as mean total cholesterol levels of at least 5 mmol/L (200 mg /dL). Few data from rigorous clinical trials assessing Artichoke leaf extract for treating hypercholesterolemia exist. Beneficial effects are reported, the evidence however is not compelling. The limited data on safety suggest only mild, transient and infrequent adverse events with short term use. More rigorous clinical trials assessing larger patient samples over longer intervention periods are needed to establish whether Artichoke leaf extract is an effective and safe treatment option for patients with high cholesterol levels.

Blood vessel integrity protection
Phytother Res. 2008. The effect of artichoke (Cynara scolymus) extract on ROS generation in HUVEC cells. Department of Experimental and Clinical Pharmacology, Pomeranian Medical University, Powstańców, Poland. The effect of an artichoke extract on induced reactive oxygen species (ROS) generation in cultured human umbilical endothelial cells (HUVECs) and its reductive properties were evaluated. Preincubation of HUVEC cells with the artichoke extract for 24 h abolished ROS generation induced by LPS and oxyLD. Potent, concentration-dependent reductive properties of the artichoke extract were demonstrated by the reduction kinetics of cytochrome c in reference to ascorbate were also revealed. The results of the present study the warrant application of artichoke extracts as endothelium protecting agents.

Cancer, mesothelioma
Oncotarget. 2015. Cynara scolymus affects malignant pleural mesothelioma by promoting apoptosis and restraining invasion. Malignant pleural mesothelioma is a poorly treated cancer arising from the pleural mesothelial lining. Here we document that the leaf extract of artichoke exerts broad antitumoral effects both in vitro and in vivo on mesothelioma cell lines. We found that artichoke treatment affects strongly cell growth, migration and tumor engraftment of mesothelioma cell lines. Strikingly, dietary feeding with Cynara scolymus leaf extract reduces the growth of mesothelioma xenografted tumors similarly to pemetrexed, a commonly employed drug in the treatment of mesothelioma. In aggregate our findings suggest that leaf extract of Cynara scolymus holds therapeutic potential for the treatment of mesothelioma.

Heartburn relief, stomach problems
Minerva Gastroenterol Dietol. 2010. Phytotherapy with a mixture of dry extracts with hepato-protective effects containing artichoke leaves in the management of functional dyspepsia symptoms. Phytotherapy with Cinarepa (a commercial mixture of dry extracts of artichoke leaf (Cynara scolymus)15% of chlorogenic acid (150 mg per capsule), dandelion radix (Taraxacum officinalis) 2% of inulin, turmeric rhizome (Curcuma longa) 95% of curcumin and rosemary bud essential oil microencapsulated) holds promise as an alternative option in the relief of functional dyspepsia symptoms and merits further investigation in controlled studies.

Aliment Pharmacol Ther. 2003. Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial. This study aimed to assess the efficacy of artichoke leaf extract in the treatment of patients with heartburn. In a double-blind, randomized controlled trial, 247 patients with heartburn were recruited and treated with either a commercial artichoke leaf extract preparation (2 x 320 mg plant extract t.d.s.) or a placebo. The primary efficacy variable was the sum score of the patient's weekly rating of the overall change in dyspeptic symptoms (four-point scale). Secondary variables were the scores of each heartburn symptom and the quality of life (QOL) as assessed by the Nepean Dyspepsia Index (NDI). Two hundred and forty-seven patients were enrolled, and data from 244 patients (129 active treatment, 115 placebo) were suitable for inclusion in the statistical analysis (intention-to-treat). The overall symptom improvement over the 6 weeks of treatment was significantly greater with artichoke leaf extract than with the placebo. Similarly, heartburn patients treated with artichoke leaf extract showed significantly greater improvement in the global quality-of-life scores (NDI) compared with the placebo-treated patients. The artichoke leaf extract preparation tested was significantly better than the placebo in alleviating symptoms and improving the disease-specific quality of life in patients with heartburn.

Phytomedicine. 2002. Artichoke leaf extract reduces mild heartburn in an open study. A recent post-marketing study indicated that high doses of standardised artichoke leaf extract may reduce symptoms of heartburn. To substantial these findings, this study investigated the efficacy of a low-dose ALE on amelioration of dyspeptic symptoms and improvement of quality of life. The study was an open, dose-ranging postal study. Healthy patients with self-reported heartburn were recruited through the media. The Nepean Dyspepsia Index and the State-Trait Anxiety Inventory were completed at baseline and after 2 months of treatment with ALE, which was randomly allocated to volunteers as 320 or 640 mg daily. In both dosage groups, compared with baseline, there was a significant reduction of all heartburn symptoms, with an average reduction of 40% in global heartburn score. However, there were no differences in the primary outcome measures between the two groups, although relief of state anxiety, a secondary outcome, was greater with the higher dosage. Health-related quality of life was significantly improved in both groups compared with baseline. We conclude that ALE shows promise to ameliorate upper gastro-intestinal symptoms and improve quality of life in otherwise healthy subjects suffering from heartburn.

IBS treatment, irritable bowel disease
J Altern Complement Med. 2004. 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. Does artichoke leaf extract ameliorate symptoms of Irritable bowel syndrome (IBS) in otherwise healthy volunteers suffering concomitant dyspepsia? A subset analysis of a previous dose-ranging, open, postal study, in adults suffering dyspepsia. Two hundred and eight (208) adults were identified post hoc as suffering with IBS. IBS incidence, self-reported usual bowel pattern, and the Nepean Dyspepsia Index (NDI) were compared before and after a 2-month intervention period. There was a significant fall in IBS incidence after treatment. A significant shift in self-reported usual bowel pattern away from "alternating constipation / diarrhea" toward "normal" was observed. NDI total symptom score significantly decreased by 41% after treatment. Similarly, there was a significant 20% improvement in the NDI total quality-of-life (QOL) score in the subset after treatment. This report supports previous findings that Artichoke leaf extract ameliorates symptoms of IBS, plus improves health-related QOL.

Liver protection
Pharm Biol. 2014. Protective effect of artichoke leaf extract against paracetamol-induced hepatotoxicity in rats. Results suggest that ALE may protect from paracetamol-induced liver toxicity via its antioxidant and anti-apoptotic properties.

Prebiotic benefit
Healthy volunteers consumed 10 g daily of very long chain inulin derived from globe artichoke for 3 weeks. Bifidobacteria and lactobacilli were significantly higher in the inulin group in comparison to the placebo group. A double-blind, placebo-controlled, cross-over study to establish the bifidogenic effect of a very-long-chain inulin extracted from globe artichoke (Cynara scolymus) in healthy human subjects. Br J Nutr. 2010.

Weight loss, losing pounds
In combination with phaseolus bean extract, it may help with weight reduction.

Review article
Przegl Lek. 2012. Artichoke -- untapped potential of herbal medicine in the treatment of atherosclerosis and liver diseases. Substances of natural origin are the subject of growing interest on the part of both researchers and doctors. One of the well known herbal medicines extensively examined in terms of clinical and pharmacological is artichoke (Cynara scolymus), which was used in European medicine from the 18th century. His multidirectional treatment is a documented fact and it is associated with treatment of dyspepsia, influence of active substances contained in artichoke on plasma lipid levels and with a strong antioxidant effect of the artichoke extract--due to this properties, artichoke compounds have a protective effect on liver cells.

Artichoke leaf side effects, safety
I am not yet aware of what kind of side effects occur since it is a relatively new supplement on the over the counter market.

Q. I need to know if there are any adverse interactions or side effects of artichoke extract and chlorella with my prescription drugs. They are 25mg Elavil, 50mg sertraline, and 10mg chlordiazepoxide.
   A. There are thousands of prescription medications on the market and thousands of herbal supplements. Not enough testing has been done to determine what kind of interactions occur when these are combined. Artichoke extract is generally safe, but since no studies are available regarding the interactions, we have to refer you to your doctor's best judgment.

Q. I have an allergy to shellfish and peanuts, I would like to know if this product would be ok with my allergy?
   A. I have not reason to suspect that it would cause an allergy but I cannot be 100 percent certain. Each person is unique.

Phytomedicine. 2005. Bioavailability and pharmacokinetics of caffeoylquinic acids and flavonoids after oral administration of Artichoke leaf extracts in humans. Various potential pharmacodynamic effects have been observed in vitro for mono- and dicaffeoylquinic acids (e.g. chlorogenic acid, cynarin), caffeic acid and flavonoids (e.g. luteolin-7-O-glucoside) which are the main phenolic constituents of artichoke leaf extract. In order to get more detailed information about absorption, metabolism and disposition of artichoke leaf extract, two different extracts were administered to 14 healthy volunteers in a crossover study. Each subject received doses of both extracts. Artichoke leaf extract A administered dose: caffeoylquinic acids equivalent to 107 mg caffeic acid and luteolin glycosides equivalent to 14.4 mg luteolin. Artichoke leaf extract B administered dose: caffeoylquinic acids equivalent to 153 mg caffeic acid and luteolin glycosides equivalent to 35 mg luteolin. Urine and plasma analysis were performed by a validated HPLC method using 12-channel coulometric array detection. In human plasma or urine none of the genuine target extract constituents could be detected. However, caffeic acid, its methylated derivates ferulic acid (FA) and isoferulic acid (IFA) and the hydrogenation products dihydrocaffeic acid (DHCA) and dihydroferulic acid (DHFA) were identified as metabolites derived from caffeoylquinic acids. Except of DHFA all of these compounds were present as sulfates or glucuronides. Peak plasma concentrations of total CA, FA and IFA were reached within 1 h and declined over 24 h showing almost biphasic profiles. In contrast maximum concentrations for total DHCA and DHFA were observed only after 6-7 h, indicating two different metabolic pathways for caffeoylquinic acids. Luteolin administered as glucoside was recovered from plasma and urine only as sulfate or glucuronide but neither in form of genuine glucosides nor as free luteolin. Peak plasma concentrations were reached rapidly within 0.5 h. The elimination showed a biphasic profile.

Anaphylactic Reaction to Inulin: First Identification of Specific IgEs to an Inulin Protein Compound.
Int Arch Allergy Immunol. 2005
A woman with a past history of allergy to artichoke presented with two episodes of immediate allergic reactions, one of which was a severe anaphylactic shock after eating two types of health foods containing inulin. Results: Dot blot assay techniques identified specific IgEs to artichoke, to yoghurt F, and to a heated BSA + inulin product. Dot blot inhibition techniques confirmed the anti-inulin specificity of specific IgE. The absence of a positive reaction to an unheated milk-inulin mixture indicates the probability of protein-inulin binding. There is no cross-reactivity with the carbohydrates of the glycosylated allergens.

Blood vessel health
Artichoke juice improves endothelial function in hyperlipemia.
Life Sci. 2004.
Artichoke extracts have been shown to produce various pharmacological effects, such as the inhibition of cholesterol biosynthesis and of LDL oxidation. Endothelial dysfunction represents the first stage of atherosclerotic disease. Aim of the study was to investigate the effects of dietary supplementation with artichoke juice on brachial FMV of hyperlipemics. We studied 18 moderately hyperlipemic patients (LDL cholesterol > 130 <200 mg/dl and/or triglycerides >150 <250 mg/dl) of both genders and 10 hyperlipemic patients, matched for age, sex and lipid parameters. In conclusion, artichoke dietary supplementation seems to positively modulate endothelial function in hypercholesterolemia.

Flavonoids from artichoke up-regulate endothelial-type nitric-oxide synthase gene expression in human endothelial cells.
J Pharmacol Exp Ther. 2004.
Nitric oxide (NO) produced by endothelial nitric-oxide synthase (eNOS) represents an antithrombotic and anti-atherosclerotic principle in the vasculature. Hence, an enhanced expression of eNOS in response to pharmacological interventions could provide protection against cardiovascular diseases. In EA.hy 926 cells, a cell line derived from human umbilical vein endothelial cells (HUVECs), an artichoke leaf extract increased the activity of the human eNOS promoter (determined by luciferase reporter gene assay). An organic subfraction from artichoke leaf extract was more potent in this respect than the crude extract, whereas an aqueous subfraction of artichoke leaf extract was without effect. Thus, in addition to the lipid-lowering and antioxidant properties of artichoke, an increase in eNOS gene transcription may also contribute to its beneficial cardiovascular profile. Artichoke flavonoids are likely to represent the active ingredients mediating eNOS up-regulation.

Hangover help
Effectiveness of artichoke extract in preventing alcohol-induced hangovers: a randomized controlled trial.
CMAJ. 2003.
Extract of globe artichoke (Cynara scolymus) is promoted as a possible preventive or cure for alcohol-induced hangover symptoms. However, few rigorous clinical trials have assessed the effects of artichoke extract, and none has examined the effects in relation to hangovers. We undertook this study to test whether artichoke extract is effective in preventing the signs and symptoms of alcohol-induced hangover. Our results suggest that artichoke extract is not effective in preventing the signs and symptoms of alcohol-induced hangover.

Choleretic activity and biliary elimination of lipids and bile acids induced by an artichoke leaf extract in rats.
Phytomedicine. 2002.
The therapeutic properties of artichoke preparations have been known since ancient times. The traditional use of artichoke leaf extract in gastroenterology is mainly based upon its strong antidyspeptic actions which are mediated by its choleretic activity. The aim of this study was to investigate the effects of artichoke leaf extract on bile flow and the formation of bile compounds in anaesthetised Wistar rats after acute and repeated (twice a day for 7 consecutive days) oral administration. A significant increase in bile flow was observed after acute treatment with artichoke leaf extract as well as after repeated administration. The choleretic effects of artichoke leaf extract were similar to those of the reference compound dehydrocholic acid (DHCA). Total bile acids, cholesterol and phospholipid were determined by enzymatic assays. There was a strong artichoke leaf extract -induced increase in total bile acid concentration over the entire experiment. With the highest dose (400 mg/kg), a significant increase was obtained after single and repeated administration. The bile acids-increased effects of artichoke leaf extract were much more pronounced than those of reference (DHCA). No significant differences in cholesterol and phospholipid content could be found.

Artichoke leaf extract reduces symptoms of irritable bowel syndrome in a post-marketing surveillance study.
Phytother Res. 2001.
Irritable bowel syndrome (IBS) is a problem reported to affect 22% of the general population. It is characterized by abdominal pain and altered bowel habit, but has so far defied elucidation of its pathogenesis and proved difficult to treat. Dyspepsia is the condition for which the herb is specifically indicated, but the symptom overlap between dyspeptic syndrome and IBS has given rise to the notion that artichoke leaf extract may have potential for treating IBS as well. A sub-group of patients with IBS symptoms was therefore identified from a sample of individuals with dyspeptic syndrome who were being monitored in a post-marketing surveillance study of artichoke leaf extract for 6 weeks. Analysis of the data from the IBS sub-group revealed significant reductions in the severity of symptoms and favourable evaluations of overall effectiveness by both physicians and patients. Furthermore, 96% of patients rated artichoke leaf extract as better than or at least equal to previous therapies administered for their symptoms, and the tolerability of artichoke leaf extract was very good. These results provide support for the notion that artichoke leaf extract has potential value in relieving IBS symptoms and suggest that a controlled trial is justified.

Efficacy of Artichoke dry extract in patients with hyperlipoproteinemia.
Arzneimittelforschung. 2000.
Efficacy and tolerability of artichoke dry extract (drug/extract ratio 25-35:1, aquous extract, CY450) as coated tablets containing 450 mg extract (tradename: Valverde Artischocke bei Verdauungsbeschwerden) was investigated in the treatment of high blood lipids and compared with placebo. 143 adult patients with initial total cholesterol of > 280 mg/dl were included in a double blind, randomized, placebo controlled, multi-center clinical trial. Patients received 1,800 mg artichoke dry extract per day or placebo over 6 weeks. Changes of total cholesterol and LDL-cholesterol from baseline to the end of treatment showed a statistically significant superiority of artichoke dry extract over placebo. There were no drug related adverse events during this study indicating an excellent tolerability of artichoke dry extract. This prospective study could contribute clear evidence to recommend artichoke dry extract CY450 for treating hyperlipoproteinemia and, thus, prevention of atherosclerosis and coronary heart disease.

Availability by herbal suppliers
Artichoke extract is available in a number of concentrations and extract potencies. Herbal Powers Ingredients has artichoke extract as 5 percent cyananine.

Questions, interactions
Can an artichoke extract supplement be taken the same day as CoQ10 and alpha lipoic acid?
   I don't see why not, but I have not come across any studies to know for sure.

Other products for sale online
Buy Artichoke Leaf Extract supplement, 90 Capsules by Enzymatic Therapy

Supplement Facts:
Servings per container 45
Amount per 2 capsules
Artichoke (Cynara scolymus) Leaf extract 320 mg
   Standardized to contain 13% - 18% caffeylquinic acids calculated as chlorogenic acid

Life Extension, Artichoke Leaf Extract, 500 mg, 180 Veggie Caps

Supplement Facts
Serving Size: 1 Vegetarian Capsule
  Amount Per Serving % Daily Value
Artichoke (Cynara scolymus) Extract Blend containing:
Artichoke (Cynara scolymus) standardized extract (leaf) providing cynarin (18.75 mg), chlorogenic acid and other caffeic acid derivatives
Artichoke (Cynara scolymus) power (leaf)
500 mg **
**Daily Value not established

Now Foods, Artichoke Extract, 450 mg, 90 Veggie Caps