Artichoke (Cynara scolymus)

Artichoke extract is sold for «natural cholesterol lowering» as a statin alternative. Cochrane 2013 reviewed 3 RCTs totalling 262 patients: pooled total cholesterol reduction 17 mg/dL and LDL 23 mg/dL with 1280–1920 mg/day × 6–12 weeks, but quality low, heterogeneity high, hard outcomes (myocardial infarction, stroke, cardiovascular mortality) not assessed. ESC/EAS 2019 in primary hypercholesterolaemia and cardiovascular risk list statins first-line (proven MACE and all-cause mortality reduction), ezetimibe second-line, PCSK9 inhibitors in familial form. SEA 2022 (Spanish Atherosclerosis Society) – same approach. Herbal extracts not included. If artichoke was recommended as a statin substitute in confirmed hypercholesterolaemia and moderate/high cardiovascular risk (SCORE2 ≥5%), consider seeking a second opinion from a cardiologist or lipidologist.

Artichoke is sold as a «natural hepatoprotector» and «liver detox agent» for non-alcoholic fatty liver disease (NAFLD). Several small RCTs documented moderate ALT and AST reductions with artichoke extract 300–600 mg/day in NAFLD patients, but quality is low, samples small, and hard outcomes (fibrosis on biopsy or elastography, liver mortality) were not assessed. AASLD 2023 and EASL-EASD-EASO 2024 list as first-line for NAFLD/MASLD: 7–10% weight loss via Mediterranean diet and physical activity, control of metabolic risk factors (diabetes, dyslipidaemia, hypertension); pharmacotherapy in confirmed NASH includes resmetirom (Rezdiffra, FDA 03/2024), pioglitazone in T2DM patients, GLP-1 receptor agonists semaglutide. Herbal extracts including artichoke are not in international guidelines. If artichoke was recommended for NAFLD instead of dietary correction, physical activity and workup (HbA1c, lipid panel, FibroScan), consider seeking a second opinion from a gastroenterologist.

Artichoke (Cynara scolymus, cynara) is a plant extract promoted as a supplement to lower blood sugar and improve metabolism in type 2 diabetes. It has not shown convincing benefit for this use: there is no evidence base confirming an effect of artichoke on glucose levels or the course of diabetes. Type 2 diabetes is managed through diet, physical activity, weight reduction, and medicines prescribed by a doctor (such as metformin), with regular glucose monitoring. Artichoke should not replace treatment with proven benefit – dropping it for the supplement risks missed care.