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Artichoke (Cynara scolymus)

Herbal preparation, supplement. In EU – traditional herbal medicinal product (EMA HMPC). In Russia OTC product Hofitol is registered

ATC code: A11JA-ARTICHOKE

Brand names – supplements: Now Artichoke Extract, Solgar Artichoke Leaf, Gaia Herbs Artichoke, Nature's Way ArtichokeSupplements are not tested in clinical trials and are not registered as medications.

Updated · Methodology

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

C

Primary hypercholesterolemia

Not recommended

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 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. 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 ( ≥5%), consider seeking a second opinion from a cardiologist or lipidologist.

Sources

  1. Cochrane: Artichoke leaf extract for treating hypercholesterolaemia (2013)
  2. EMA HMPC: European Union herbal monograph on Cynara cardunculus L. (syn. Cynara scolymus L.), folium (2018)

ICD-10: E78.0 · ICD-11: 5C80.00

D

Non-alcoholic fatty liver disease

Not recommended

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. 2023 and --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, 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 (, lipid panel, FibroScan), consider seeking a second opinion from a gastroenterologist.

Sources

  1. AASLD: AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease (2023)
  2. EFSA: Scientific Opinion on the substantiation of health claims related to various foods/food constituents – no anti-aging claim approved (2010)
  3. EMA HMPC: European Union herbal monograph on Cynara cardunculus L. (syn. Cynara scolymus L.), folium (2018)

ICD-10: K76.0 · ICD-11: DB92

D

Type 2 diabetes mellitus

Not recommended

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.

Sources

  1. ADA: Standards of Care in Diabetes 2024 – pharmacologic approaches to glycemic treatment (2024)
  2. EMA HMPC: European Union herbal monograph on Cynara cardunculus L. (syn. Cynara scolymus L.), folium (2018)

ICD-10: E11 · ICD-11: 5A11

How to read tiers A–F
  • AStrong evidence – first or second line in international guidelines
  • BRecommended in selected cases
  • CStudy data contradict each other
  • DBenefit not proven, no documented harm
  • FDocumented harm, or risk without benefit

Mechanism of action

Artichoke leaf extract contains cynarin, chlorogenic acid, luteolin, flavonoids and bitter principles. In animal and in vitro models it stimulates bile secretion (choleretic effect), increases biliary cholesterol excretion, inhibits de novo cholesterol synthesis via HMG-CoA reductase suppression and shows antioxidant activity. In humans the mechanism is partially confirmed: small RCTs documented moderate total cholesterol and reductions (Cochrane 2013 – overall effect small, high heterogeneity). HMPC 2018 recognised artichoke as a traditional herbal medicinal product for dyspeptic complaints and flatulence based on 30 years of traditional use, not on proven efficacy. 2010 rejected all «liver detoxification» and «liver protection» health claims for artichoke.

Safety

Contraindications

  • Pregnancy and lactation (per EMA HMPC)
  • Children under 18
  • Biliary tract obstruction, gallstone disease with active calculi
  • Acute liver and gallbladder disease
  • Allergy to Asteraceae family plants (wormwood, ragweed, chamomile, artichoke)
  • Anticoagulant therapy (warfarin, apixaban, rivaroxaban) – theoretical bleeding risk

Serious adverse effects

  • Biliary colic in patients with gallbladder calculi
  • Anaphylactic reactions (rare) in severe Asteraceae allergy
  • Masking of NAFLD, hepatitis and other liver disease symptoms with diagnostic delay

Common adverse effects

  • Diarrhoea and loose stools (choleretic effect)
  • Flatulence, abdominal cramping
  • Nausea
  • Allergic reactions in patients with Asteraceae intolerance

Pregnancy: can you take Artichoke (Cynara scolymus)?

No RCT data in pregnancy. EMA HMPC 2018 lists pregnancy as contraindication for the traditional herbal product from artichoke. In Russia Hofitol is used in late gestosis under supervision, evidence base small.

Breastfeeding: can you take Artichoke (Cynara scolymus)?

No data on cynarin and chlorogenic acid milk transfer. EMA HMPC 2018 lists lactation as contraindication. Lactating women should avoid.

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Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

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Frequently asked

What is Artichoke (Cynara scolymus) used for?

Artichoke (Cynara scolymus) is evaluated for the following indications with varying evidence strength: Primary hypercholesterolemia (evidence tier C), Non-alcoholic fatty liver disease (evidence tier D), Type 2 diabetes mellitus (evidence tier D). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Artichoke (Cynara scolymus)?

Common side effects of Artichoke (Cynara scolymus) (≥ 1 in 100): Diarrhoea and loose stools (choleretic effect), Flatulence, abdominal cramping, Nausea, Allergic reactions in patients with Asteraceae intolerance. See the Safety section for uncommon and serious reactions.

Is Artichoke (Cynara scolymus) safe during pregnancy?

No RCT data in pregnancy. EMA HMPC 2018 lists pregnancy as contraindication for the traditional herbal product from artichoke. In Russia Hofitol is used in late gestosis under supervision, evidence base small.

Is Artichoke (Cynara scolymus) compatible with breastfeeding?

No data on cynarin and chlorogenic acid milk transfer. EMA HMPC 2018 lists lactation as contraindication. Lactating women should avoid.

Who should not take Artichoke (Cynara scolymus)?

Artichoke (Cynara scolymus) is contraindicated in: Pregnancy and lactation (per EMA HMPC); Children under 18; Biliary tract obstruction, gallstone disease with active calculi; Acute liver and gallbladder disease; Allergy to Asteraceae family plants (wormwood, ragweed, chamomile, artichoke). Full list in the Safety section.

Other drugs in this group

Ascorbic acid, Ashwagandha (Withania somnifera), Astaxanthin, Bacopa monnieri (brahmi), Cordyceps (Cordyceps sinensis, Cordyceps militaris), Lycopene, Pyrroloquinoline quinone (PQQ), Silicon (organic silicon, silica from horsetail or bamboo)