Artichoke Extract: Improves Digestion, Liver Function & Cholesterol Levels]

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ARTICHOKE EXTRACT: Improves Digestion, Liver Function, and Cholesterol

Levels

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The globe artichoke (Cynara scolymus) is not only a delicious nutritious

food it is also a valuable medicine. It's historical and folk-use as a

digestive aid and liver remedy is being validated by detailed scientific

investigation including double-blind clinical studies. The modern use of

artichoke as a medicine utilizes extracts of the leaves of the plant

standardized for key components known as caffeoylquinic acids.

 

How does artichoke extract work?

 

Its basic mechanism of action centers around its affect on the liver. First

of all, artichoke extract has been shown to enhance detoxification reactions

as well as protect the liver from damage.1-3 This combination of effects is

very important to healthy liver function. During detoxification of toxic

substances in the liver the toxic substance is often initially converted to

an even more toxic form. Without adequate protection, every time the liver

neutralizes a toxin, it is damaged in this process. Artichoke extract has

been shown to provide this valuable protection.

 

Once the liver has modified a toxin, it needs to be eliminated from the body

as soon as possible. One of the primary routes of elimination is through the

bile. However, when the manufacture of bile is reduced or the excretion of

bile is inhibited (a condition called cholestasis), toxins stay in the liver

and body longer. Another beneficial effect of artichoke is that is acts as a

choleretic.

 

What is a choleretic?

 

A choleretic is a substance that increases the formation and flow of bile to

and from the liver. Bile is a thick, yellowish-green fluid excreted from the

liver, stored in the gallbladder, and released into the intestine to aid in

the digestion and absorption of fats. Bile contains more than 97% water. Its

most important components, however, are bile acids (also referred to as bile

salts). Bile acids are natural emulsifying compounds that form complexes

with fatty materials in the gut to aid in their assimilation. Bile also

plays an important role in making the stool soft by promoting the

incorporation of water into the stool. Without enough bile, the stool can

become quite hard and difficult to pass. Bile also helps to keep the small

intestine free from microorganisms (parasites).

 

In experimental animal and human studies, artichoke extract has increased

the flow of bile by 90 to 150%!1 In one study, artichoke extract

administered as a single dose of 1.92 g produced a 127.3% increase in bile

secretion after 30 minutes; after 60 minutes, 151.5%; and after another 60

minutes, 94.3%.4

 

Why is artichoke extract's choleretic effect important?

 

Decreased bile flow is a common cause of digestive disturbance including fat

malabsorption, excessive flatulence (gas), bloating after eating, and

constipation (or diarrhea). Increasing bile flow is also very important in

treating a condition of the liver known as cholestasis.

 

Cholestasis has several causes, including obstruction of the bile ducts and

impairment of bile flow within the liver. The most common cause of

obstruction of the bile ducts is the presence of gallstones. Currently, it

is conservatively estimated that 20 million people in the U.S. have

gallstones. Nearly 20% of the female and 8% of the male population over the

age of 40 are found to have gallstones on biopsy and approximately 500,000

gallbladders are removed because of stones each year in the U.S. The

prevalence of gallstones in this country has been linked to the high-fat,

low-fiber diet consumed by the majority of Americans.

 

Impairment of bile flow within the liver can be caused by a variety of

agents and conditions, as listed in Table 1. These conditions are often

associated with alterations of liver function in laboratory tests (serum

bilirubin, alkaline phosphatase, SGOT, LDH, GGTP, etc.) signifying cellular

damage. However, relying on these tests alone to evaluate liver function is

not adequate, since, in the initial or subclinical stages of many problems

with liver function, laboratory values remain normal. Among the symptoms

people with enzymatic damage may complain of are fatigue, general malaise,

digestive disturbances, allergies and chemical sensitivities, premenstrual

syndrome, and constipation. Artichoke extract may ultimately be shown to be

helpful in all of these conditions via improved liver function. Table 1.

Causes of Cholestasis

 

Presence of gallstones

Alcohol

Endotoxins

Hereditary disorders such as Gilbert's syndrome

Hyperthyroidism or thyroxine supplementation

Viral hepatitis

Pregnancy

Certain chemicals or drugs:

Natural and synthetic steroidal hormones:

Anabolic steroids

Estrogens

Oral contraceptives

Aminosalicylic acid

Chlorothiazide

Erythromycin estolate

Mepazine

Phenylbutazone

Sulphadiazine

Thiouracil

 

 

 

 

Perhaps the most common cause of cholestasis and impaired liver function is

alcohol ingestion. In some especially sensitive individuals, as little as 1

oz of alcohol can produce damage to the liver, which results in fat being

deposited within the liver. All active alcoholics demonstrate fatty

infiltration of the liver.

 

How does artichoke extract compare with milk thistle extract?

 

Artichoke extract is very similar to milk thistle extract - a popular herbal

liver remedy and detoxification enhancer. First of all, both plants are

members of the thistle family. Their active compounds, cynarin and

silymarin, respectively, are also quite similar. As far as which is better,

it really depends upon the patient. For patients with viral hepatitis (acute

or chronic), I think silymarin is a better choice.

 

Milk thistle extract standardized for silymarin content (e.g., 70%) have

been shown to be effective in both acute and chronic viral hepatitis in

double-blind, controlled studies. Recently, a new form of silymarin has

emerged that may provide even greater benefit. The new form binds silymarin

to phosphatidylcholine (referred to as silymarin phytosome). A growing body

of scientific research indicates that silymarin phytosome is better absorbed

and produces better clinical results than unbound silymarin.5-8 These

benefits were demonstrated in one study involving 232 patients with chronic

hepatitis (viral, alcohol, or chemically-induced) treated with silymarin

phytosome at either 120 mg twice daily or 120 mg three times daily for up to

120 days.8 Liver function tests were compared to a group of controls (49

treated with a commercially available unbound silymarin; 117 untreated or

given placebo). Liver function returned to normal faster in the patients

given silymarin phytosome in all

patients and in all subtypes compared to both the commercially available

silymarin or placebo.

 

I also think that phosphatidylcholine bound silymarin is a better choice in

patients with gallstones. In regards to artichoke extract, I think it is a

better choice as a general tonic to improve liver function and

detoxification. I also think artichoke extract is a better choice as a

digestive aid in patients with digestive disturbance such excessive

flatulence, bloating after eating, and constipation (or diarrhea).

 

Can artichoke extract really help improve digestion?

 

Absolutely. The evidence is provided by the results of a study evaluating a

standardized artichoke extract in 553 patients with various digestive

disorders.9 The average patient age was 54.7 years old in the study. The

average duration of use was 43.5 days. The most prominent diagnoses were

dyspeptic discomforts (gas, bloating, intestinal cramping), functional

biliary colic (gallbladder attacks), and severe constipation. The associated

digestive disturbances had been present on average for 155 weeks prior to

inclusion in the study - obviously these symptoms were of a chronic nature.

The standardized artichoke preparation was typically taken at a dosage of

one to two of the 320 mg capsules three times daily.

 

The digestive disturbances regressed after six weeks of treatment on average

by 70.5%; the most pronounced regression was found for vomiting (88.3%),

nausea (82.4%), abdominal pain (76.2%), loss of appetite (72.3%),

constipation (71.0%), flatulence (68.2%), and fat intolerance (58.8%). In

85% of patients the therapeutic efficacy of artichoke extract was judged by

the physicians as excellent or good, in 12% as moderate and in 3% as

insufficient or minimal.

 

In another study of patients suffering from abdominal pain, bloating,

constipation, lack of appetite, and nausea, artichoke extract produced

improvements in 65 to 72% of patients after one week and 80 to 92% after 6

weeks.

 

Can artichoke extract help with the irritable bowel syndrome?

 

The irritable bowel syndrome (IBS) is a disorder of the large intestine

Characterized by some combination of: (1) abdominal pain, (2) altered bowel

function, constipation, or diarrhea, (3) hypersecretion of colonic mucus,

(4) dyspeptic symptoms (flatulence, nausea, anorexia), and (5) varying

degrees of anxiety or depression. IBS has been referred to in the past as

nervous indigestion, spastic colitis, mucous colitis, and intestinal

neurosis.

 

Artichoke extract can help with IBS, but I would recommend giving

enteric-coated peppermint oil a try first. Several double-blind studies have

shown enteric-coated peppermint oil capsules to be a very effective

treatment of the irritable bowel syndrome. Enteric coating involves coating

the capsule in a manner that will not allow the capsule to break down until

after it has passed through the stomach and into the small intestine.

Enteric coating is necessary, as menthol (the major constituent of

peppermint oil) and other volatile compounds in peppermint oil would cause

relaxation of the sphincter separating the esophagus and the stomach.

Without enteric coating, a significant amount of heartburn that can be

produced.

 

The most recent, and perhaps the best-designed, study with enteric-coated

peppermint oil involved 110 patients with symptoms of IBS.10 The patients

took one capsule of either enteric-coated peppermint oil (0.2 ml) or a

placebo three to four times daily, 15-30 minutes before meals, for one

month. The results on the major symptoms of IBS are given below:

 

 

Parameter ECPO Placebo

Abdominal pain 79% 79%

Abdominal distension 83% 29%

Stool frequency 83% 33%

Borborygmi 73% 31%

Flatulence 79% 22.5%

 

 

These results are quite impressive, especially given the safety of

enteric-coated peppermint oil. Only two cases of side effects were

reported - one patient developed heartburn (because of chewing the tablet)

and one patient developed a transient skin rash.

 

Enteric-coated peppermint oil is thought to work by improving the rhythmic

contractions of the intestinal tract and relieving intestinal spasm. An

additional benefit of peppermint oil is its effectiveness against Candida

albicans. This action is important in the IBS as an overgrowth of C.

albicans may be an underlying factor, especially in cases that do not

respond to dietary advice and for those who consume large amounts of sugar.

 

If you have IBS, I would recommend giving artichoke a try only if the

enteric-coated peppermint oil does not provide relief after a one-month

trial.

 

What about lowering cholesterol?

 

Artichoke extract exerts a dual effect on cholesterol metabolism. First of

all, it decreases the manufacture of cholesterol in the liver.11

Approximately 80-90% of the cholesterol in the blood is manufactured by the

liver and is not derived from the diet. The other way in which artichoke

extract effects cholesterol levels is by increasing the conversion of

cholesterol to bile acids.1,11 One of the functions of cholesterol is to be

the building block of bile acids. I think in many people one of the reasons

that their cholesterol levels are high is because there is impaired

conversion of cholesterol to bile acids. In this scenario, I believe the low

bile acid levels result in sending a powerful signal to the liver to provide

more cholesterol.

 

In the study evaluating artichoke extract in 553 patients with various

digestive disorders in addition to improving digestion, the artichoke

extract significantly lowered blood cholesterol levels.9 In spite of the

relatively short duration of therapy (6 weeks on average), the study showed

an 11.5% reduction in the average serum cholesterol from an initial average

of 264 mg/dl to 233 mg/dl. Serum trigylcerides were also reduced from

initially 214.97 mg/dl to 188.07 mg/dl, corresponding to a decrease of

12.5%.

 

What is the proper dosage for artichoke extract?

 

The first thing you need to look for is to make sure that the extract

provides 13-18% caffeoylquinic acids calculated as chlorogenic acid. The

dosage for such a preparation is 160 to 320 mg three times daily with meals.

 

Is artichoke extract safe?

 

Absolutely - it is a food-based extract. In a large safety study only one

out of one hundred subjects reported mild side effects (e.g., transient

increase in flatulence). In other words, 99 out of 100 experienced

absolutely no side effect.9

 

References:

 

Kraft K: Artichoke leaf extract - Recent findings reflecting effects on

lipid metabolism, liver and gastrointestinal tracts. Phytomedicine 4:369-78,

1997.

Gebhardt R: Antioxidative and protective properties of extracts from leaves

of the artichoke (Cynara scolymus L.) against hydroperoxide-induced

oxidative stress in cultured rat hepatocytes. Toxicol Appl. Pharmacol.

144:279-286, 1997.

Gebhardt R: Hepatoprotection through artichoke extracts. Pharmazeutische

Zeitung 140:34-37, 1995.

Kirchoff R, et al.: Increase in choleresis by means of artichoke extract.

Phytomedicine 1:107-115, 1994.

Vailati A, et al.: Randomized open study of the dose-effect relationship of

a short course of IdB 1016 in patients with viral or alcoholic hepatitis.

Fitoterapia 44(3):219-28, 1993.

Mascarella S, et al.: Therapeutic and antilipoperoxidant effects of

silybin-phosphatidylcholine complex in chronic liver disease: Preliminary

results. Curr Ther Res 53(1):98-102, 1993.

Buzzelli G, et al.: A pilot study on the liver protective effect of

silybin-phosphatidylcholine complex (IdB1016) in chronic active hepatitis.

Int J Clin Pharmacol Ther Toxicol 31:456-60, 1993.

Marena C and Lampertico: Preliminary clinical development of silipide: A new

complex of silybin in toxic liver disorders. Planta Medical 57(S2):A124-5,

1991.

Fintelmann V: Antidyspeptic and lipid-lowering effects of artichoke leaf

extract - Results of clinical studies into the efficacy and tolerance of

Hepar-SL® forte involving 553 patients. J Gen Med 2:3-19, 1996.

Liu JH, et al.: Enteric-coated peppermint oil capsules in the treatment of

irritable bowel syndrome: A prospective, randomized trial. Gastroenterol

32:765-8, 1997.

Gebhardt R: Artichoke extract- - In-vitro proof of cholesterol biosynthesis

inhibition. Medwelt 46:348-350, 1995.