Gall Stones - Artichoke Leaf Extract, Benefits, Side Effects - Page 3

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Digestive System Disorders - Page 3

Benefits of Artichoke
The artichoke plant is best known for its "heart" -- the bottom part of its spiky flower bud that many of us have learned to appreciate as both a delicacy and a nutritious vegetable.  However, other parts of this tall thistle-like plant have proven to be even more beneficial to our health.  Clinical studies show its large basal leaves to be effective for supporting digestion and liver function as well as cholesterol levels.

Since ancient times, humans have looked to nature for help with diseases.  Up until modern times most remedies were derived from the plant kingdom.  Even today, a large percentage of our current pharmaceutical drugs are based on plant extracts from various parts of the world.  Many old herbal remedies, however, have fallen into oblivion with the development of modern medicine.

Artichoke leaf extract is a phyto-pharmaceutical that experiential and clinical effects have been confirmed to a great extent by biomedical research.  Its major active components have been identified as well as some of its mechanisms of action in the human body.

The historical use of the plant includes its use as an antioxidant, liver-protector, bile-enhancer, and lipid-lowering nutrient.  More research is warranted to determine, in detail, the mechanisms of action for these effects.  However, there appears to be enough evidence to suggest a potential role for artichoke extract in some areas where modern medicine does not have much to offer.

Artichoke was used as a food/medical remedy as early as the 4th century B.C.  At the time, a pupil of Aristotle named Theophrastus was one of the first to describe the plant in detail.  Enjoyed as a delicacy, an appetizer, and a digestive aid by the aristocracy of the Roman Empire, it later seems to have fallen into oblivion until the 16th century when medicinal use of the artichoke for liver problems and jaundice was recorded.  In 1850 a French physician successfully used extract of artichoke leaves in the treatment of a boy who had been sick with jaundice and made no improvement.  This accomplishment inspired researchers to find out more about the effects of this extract and spurred their research resulting in the knowledge we have today about its mechanisms of action.

Artichoke leaf extract is made from the long, deeply serrated basal leaves of the artichoke plant.  This part is chosen for medicinal use because the concentration of the biologically active compounds is higher here than in the rest of the plant.  The most active of these compounds have been discovered to be the flavonoids and caffeoylquinic acids.  These substances belong to the polyphenol group and include chlorogenic acid, caffeoylquinic acid derivatives (cynarin is one of them), luteolin, scolymoside, and cynaroside.

Cynarin was the first constituent of the extract to be isolated in 1934.  Interestingly, it is found only in trace amounts in the fresh leaves, but is formed by natural chemical changes that take place during drying and extraction of the plant material.  Cynarin was originally believed to be the one active component of the extract.  Today, the whole complex of compounds is considered important since it has not yet been completely clarified which component is responsible for each effect.  It is claimed that neither cynarin alone nor fresh plant material achieves the potency of the dried total extract (Kirchhoff et al., 1994).

Chlorogenic acid, another major component of the leaf extract, has recently become known as a powerful antioxidant.  Laboratory investigations are ongoing worldwide with findings for future clinical applications in areas such as HIV, cancer, and diabetes.

Most of the modern research on artichoke is with the German artichoke extract, Hepar SL forte, standardized to contain 3% caffeoylquinic acids.  New, even more potent extracts, are now available on the American market (see Digest RC and Artichoke Leaf Extract).

Biological Effects
The most uses of artichoke since ancient times have been as an aid for indigestion and as a liver tonic.  The mechanism of action, however, has been essentially unknown. Recent findings have provided a new foundation for our understanding and additional benefits that the extract provides.

The importance of effective liver function for overall health in general and proper gastrointestinal function is rarely emphasized in this country.  One reason may be that there is neither laboratory evidence nor specific physical symptoms to reveal an overburdened liver in the beginning stages.  The symptoms may be nonspecific such as general malaise, fatigue, headache, epigastric pain, bloating, nausea, or constipation.  Discomfort following meals and intolerance of fat are also notable indications of disturbances in the biliary system.

It is estimated that at least 50% of patients with dyspeptic complaints have no verifiable disease.  Because of the liver's essential role in detoxification, even minor impairment of liver function can have profound effects.  It is important to take such chronic complaints seriously.  In Germany and France, for example, physicians frequently prescribe herbal liver remedies such as artichoke extract with good results when presented with these chronic but non-specific symptoms.

Bloating, Detoxification & Bile Flow
The proven basis for the benefits of leaf extract on the gastrointestinal system is the promotion of bile flow.  Bile is an extremely important digestive substance that is produced by the liver and stored in the gall bladder.  The liver manufactures about one quart a day of bile to meet digestive requirements.  It is secreted into the small intestine where it emulsifies fats and fat-soluble vitamins improving absorption.  Any interference with healthy bile flow can create a myriad of immediate digestive disorders such as bloating.

While digestive enzymes facilitate the breakdown of food in the stomach, the impact of bile acids secreted from the liver into the small intestine may be even more important.  Bile should freely flow into the small intestine to aid in the digestion of fat and protein.  Many European doctors believe that inadequate bile acid flow is a major cause of digestive disorders.

Good bile flow is also essential for detoxification which is one of the major tasks of the liver.  The liver is constantly bombarded with toxic chemicals from the environment -- the food we eat, the water we drink, and the air we breathe.  Bile serves as a carrier for these toxic substances.  It delivers them into the intestines for further elimination from the body.  This is the major route for excretion of cholesterol.  Another feature of bile is helpful here -- its promotion of intestinal peristalsis which helps prevent constipation.

When the excretion of bile is inhibited for various reasons (gall bladder stones or gall bladder disease), toxins and cholesterol stay in the liver longer with damaging effects.  Gall bladder stones obstruct bile ducts.  Other impairments of bile flow within the liver can be alcohol ingestion, viral hepatitis, chemicals, and drugs.  In the initial stages of liver dysfunctions, laboratory tests such as serum bilirubin, alkaline phosphatase, SGOT, LDH, and GGTP often remain normal.  It is not adequate to rely on such tests alone.  Symptoms that may indicate reduced liver function are general malaise, fatigue, digestive disturbances, and sometimes, allergies and chemical sensitivities.

Fatty Livers, Alcohol, & Artichoke
Excessive alcohol consumption is by far the most common cause of impaired liver function in the United States.  It stimulates fat infiltration into the liver cells, causing the so-called "fatty liver."  Some livers are very sensitive to even minute amounts of alcohol -- others are more tolerant.  Recent research suggests that fatty liver is more serious than previously believed -- it may develop into an advanced liver disease such as inflammation, fibrosis, and cirrhosis.

Because of its long historical use for liver conditions, it seemed reasonable to investigate the artichoke plant scientifically and the first clinical studies were conducted in the 1930s with encouraging results.  In the 1990s the interest has been intensified and several excellent clinical studies have been conducted during the last decade.

Realizing the importance of adequate healthy bile flow, German researchers set out to confirm the earlier findings of the artichoke plant in a controlled double-blind study on healthy volunteers (Kirchhoff et al., 1994).  The participants were given a one-time dose of artichoke extract or placebo and their bile secretion was measured with special techniques over the following hours.  The bile secretion was found to be significantly higher in the group that received the artichoke extract.

Another clinical study showed an improvement of symptoms in 50% of patients with dyspeptic syndrome after 14 days of treatment with artichoke leaf extract.  The study involved 60 patients with nonspecific symptoms such as upper abdominal pain, heartburn, bloating, constipation, diarrhea, nausea, and vomiting.  In the placebo group, as a comparison, improvements of less distinct quality were noticed in 38% of the participants (Kupke et al., 1991).

Interesting results were also demonstrated in a large open label study of 417 participants with liver or bile duct disease.  Most of these patients had long-standing symptoms for many years.  They suffered from upper abdominal pain, bloating, constipation, lack of appetite, and nausea.  These patients were treated with artichoke leaf extract for 4 weeks.  After 1 week, around 70% of the patients experienced positive results and after 4 weeks the percentage was even higher (approximately 85%) (Held 1991).

Even more remarkable, another open label study (Fintelmann, 1996) was done involving 553 outpatients with nonspecific dyspeptic complaints.  They were treated with standardized artichoke leaf extract.  The subjective complaints declined significantly within 6 weeks of treatment.  Improvements were found for vomiting (88%), nausea (83%), abdominal pain (76%), loss of appetite (72%), severe constipation (71%), flatulence (68%), and fat intolerance (59%).  Ninety-eight percent of the patients judged the effect of the extract to be considerably better, somewhat better, or equal to that achieved during previous treatment with drugs.  The dose used in this study was 1 to 2 capsules 3 times daily of the preparation Hepar SL Forte.  One capsule contains 320 mg of dry extract of artichoke leaves standardized to provide 3% caffeoylquinic acid.

The study by Fintelmann confirmed the efficacy of the artichoke extract for dyspepsia and demonstrated a significant effect on fat (lipid) metabolism.  In addition, the researchers discovered a significant positive cholesterol and triglyceride blood level relationship which confirmed a discovery made in the 1930s.

Safety
Artichoke leaf extract is well tolerated and has few side effects in recommended dosages.  The use of the artichoke plant as food in many countries over hundreds of years supports its safety.  More important, however, is that several rigorous studies report the absence of adverse side effects when using a standardized extract compared to a placebo.  In a large safety study, only one out of 100 subjects reported mild side effects such as transient increases in flatulence.

Local eczema reactions have been reported after occupational exposure and skin contact with the fresh plant or its dried parts.  Such an allergy should be considered a contraindication for external use of the extract.  No reactions to orally ingesting the extract have been observed.  Because of its bile-stimulating effect, the extract should not be taken by individuals with gall stones or other bile duct occlusion.  Get rid of the stones before you use artichoke.  If doing a search for Dr. Hulda Clark in Yahoo or Google, you will find several links that lead to her suggestions on dealing with gallstones.

Artichoke leaf extract has proven to be a safe and natural way to deal with general health because of its many applications to essential physiological functions.  As a nutritional supplement and antioxidant, it can safely be used as an adjunct to conventional therapies.

How Eastern Europeans Cope with Digestive Disorders
The difference in life expectancy between the best and worst European countries is more than 10 years.  In the early 1990s, overall Eastern European mortality was 20 to 100% higher than in the West.  The reasons for these differences in mortality are attributed to poor diet, excess alcohol consumption, heavy smoking, and other dangerous health behaviors in Eastern Europe.

One dietary explanation for the decreased life span among Eastern Europeans is that their intake of antioxidants from fruits, vegetables, and nuts is much lower compared to the West.  A severe deficiency of antioxidant vitamins, along with a low intake of folic acid and bioflavonoids, partially accounts for the high level of cardiovascular disease in Eastern Europe.

The traditional Eastern European diet consists of lots of animal fats and protein and very little in the way of fresh fruits and vegetables.  This poor diet not only shortens life span, but also creates an epidemic of acute digestive disorders.

While digestive complications increase as people age, the bad health habits of the Eastern Europeans exacerbate common problems such as heartburn, bloating, gas, constipation, nausea, cramps, diarrhea, and irritable bowel syndrome.

 

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