CLINICAL APPLICATIONS

* Dyslipidemia

¡± Hyperlipidemia (high cholesterol and triglycerides levels)

¡± Hypercholesterolemia (high cholesterol levels)

¡± Hypertriglyceridemia (high triglycerides levels)

* Arteriosclerosis and atherosclerosis

 

WESTERN THERAPEUTIC ACTIONS

* Antihyperlipidemic effect to reduce plasma levels of cholesterol and triglycerides

* Reduces absorption of fatty foods and enhances breakdown of fatty tissues

* Antiatherosclerotic effect to prevent arteriosclerosis and atherosclerosis

* Vasodilating, antiplatelet, and anticoagulant effects to prevent angina

 

CHINESE THERAPEUTIC ACTIONS

* Dissolves dampness and eliminates phlegm

* Invigorates blood circulation

 

DOSAGE

Take 3 to 4 capsules three times daily on an empty stomach. For maximum effectiveness, take the last dose one hour prior to bedtime, as synthesis of cholesterol is most active at night. Maintenance dose is 2 capsules two times a day.

 

INGREDIENTS

Cang Zhu (Rhizoma Atractylodis)

Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae)

Ge Gen (Radix Puerariae Lobatae)

He Ye (Folium Nelumbinis)

Hu Zhang (Rhizoma et Radix Polygoni Cuspidati)

Jiao Gu Lan (Rhizoma seu Herba Gynostemmatis)

Ju Hua (Flos Chrysanthemi)

Jue Ming Zi (Semen Cassiae)

Shan Zha (Fructus Crataegi)

Yi Yi Ren (Semen Coicis)

Ze Xie (Rhizoma Alismatis)

Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata)

Zi Mu Xu (Herba Medicaginis)

 

BACKGROUND

Dyslipidemia is the elevation of cholesterol and/or triglycerides levels that contributes to the development of arteriosclerosis and atherosclerosis and increases the risks of coronary artery disorder. Causes of dyslipidemia may be primary (genetic) or secondary (including diet, obesity, diabetes). Optimal treatment requires dietary changes, exercise, and if necessary, use of herbs or drugs to lower lipids.

 

FORMULA EXPLANATION

According to traditional Chinese medicine, cholesterol is considered as an excess deposit of dampness and phlegm in the blood vessels. To effectively reduce plasma levels of cholesterol and triglycerides, treatment must focus on dissolving dampness, eliminating phlegm, and invigorating blood circulation.

        To dissolve dampness, diuretic and digestive herbs are used in Cholisma. Shan Zha (Fructus Crataegi) is the primary digestive herb used to break down animal fat. It has been found to be effective in lowering serum cholesterol and blood pressure. Ze Xie (Rhizoma Alismatis) and Yi Yi Ren (Semen Coicis) are two diuretic herbs that have actions similar to choline and lecithin to lower blood sugar and cholesterol. Jue Ming Zi (Semen Cassiae), He Ye (Folium Nelumbinis), Ju Hua (Flos Chrysanthemi) and Jiao Gu Lan (Rhizoma seu Herba Gynostemmatis) clear damp-heat, lower serum cholesterol and blood pressure. Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) is a unique herb that tonifies Kidney jing (essence) and reduces cholesterol and triglycerides at the same time. With its aromatic property, Cang Zhu (Rhizoma Atractylodis) dries up dampness and eliminates phlegm. Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) invigorates blood circulation, improves microcirculation, inhibits coagulation of blood, and lowers blood cholesterol. Hu Zhang (Rhizoma et Radix Polygoni Cuspidati) detoxifies the Liver and lowers the cholesterol. Ge Gen (Radix Puerariae Lobatae) dilates blood vessels to lower blood pressure. Zi Mu Xu (Herba Medicaginis) may reduce cholesterol absorption from food and atherosclerotic formation.

        Overall, Cholisma effectively lowers cholesterol and triglyceride levels by dissolving dampness, eliminating phlegm, and invigorating blood circulation.

 

CAUTIONS & CONTRAINDICATIONS

* Jue Ming Zi (Semen Cassiae), Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) and Ju Hua (Flos Chrysanthemi) may cause loose stools or diarrhea for those with sensitive gastrointestinal tracts. Should this occur, reduce the dosage to 2 capsules three times daily.

* Hypertension should also be suspected if the patient has high cholesterol. Treat both hypertension and dyslipidemia simultaneously for maximum results.

* This herbal formula contains herbs that invigorate blood circulation, such as Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[1]

* According to most textbooks and contemporary references, the classic entry of "He Shou Wu" is now separated into two entries: the unprepared Sheng Shou Wu (Radix Polygoni Multiflori) and the prepared Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata), as they have significantly different therapeutic effects and side effects. Sheng Shou Wu (Radix Polygoni Multiflori) is a stimulant laxative that treats constipation, but may cause nausea, vomiting, abdominal pain, diarrhea, and in rare cases, liver disorder (dose- and time-dependent, and reversible upon discontinuation).[2] On the other hand, Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) is a tonic herb that is safe and well-tolerated. The dramatic changes in the therapeutic effect and safety profile are attributed to the long and complicated processing of the root with Hei Dou (Semen Sojae) through repeated blending, cooking, and drying procedures. When properly processed, the chemical composition of the root changes significantly. Many new compounds are generated from the Maillard reaction (four furanones, two furans, two nitrogen compounds, one pyran, one alcohol and one sulfur compound). Furthermore, the preparation process causes changes in the composition of sugars and 16 kinds of amino acids; it also reduces the pH of the herb from 6.28 to 5.61.[3],[4] In summary, these changes give rise to the tonic effects of the prepared roots, and eliminate the adverse reactions associated with the unprepared roots. Note: Due to medical risks and legal liabilities, it is prudent to exercise caution and not use this herb in either prepared or unprepared forms in patients with pre-existing or risk factors of liver diseases.

 

CLINICAL NOTES

* The baseline cholesterol level should be established prior to the initiation of herbal therapy; and the first follow-up test should be done one month after the initiation of herbal therapy. Subsequent follow-ups can be done every two to three months to determine overall effectiveness. Cholesterol testing kits are available over-the-counter in most pharmacies. Results may vary from patient to patient. Lifestyle and dietary changes are also crucial for satisfactory results.

* Cholisma is specifically formulated to reduce blood cholesterol and triglyceride levels. Patients must take this herbal formula on a long-term basis for maximum results.

* Dyslipidemia has many secondary causes (obesity, diabetes, hypothyroidism, and use of drugs such as thiazides, beta-blockers, estrogen and progestins, and glucocorticoids) and multiple complications (atherosclerosis, arteriosclerosis, coronary artery disease, angina pectoris and hypertension). Therefore, optimal treatment must address both the causes and the complications. See Supplementary Formulas for more details.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* The overall general feel of the pulse is greasy. A greasy pulse is a pulse in which its border is not clear due to plaque built-up on the arterial wall. The more forceful and harder the pulse is, the worse the plaque built-up. The amplitude of the pulse is also limited.

 

SUPPLEMENTARY FORMULAS

* For obese patients with an excess appetite, add Herbalite.

* For fatty liver and obesity, use Cholisma (ES).

* For diabetes mellitus and high blood glucose, add Equilibrium.

* For hypothyroidism, add Thyro-forte.

* For hypertension with dizziness or vertigo, combine with Gastrodia Complex.

* For hypertension with anger or flushed face, combine with Gentiana Complex.

* For edema, add Herbal DRX.

* For excess heat in the body, add Gardenia Complex.

* For excessive blood stagnation in the body, add Circulation (SJ).

* For coronary heart disorders, add Circulation.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Bleed Weizhong (BL 40) or wherever there is a visible, dilated vein in the area of the transverse crease of the popliteal fossa.

* Taichong (LR 3), Xingjian (LR 2), Zusanli (ST 36), Quchi (LI 11), Fenglong (ST 40)

* Gongsun (SP 4), Sanyinjiao (SP 6), Zhongwan (CV 12), Ququan (LR 8)

 

Classic Master Tung's Points:

* Fuding (T 44.04), Houzhi (T 44.05), Luotong (T 44.14), Zhitong (T 44.13), Xinling (T 33.17)*, Linggu (T 22.05), Jianzhong (T 44.06), Dizong (T 44.09)

 

Master Tung¡¦s Points by Dr. Chuan-Min Wang:

* Elevated cholesterol or triglyceride: Bleed Sihuashang (T 77.08), Sihuazhong (T 77.09), Sihuafu (T 77.10), Sihuaxia (T 77.11). Needle Qimen (T 33.01), Qijiao (T 33.02), Qizheng (T 33.03), Muliu (T 66.06), Mudou (T 66.07).

 

Balance Method by Dr. Richard Tan:

* Left side: Yinlingquan (SP 9), Xuehai (SP 10), Waiguan (TH 5)

* Right side: Zusanli (ST 36), Fenglong (ST 40), Daling (PC 7), Laogong (PC 8)

* Alternate sides from treatment to treatment.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Coronary heart disease: Heart, Liver, Chest, Small Intestine, Sympathetic, Coronary Vascular Subcortex

 

NUTRITION

* Increase the daily intake of cholesterol-lowering foods such as apples, bananas, carrots, cold-water fish, dried beans, garlic, grapefruit, olive oil, and fibers such as bran and oats.

* Increase the intake of niacin, which can lower total cholesterol levels by up to 18%, increase HDL cholesterol by up to 32%, and lower triglycerides by up to 26%. Slow release form of niacin is preferred to minimize side effects such as flushing and stomach pain.

* Other supplements that are beneficial are vitamin B5, vitamin C, vitamin E, chromium picolinate, lecithin, and coenzyme Q10.

* Increase the intake of vinegar, as it will help to soften the blood vessels and prevent atherosclerosis.

* Decrease the intake of food that will raise cholesterol levels, including but not limited to: beer, wine, cheese, tobacco products, meat, aged and cured meats, sugar, and greasy or fried foods.

* Avoid greasy, fatty, fried and oily foods. Seafood should also be reduced.

 

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Make soup with diced artichoke hearts, sliced ginger, and 1/2 head of cabbage. Eat a bowl daily.

* Drink one glass daily of pureed asparagus juice, including the pulp; add one teaspoon of honey.

* Use white mushrooms and corn silk to make soup or tea regularly.

* Add rice bran to a grain dish every day for at least two months.

* Incorporate pinto beans and other beans that are high in fiber and rich in folate that lowers cholesterol into the diet regularly.

 

LIFESTYLE INSTRUCTIONS

* Exercise is the best way to decrease the buildup of cholesterol in the arteries. It also helps to reduce weight.

* Drink tea on a daily basis, especially after meals, to facilitate the elimination of fatty foods from the diet. Beneficial teas include pu-er, black, oolong or green tea.

* Avoid the use of alcohol and exposure to tobacco. They increase cholesterol buildup and hardening of the arteries.

 

CASE STUDIES

* A 39-year-old male patient presented with a history of loose stools, allergies, and poor circulation with high cholesterol. His reports showed 263 mg/dL for total cholesterol levels. The practitioner diagnosed this condition as Spleen qi deficiency with damp and phlegm accumulation. Cholisma was prescribed at 6 grams a day for about five months. After taking the herbs for five months, the patient retested his cholesterol levels and it had dropped to 228 mg/dL. He was very happy with the results, which he attributed mostly to Cholisma. He had also increased his exercise and was eating healthier as well. Submitted by A.Z., Los Angeles, California.

* P.Z., a 61-year-old male, presented with high triglycerides. His tongue was red with yellow tongue coating. His pulse was wiry and slippery. The patient was overweight. Cholisma was prescribed at 4 capsules three times daily. His triglycerides dropped from 250 to 136 mg/dL after herbal and acupuncture treatments. Submitted by W.F., Bloomfield, New Jersey.

* A 31-year-old female who went to her medical doctor for a postpartum check-up had a blood cholesterol level of 375 mg/dL. Since she was nursing, her doctor refused to prescribe any drugs. She decided to begin herbal treatment with marked changes to the diet and lifestyle. She was instructed to take Cholisma, 2 grams three times daily. In addition, she exercised for 30 minutes three times per week. Furthermore, she avoided red meat and carbohydrate as much as possible, and increased the intake of fresh fruits and vegetables. Two months after the initial check-up, her cholesterol was reduced from 375 to 266 mg/dL. The patient continued to take Cholisma. Submitted by J.C., Diamond Bar, California.

* K.N., a 69-year-old female, presented with left hand trigger finger and low back pain. It was also noted that she had high cholesterol shown by lab results and borderline high blood pressure. The TCM diagnosis was Liver and Kidney yin deficiencies with Lung heat; her Western diagnosis was hypertension and arthritis. Cholisma was prescribed, in which a reduction of her cholesterol levels were experienced as well as normal blood pressure again. In addition to taking the herbs, the patient was swimming for exercise. Submitted by M.P., Muskego, Wisconsin.

* R.L., a 79-year-old female, presented with post-stroke symptoms of paralysis on the right side (leg, arm, and face). Her blood pressure was 140/80 mmHg and the heart rate was 90 beats per minute. She also had high cholesterol. She was diagnosed with wind-stroke with blood stagnation. Neuro Plus and Cholisma were prescribed at 4.5 grams and 1.5 grams each day, respectively. This patient also received acupuncture. After ten weeks of treatment, the patient regained movement of her leg and partial movement of her arm and almost full movement of her face and mouth. Neuro Plus also helped the patient regain strength. These were very quick results. In addition, the cholesterol level dropped from 250 to 180 mg/dL. Submitted by W.F., Bloomfield, New Jersey.

* A 46-year-old female speech therapist presented with weight gain, pain in the left arm and a slow metabolism. Her cholesterol reading was noted at 280 mg/dL. The TCM diagnosis included damp and phlegm stagnation as well as blood stagnation as indicated by a red tongue body with a thick tongue coating and a ¡§rolling¡¨ pulse. Within three months of taking Cholisma, her cholesterol reading decreased to 220 mg/dL. Within six months of exclusively taking Cholisma, her cholesterol reading fell to 198 mg/dL. Submitted by T.G., Albuquerque, New Mexico.

* A 22-year-old female presented with high triglycerides and high ALT. The patient appeared thin and pale. Her limbs were always cold and she was easily agitated. Her blood pressure was 115/70 mmHg and the heart rate was 72 beats per minute. The TCM diagnosis was yang deficiency with heat in the Liver. She was prescribed Liver DTX at 3 capsules three times a day with Cholisma at 2 capsules twice a day. She also received acupuncture. After six weeks, her liver enzymes and triglycerides levels returned to normal. Submitted by W.F., Bloomfield, New Jersey.

* A 50-year-old unemployed male presented with a family history of heart disease and diabetes. He was also described as overweight and extremely irritated. With increased levels of triglycerides, cholesterol and VLDL, the practitioner diagnosed the patient with dyslipidemia. The TCM diagnosis was Liver and Kidney yin deficiency. The patient took Cholisma continuously for one year, but refused to do another laboratory test in order to note any significant changes. Without any changes to his diet and physical activities, he was still able to lose weight. The practitioner recommended Cholisma to his other patients with similar conditions. He also noted that Cholisma worked slower in comparison with drugs such as Lipitor (atorvastatin) and Zocor (simvastatin). Submitted by F.A., Calabasas, California.

* J.L., an 86-year-old male, presented with hypertension, insomnia, anxiety and high cholesterol. His blood pressure was 180/90 mmHg and the heart rate was 60 beats per minute. The blood pressure was higher in the morning (180-190/90-95 mmHg) than in the evening (170-180/85-90 mmHg). The TCM diagnosis was damp-heat accumulation. Gastrodia Complex at 4.5 grams a day and Cholisma at 1.5 grams a day were prescribed. This patient also received acupuncture. After six weeks of treatment, both morning and evening blood pressure were down to an average of 147/80 mmHg. Submitted by W.F., Bloomfield, New Jersey.

* L.L., a 56-year-old female, presented with frustration, anger and sadness over losing her home in the hurricanes. She was unable to move through these emotions. She was also diagnosed with hypertension, high cholesterol, and post-traumatic stress syndrome recently, and refused to take medications. Her blood pressure was 138/78 mmHg and her heart rate was 82 beats per minute. She also suffered from headaches in the temporal region and the vertex. Other symptoms included twitching of the eyes, agitation, red eyes, and a scalloped tongue with thick yellow tongue coating. The TCM diagnoses were damp-heat in the Liver and Gallbladder, Kidney yin deficiency, and excess fire and wind rising. She was prescribed the following formulas: Calm (ES) at 1 to 3 capsules, as needed, Cholisma at 4 capsules twice daily, and Gentiana Complex at 5 capsules twice daily. The patient gained control of her emotions immediately after taking Calm (ES). Blood pressure gradually reduced over time to 120/72 mmHg. The practitioner commented that the combination of these formulas is phenomenal. Submitted by M.H., West Palm Beach, Florida.

* M.C., a 49-year-old highly-stressed executive, presented with elevated SGPT, LDL and cholesterol levels. He stated he frequently checked his blood pressure and it ranged from 135-148/85-91 mmHg. He was never diagnosed with hypertension but had an upcoming insurance physical and wanted to lower his blood pressure naturally [without using drugs]. He also complained of low-grade temporal headaches, a pressured feeling in the head, and neck and shoulder tension. His blood pressure at the time of examination was 148/94 mmHg and his heart rate was 72 beats per minute. He worried excessively, in part because his son was diagnosed with a brain tumor ten years ago. He also suffered from insomnia, and fist clenching that lasted throughout the day. He said that his stress caused numbness and tension of his left shoulder and rhomboid area. The TCM diagnoses include Liver qi stagnation and Spleen qi deficiency. Cholisma at 4 capsules three times daily and Liver DTX at 5 capsules at night were prescribed. He reported after taking the herbs that he passed his insurance exam. Blood pressure has stayed down at 120/72 mmHg. His stress was manageable and there were no more headaches. His energy level was also excellent. His cholesterol levels also dropped from 216 to 186 mg/dL. The practitioner reported that the patient is now a believer of herbs. Submitted by M.H., West Palm Beach, Florida.

* E.S., a 48-year-old male, presented with hypercholesterolemia and hypertension. His pulse was deep and slippery; his tongue was normal. The patient refused acupuncture treatment, requesting only herbal treatment. Cholisma was prescribed at two grams, three times daily on November 4, 2004, along with recommendations for improved diet and exercise habits. After two months of herbal therapy, lab reports [table below] showed significant reduction of total cholesterol, LDL and triglyceride levels, and an increase of healthy HDL. There was also a reduction of blood pressure. The patient continues to take the herbs. Lab reports before and after commencement of herbal treatments show significant improvements. Submitted by C.L., Chino Hills, California.

Lab Tests for E.S.	10-21-2004	11-04-2004	01-13-2005
Cholesterol	221 mg/dL	Herbal Treatment	206 mg/dL
HDL	66 mg/dL		69 mg/dL
LDL	141 mg/dL		123 mg/dL
Triglycerides	73 mg/dL		68 mg/dL
Blood Pressure	140/100 mm Hg		118/80 mm Hg

                               

PHARMACOLOGICAL AND CLINICAL RESEARCH

Cholisma is formulated with both Chinese and Western herbs that have been proven to reduce blood cholesterol and triglyceride levels. All the herbs work in synergy to reduce blood cholesterol and triglycerides levels by reducing the absorption of fatty foods, enhancing the breakdown of fatty tissues and decreasing the synthesis of cholesterol.

        Cholisma contains many herbs with multiple mechanisms of actions to lower plasma cholesterol and triglycerides. Zi Mu Xu (Herba Medicaginis) has been shown to reduce cholesterol absorption and decrease atherosclerotic formation.[5]^,[6],[7] It significantly reduces cholesterol absorption through direct binding in the gastrointestinal tract.[8] Zi Mu Xu (Herba Medicaginis) also reduces the cholesterol level by decreasing the accumulation and synthesis of cholesterol in the liver.[9] Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) reduces intestinal absorption of dietary cholesterol, and has been shown to decrease triglycerides and low-density lipoproteins but increase high-density lipoproteins.[10]^,[11],[12] He Ye (Folium Nelumbinis) has an antihyperlipidemic effect and effectively ameliorates lipid metabolic disorders (dyslipidemia, hypercholesterolemia, and fatty liver) caused by high fat diet, with efficacy similar to that of silymarin and Zocor (simvastatin).[13] Hu Zhang (Rhizoma et Radix Polygoni Cuspidati) and Jiao Gu Lan (Rhizoma seu Herba Gynostemmatis) have similar effects, as they both lower triglyceride, total cholesterol, and low-density lipoprotein levels.[14]^,[15],[16] Jue Ming Zi (Semen Cassiae) has multiple therapeutic benefits: it decreases low-density lipoproteins, increases high-density lipoproteins, and lowers blood pressure without any serious adverse effects.[17]^,[18],[19] Shan Zha (Fructus Crataegi) also has marked effectiveness for reduction of plasma cholesterol levels. It enhances LDL-receptor activity, increases hepatic breakdown, and decreases synthesis of cholesterol.[20]^,[21]

        Clinically, many studies have been conducted to demonstrate the therapeutic benefits of these herbs. According to one study, administration of Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) showed a 90.93% rate of effectiveness to treat 32 patients with elevated cholesterol levels.[22] According to another study, 48 patients treated with Jue Ming Zi (Semen Cassiae) in syrup for two months reported reduction in blood cholesterol in 95.8% of the patients, reduction in triglycerides in 86.7%, and reduction of beta-lipoprotein in 89.5%.[23] Lastly, 30 patients with elevated cholesterol levels were treated with 90% rate of effectiveness using an herbal formula that contained Shan Zha (Fructus Crataegi), Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae), and Ge Gen (Radix Puerariae Lobatae).[24]

        In addition to lowering plasma cholesterol and triglycerides, Cholisma contains herbs to treat arteriosclerosis and atherosclerosis and reduce risks of heart attacks. Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) has antiatherosclerotic benefits and has been shown to prevent development of atherosclerotic lesions.[25] The mechanism of action is the inhibition of the expression of intercellular adhesion molecule (ICAM)-1 and vascular endothelial growth factor (VEGF) in foam cells.[26] Furthermore, several herbs in this formula, such as Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae), have antiplatelet and anticoagulant activities to prevent formation of blood clots.[27]^,[28] In addition, Ge Gen (Radix Puerariae Lobatae) and Shan Zha (Fructus Crataegi) have a vasodilating effect to dilate coronary artery and prevent heart attack.[29]^,[30],[31] Clinically, these herbs have been used successfully to treat many cardiovascular disorders, such as angina,[32] thrombosis,[33] coronary artery disorder,[34] and transient ischemic attack.[35]

        In summary, Cholisma is an excellent formula to treat dyslipidemia, arteriosclerosis and atherosclerosis, and prevent heart attack.

 

COMPARATIVE ANALYSIS

Dyslipidemia is the accumulation of abnormally high levels of fats (cholesterols, triglycerides, or both) in the blood. If untreated, dyslipidemia can lead to the development of arteriosclerosis and atherosclerosis and significantly increase the risk of coronary artery disease (CAD). One of the most common misconceptions about dyslipidemia is that this condition is ¡§genetically predetermined,¡¨ and therefore, can only be treated with pharmaceutical drugs. This is incorrect because diet and lifestyle changes are the most effective prevention and treatment modalities. However, most practitioners and patients are ¡§commercially preconditioned¡¨ into believing drugs are the best and only treatment. As such, drugs for dyslipidemia are now among the most commonly prescribed drugs in the United States.

        There are several categories of drugs that may be used to treat dyslipidemia. The most commonly used category is HMG-CoA reductase inhibitors, with examples such as Lipitor (atorvastatin), Zocor (simvastatin), and Pravachol (pravastatin). Also known as ¡§statin¡¨ drugs, these drugs reduce plasma cholesterol and triglyceride levels by reducing their synthesis in the liver. In most cases, these drugs are effective and are well tolerated. However, these drugs have been shown to cause serious and potentially life-threatening side effects in a small number of patients, such as rhabdomyolysis with kidney failure (0.5%), liver impairment (2.3%), and increased risk of liver cancer.[36] Furthermore, discontinuation of these drugs is frequently associated with a rebound increase of cholesterol and triglyceride levels. Given the potential risks versus benefits, it is important to take drugs only when necessary, and once on drug therapy, be monitored closely by a medical doctor so the drug can be discontinued immediately if these serious side effects begin to develop.

        According to TCM, dyslipidemia is diagnosed as the accumulation of damp and phlegm in the blood vessels. This condition may be treated effectively with herbs, with gradual and consistent reduction of plasma cholesterol levels by an average of 10 to 15 mg/dL per month. However, the therapeutic effects of herbs may require two to three months before they become more noticeable. The herbs in Cholisma are very well tolerated by patients, and are associated with few or no known side effects.

        Dyslipidemia is a serious condition that requires treatment. The best and most effective treatment is diet and lifestyle changes, as outlined earlier in this monograph. Herbal therapy may be added to facilitate and enhance the overall results. Lastly, and only if necessary, drug therapy may be used but only with careful screening and supervision.