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Western herbalism

ArtichokeCynara cardunculus (syn. Cynara scolymus)

The leaf of the globe artichoke, not the edible bud; a 247-person trial found fewer dyspepsia symptoms than placebo over 6 weeks, with a modest effect size.

Botanical name
Cynara cardunculus (syn. Cynara scolymus)
Part used
leaf
Also called
Globe artichoke leaf, Artichoke leaf extract (ALE), Cynarae folium
Used in
Western herbalism
Taken for
Indigestion, Bloating, Gas, Liver and bile
Sold as
capsules, tea, extract, tincture, powder

What artichoke is

The artichoke sold as a supplement is the leaf, not the edible flower bud. It comes from the globe artichoke (Cynara cardunculus, also called Cynara scolymus), a thistle-like member of the daisy family, Asteraceae. The large, bitter basal leaves are harvested before flowering, dried, and extracted with water or dilute alcohol.

Products come in several forms. The European monograph lists comminuted dried leaf for tea, powdered leaf, dry water extracts of dried or fresh leaves, and soft extracts, with the strengths expressed as drug-to-extract ratios (DER, the number of parts of leaf used to make one part of extract). Because extraction methods differ so much, the doses in trials and on labels are not interchangeable: 320 mg of one extract is not 320 mg of another.

Artichoke leaf extract is often combined with other herbs in digestive products, notably with ginger in a standardized capsule used in two of the trials below.

What the traditions use it for

Western herbalism

European herbal practice uses artichoke leaf as a digestive herb, taken for fullness after meals. The European Medicines Agency’s herbal committee lists artichoke leaf as a traditional herbal medicine for the symptomatic relief of digestive disorders such as dyspepsia with a sensation of fullness, bloating and flatulence, on the basis of long-standing use alone. A review of its pharmacology notes that antioxidant, choleretic (bile-promoting), hepatoprotective and lipid-lowering effects have been reported and that these correspond with the plant’s historical use, but most of that work is laboratory and animal research.

The constituents

The leaf extract’s main ingredient in the bile studies is cynarin, a dicaffeoylquinic acid. Reviews of the plant list antioxidant, choleretic and lipid-lowering effects, mostly from experimental work. In a pilot crossover study of 20 volunteers, a single 1.92 g dose of an artichoke extract placed directly into the duodenum raised bile secretion by up to 151.5% of the starting value, though placebo also produced a rise. That route is not how a capsule works. In 11 healthy volunteers, a capsule of ginger plus artichoke extract before a meal was followed by a stomach area about 24% smaller an hour after eating than with placebo, which the authors read as faster emptying.

The human evidence

Artichoke leaf extract has more controlled evidence for dyspepsia (upper-abdominal fullness, pain and nausea after eating) than most single herbs. In the main trial, 247 patients with functional dyspepsia took two 320 mg capsules three times daily (1,920 mg a day) or placebo for six weeks. The 244 analyzed showed greater overall symptom improvement with the extract (score 8.3 against 6.7, P < 0.01) and a larger improvement on the Nepean Dyspepsia Index of quality of life (−41.1 against −24.8, P < 0.01). The Cochrane review of non-Chinese herbal medicines for functional dyspepsia pooled this trial as a standardized mean difference of −0.34 (95% CI −0.59 to −0.09), low-certainty evidence, a small effect.

A combination of ginger and artichoke extracts was tested in 126 people with functional dyspepsia (4 weeks, two capsules a day). After 14 days the supplement group improved and the placebo group did not, with advantages for nausea, epigastric fullness, epigastric pain and bloating; Cochrane gave a risk ratio of 1.64 (95% CI 1.27 to 2.13), low certainty. Because ginger is the other ingredient, the result cannot be assigned to artichoke.

Open-label data are positive but cannot rule out placebo effects. In 516 people recruited through the media, 2 months of 320 or 640 mg a day was followed by an average 40% fall in dyspepsia scores in both groups. In a post hoc subset of 208 with IBS symptoms from that study, reported IBS incidence fell by 26.4%. We could not find a placebo-controlled trial of artichoke in IBS.

StudyDoseWhat it found
Randomized placebo-controlled trial, 247 patients with functional dyspepsia (244 analyzed), 6 weeks PMID 14653829Two 320 mg extract capsules, three times dailyOverall symptom improvement 8.3 vs 6.7 (P < 0.01); quality-of-life index -41.1 vs -24.8 (P < 0.01)
Cochrane review of non-Chinese herbal medicines for functional dyspepsia (artichoke: 1 study, 244 participants) PMID 37323050As in the underlying trialArtichoke SMD -0.34 (95% CI -0.59 to -0.09), low certainty; ginger plus artichoke RR 1.64 (1.27 to 2.13), 126 participants, low certainty
Randomized placebo-controlled trial of ginger plus artichoke extract, 126 people with functional dyspepsia (a combination) PMID 25954317Two capsules a day, 4 weeksImprovement after 14 days only on supplement; advantages for nausea, fullness, pain, bloating
Open-label dose-ranging study, 516 adults with dyspepsia (454 completed) PMID 12587688320 or 640 mg a day for 2 monthsAverage 40% reduction in global dyspepsia score in both groups; no dose difference on the main outcome
Post hoc subset of the open study, 208 adults with IBS symptoms PMID 15353023320 or 640 mg a day for 2 monthsIBS incidence down 26.4%; symptom score down 41% (no control group)
Randomized crossover pilot, 20 volunteers, bile secretion PMID 231958821.92 g extract placed in the duodenum (single dose)Bile secretion up to 151.5% of baseline; placebo also rose; extract higher at 120 and 150 minutes

Doses, in trials and in practice

The main dyspepsia trial used two 320 mg capsules of a commercial extract three times daily (1,920 mg a day) for six weeks, and the open-label study used 320 or 640 mg a day for two months.

The European monograph’s traditional-use posology for adolescents and adults is: 1.5 g of comminuted dried leaf in 150 ml of boiling water four times daily (3 to 6 g a day); 600 to 1,500 mg of powdered leaf a day in divided doses; or 200 to 640 mg of a dry water extract of dried leaf per dose (400 to 1,320 mg a day). It advises seeing a practitioner if symptoms last beyond 2 weeks.

The amounts above are what trials and pharmacopoeias record, not a dose for you; your medicines and conditions change the answer, and a clinician or pharmacist who knows them is the person to ask.

What is known about safety

The European monograph lists slight diarrhea with abdominal spasm, nausea and heartburn as reported effects, frequency unknown, plus allergic reactions. It contraindicates artichoke leaf for people hypersensitive to the daisy family (Asteraceae) and for those with bile duct obstruction, bile duct inflammation, liver disease, gallstones or other biliary disorders needing medical supervision. Safety in pregnancy and breastfeeding has not been established, and the monograph does not advise use in either. Use under age 12 is not established, no overdose cases are on record, and tests of reproductive toxicity, genotoxicity and carcinogenicity have not been performed. The trials we read described the extracts as well tolerated, but they were short (4 to 8 weeks).

Where it meets prescription medicines

The European monograph lists no reported interactions, and we could not find a drug-interaction study of artichoke leaf extract. The bile-secretion pilot (20 volunteers, extract placed in the duodenum) shows an effect on bile flow, so the question of whether the extract changes the absorption of fat-soluble medicines or of drugs cleared in bile is a theoretical one that no study we found has tested. The catalog’s own drug rules for artichoke products are listed automatically on this page.

Medicines the site’s own interaction rules flag with artichoke

The quiz applies these rules when someone names a medicine. They come from published interaction references and are a reason to ask a pharmacist, not a diagnosis:

Catalog entries that list artichoke

If you want artichoke in a product rather than as a loose herb, these are the entries that carry it, with the label amounts and the reviews read.

Omyo GLP-1 Digestive Support 4.8 out of 5 from 2,814 ratings from omyohealth.com · $2.00 a day Totaria 5-in-1 Probiotic, Prebiotic and Postbiotic, 60 Billion CFU 4.5 out of 5 from 1,246 ratings from Amazon · $0.19 a day Akka Liver and Gut Superbiotic 4.4 out of 5 from 1,107 ratings from Amazon · $2.13 a day NOW Foods Artichoke Extract 450 mg 4.5 out of 5 from 805 ratings from Amazon · $0.14 a day Silver Fern Brand Motility 3.8 out of 5 from 122 ratings from Amazon · $2.22 a day GutPersonal The Mover Motility Support 4.68 out of 5 from 25 ratings from gutpersonal.com · $0.92 per day at one capsule; $1.83 at the two-capsule top of the stated range; monthly subscription $1.65 at two

Match it to your own case

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Herbs that sit beside it

Ayurvedic / TCM / Western Ginger Zingiber officinale Western Milk thistle Silybum marianum Western / TCM Dandelion Taraxacum officinale (and T. mongolicum in Chinese medicine) Western Peppermint Mentha x piperita Western Gentian Gentiana lutea

The questions that come up

Is artichoke leaf the same as eating artichokes?

No. The supplements use extract from the leaf, and the trials gave defined milligram doses of a standardized extract. The edible bud is a food, and the dyspepsia trials did not test it.

Does artichoke help indigestion?

A 247-person placebo-controlled trial found greater symptom improvement over six weeks (8.3 against 6.7, P < 0.01). The Cochrane review pooled the evidence as a small effect of low certainty (SMD -0.34). Open-label studies were more positive, and they lack a placebo group.

Who should avoid artichoke leaf extract?

The European monograph contraindicates it in bile duct obstruction, bile duct inflammation, liver disease and gallstones, and for people allergic to the daisy family. It does not advise use in pregnancy or breastfeeding.

Are ginger and artichoke tested together?

Yes. A 126-person trial of a ginger and artichoke supplement found improvement in nausea, fullness, pain and bloating over placebo, and Cochrane gave a risk ratio of 1.64 with low certainty. The combination cannot show how much came from each herb.

Sources