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, and diabetes). Complications
of dyslipidemia include atherosclerosis, arteriosclerosis, coronary artery disease, angina pectoris,
hypertension and fatty liver. Optimal treatment requires dietary changes,
exercise, and if necessary, use of herbs or drugs to lower lipids.
to traditional Chinese medicine, cholesterol and triglycerides are considered
as excess accumulations of dampness (hyperglycemia) and phlegm in the blood
vessels (dyslipidemia), liver (fatty liver), and
body (obesity). To effectively reduce plasma levels of cholesterol and
triglycerides, treat fatty liver, and reduce body weight, treatment must focus
on dissolving dampness, eliminating phlegm, invigorating blood circulation, and
In Cholisma (ES), Ze Xie (Rhizoma Alismatis) resolves
dampness and Hai Zao (Sargassum) eliminates
phlegm. Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae), Yu Jin (Radix
Curcumae), and Shan Zha (Fructus Crataegi) activate blood
circulation and eliminate blood stasis; keeping the flow of blood smooth will
prevent plaque buildup on the vessel walls and ensure a healthy cardiovascular
system. In addition, the liver has a remarkable power to regenerate itself, and
it does so even faster when blood movers are used to ensure the proper supply
of nutrients and elimination of waste. Long-term stagnation of damp, phlegm,
and blood will create heat. Therefore, several herbs are used to clear heat,
such as Jue Ming Zi (Semen Cassiae), Da Huang (Radix et
Rhizoma Rhei), Yin Chen (Herba Artemisiae Scopariae), Ge Gen
(Radix Puerariae Lobatae) and Huang Qin (Radix Scutellariae). Yin
Chen (Herba Artemisiae Scopariae) and Da Huang (Radix et Rhizoma
Rhei) ensure the healthy function of the liver and gallbladder by promoting the
secretion of bile, digestion of fat, and the dispelling of damp-heat
accumulation in the Liver and Gallbladder.
In summary, Cholisma (ES)
is an excellent formula to treat individuals with an overall condition
characterized by elevated cholesterol and triglyceride levels, accompanied by a
fatty liver and obesity.
CAUTIONS & CONTRAINDICATIONS
* Cholisma (ES) is
contraindicated during pregnancy.
* Jue Ming Zi (Semen Cassiae) and Da Huang (Radix et
may cause loose stool or diarrhea for those with sensitive gastrointestinal
tracts. Should this occur, reduce the dosage to 2 to 3 capsules three times
* The following warning statement
is required by the State of California: This product contains Da
Huang (Radix et Rhizoma Rhei).
Read and follow directions carefully. Do not use if you have or develop
diarrhea, loose stools, or abdominal pain because Da
Huang (Radix et Rhizoma Rhei) may worsen these conditions and
be harmful to your health. Consult your physician if you have frequent diarrhea
or if you are pregnant, nursing, taking medication, or have a medical
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.
* Cholisma (ES) is specifically formulated to
reduce blood cholesterol and triglyceride levels in individuals with fatty
liver and/or obesity. Patients must take this herbal formula on a long-term
basis for maximum results.
* The baseline cholesterol levels
should be established before the initiation of herbal therapy; 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 result.
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, hypertension and fatty liver).
Therefore, optimal treatment must address both the causes and the
complications. See Supplementary Formulas for more details.
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.
liver: deep and forceful pulse on the left guan
* For high cholesterol and triglyceride levels without fatty liver or obesity, use Cholisma instead.
obese patients with an excess appetite, add Herbalite.
patients with diabetes mellitus, add Equilibrium.
deficient-type hypertension with dizziness or vertigo, combine with Gastrodia Complex.
excess-type hypertension with anger or flushed face, combine with Gentiana Complex.
coronary heart disorders, add Circulation.
* For excess heat everywhere in the body, add Gardenia Complex.
* For hepatitis or other liver dysfunction,
add Liver DTX.
Bleed Weizhong (BL 40) or wherever there is visible,
dilated vein in the transverse crease of the popliteal fossa.
Taichong (LR 3),
Xingjian (LR 2),
Zusanli (ST 36),
Quchi (LI 11),
Fenglong (ST 40)
Alternate the following two sets of points:
(SP 6), Zusanli (ST 36), and Neiguan (PC 6)
(SP 3), Yanglingquan (GB 34), and Fenglong
* Obesity: Shenmen (HT 7), Liangqiu (ST 34),
Gongsun (SP 4),
Tianshu (ST 25),
Daling (PC 7),
Qihai (CV 6),
Guanyuan (CV 4)
Master Tung's Points:
* Hyperlipidemia: 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)
* Obesity (general): Linggu (T 22.05), Huaguyi (T 55.02), Huagusi
(T 55.05), Yizhong (T 77.05), Erzhong (T 77.06), Sanzhong (T 77.07), Zusanli (ST
36), Menjin (T 66.05), Liangqiu (ST 34), Renhuang (T 77.21), Tongguan
(T 88.01), Tianhuangfu [Shenguan] (T
77.18), Mufu (T 88.38)*, Minghuang (T 88.12). Bleed SP
and ST areas on the back and dark veins nearby Weizhong (BL 40), Sihuashang (T 77.08), Sihuazhong (T 77.09), Sihuaxia (T 77.11), Yizhong (T 77.05), Erzhong
(T 77.06) and Sanzhong (T 77.07). Bleed
before needling for best result.
* Fatty liver: Ganmen (T 33.11), Minghuang (T 88.12), Huoquan
(T 88.16). Bleed the LR area in the back wtih cupping. Bleed before needling for best result.
Tungs 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
Method by Dr. Richard Tan:
Medicine by Dr. Li-Chun Huang:
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 oat.
the patients to consume large quantities of fresh fruits and vegetables.
the intake of food that will raise cholesterol levels, including but not
limited to: beer, wine, cheese, aged and cured meats, sugar, and greasy or
fried foods. Avoid eating red meat, fatty foods, processed or fried foods, soda,
pastries, pies, doughnuts, candy, and other sweets.
small, frequent meals throughout the day instead of a few large ones. Eat slowly
and chew thoroughly.
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.
supplements that are beneficial are vitamin B5, vitamin C, vitamin E, chromium
picolinate, lecithin, and coenzyme Q10.
greasy, fatty, fried and oily foods. Seafood should also be reduced.
Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:
soup with diced artichoke hearts, sliced ginger, and 1/2 head of cabbage. Eat a
one glass daily of pureed asparagus juice, including the pulp; add one teaspoon
white mushrooms and corn silk to make soup or tea regularly.
rice bran to a grain dish everyday for at least two months.
pinto beans and other beans that are high in fiber and contain rich folate that
lowers cholesterol into the diet regularly.
tea on a daily basis, especially after meals, to decrease the absorption of
fatty foods from the diet. Beneficial teas include pu-er,
black, oolong or green tea.
the consumption of alcohol and exposure to tobacco. They increase cholesterol
buildup and hardening of arteries.
importance of a regular exercise routine cannot be over-emphasized. Exercise
will improve energy levels, normalize metabolic functions, reduce fat, and burn
* Change dietary and exercise
habits to avoid rebound weight gain.
* Do not lose weight drastically.
Rapid weight loss may be hazardous and is more likely to lead to rebound weight
57-year-old female presented with an enlarged liver. She has a history of
hepatitis and a cholecystectomy previously. Symptoms included shortness of
breath, edema in the upper body and liver enzyme elevation. The TCM diagnosis
was Spleen qi deficiency with phlegm. Liver DTX and Cholisma (ES) were both
prescribed for five months. Her liver was normal in size without any discrete
mass. As a result of taking the herbs, the patient's overall condition had
improved. It was confirmed through another testing that her liver enzyme levels
were back to normal. She hasnt had any issues since. Submitted by H.C., Sydney,
AND CLINICAL RESEARCH
Cholisma (ES) is formulated to treat dyslipidemia (hyperlipidemia,
hypercholesterolemia and hypertriglyceridemia). This formula incorporates many
herbs with excellent antihyperlipidemic effects to reduce plasma levels of
cholesterol and triglycerides. Furthermore, Cholisma (ES) is also
beneficial to treat related conditions and compilations, such as obesity,
diabetes mellitus, and fatty liver.
contains many herbs with multiple mechanisms of actions to lower plasma
cholesterols and triglycerides. Ze
Alismatis) has a remarkable antihyperlipidemic effect, and has been
shown in various clinical studies to effectively treat dyslipidemia, hypercholesterolemia, arteriosclerosis and fatty liver., Jue Ming Zi (Semen Cassiae) has
multiple therapeutic benefits: it lowers low-density
lipoproteins, increases high-density lipoproteins, and lowers blood
pressure without any serious adverse
Ge Gen (Radix Puerariae Lobatae)
and Shan Zha (Fructus Crataegi) have
both shown marked effectiveness for reduction of plasma cholesterol levels,
with mechanisms of action attributed to enhancement of LDL-receptor activity, increased
hepatic breakdown and decreased synthesis of cholesterol., Yu Jin (Radix Curcumae) has potent
antioxidant and antihyperlipidemic
functions, and demonstrates a comparable effect to that of Mevacor
(lovastatin) to decrease plasma levels of cholesterol, triacylglycerol, and
low-density lipoprotein cholesterol.
Lastly, Yu Jin (Radix Curcumae), Da Huang (Radix et Rhizoma Rhei) and
Yin Chen (Herba Artemisiae Scopariae)
are all effective in lowering plasma and liver content of cholesterols and
Clinical applications of these herbs include dyslipidemia, hypercholesterolemia,
and coronary artery disease.,,
Clinically, many studies have been
conducted to demonstrate the therapeutic benefits of these herbs to treat dyslipidemia.
According to one clinical study, use of Jue Ming Zi
(Semen Cassiae) effectively reduces cholesterol levels to normal within
6 weeks in 98 of 100 patients.
According to another clinical study, use of Jue Ming Zi
(Semen Cassiae) in 48 patients is associated with reduction in blood
cholesterol in 95.8% of the patients, reduction in triglycerides in 86.7%, and
reduction of beta-lipoprotein in 89.5%. Lastly, 30 patients with elevated
cholesterol levels were treated with a 90% rate of effectiveness using an
herbal formula that contained Shan
Crataegi), Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) and Ge Gen (Radix Puerariae Lobatae).
Cholisma (ES) also
has herbs to lower blood glucose to treat diabetes mellitus and reduce body
weight to treat obesity, conditions commonly associated with dyslipidemia. Oral
administration of Ge Gen (Radix Puerariae Lobatae)
in herbal decoction has been shown to lower blood glucose levels.
In addition, administration of puerariafuran from Ge Gen
(Radix Puerariae Lobatae) is associated
with a preventative effect against diabetic complications, such as
cataracts. Yin Chen (Herba Artemisiae Scopariae)
has an antiobesity effect, and has been
shown to effectively reduce body weight and inhibit lipid accumulation,
according to one study in subjects fed a high fat diet.
According to one clinical study, successful reduction of body weight was
reported in 79 of 96 patients using a combination of herbal therapy, diet
changes, and exercise regimens. The herbal formula contained Jue Ming Zi (Semen Cassiae), Ze Xie (Rhizoma Alismatis), Shan Zha
(Fructus Crataegi) and others.
summary, Cholisma (ES) is
one of the best formulas to treat elevated cholesterol and triglyceride
levels with complications such as fatty liver, obesity, and diabetes. The
formula is most effective if combined with lifestyle and dietary changes as
obesity, and fatty liver are three conditions that are often closely linked to
each others. Dyslipidemia is the accumulation of abnormally high levels of fats
(cholesterols, triglycerides, or both) in the blood, fatty liver is the excess
accumulation of fat in the liver cells, and obesity is the abnormal increase in
body weight. If untreated, these conditions increase risk of diabetes, coronary
artery disease, and cardiovascular and cerebrovascular disorders.
In Western medicine, dyslipidemia is
usually treated with HMG-CoA reductase inhibitors, a category of drugs that
includes 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.
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 the medical doctor so the drug
can be discontinued immediately if these serious side effects begin to develop.
Obesity, a common health problem that is
quickly becoming an epidemic, has few treatment options available. There are
only a few drugs approved by the Food and Drug Administration for long-term
weight loss, and they have serious side effects. Xenical (orlistat) reduces
body weight by blocking absorption of fat in the digestive tract. Because it
interferes with the normal absorption process, this drug is known to cause many
gastrointestinal side effects, such as fecal incontinence, fecal urgency,
flatulence with discharge, increased defecation, oily
evacuation, oily rectal leakage, steatorrhea, and projectile diarrhea. Meridia
(sibutramine) is a
stimulant agent that causes weight loss by increasing metabolism and
suppressing appetite. Similar to many other stimulant weight-loss drugs, use of
cause anorexia, anxiety, constipation, dizziness, headache, insomnia,
irritability, nervousness, rhinitis, xerostomia, hypertension, congestive heart
failure, arrhythmias, seizure and stroke.
Fatty liver is a potentially serious
condition that, if untreated, may lead to liver cirrhosis. Unfortunately, there
is no drug treatment for fatty liver in Western medicine.
obesity, and fatty liver are all characterized by the presence of damp and
phlegm affecting various parts of the body. Use of herbs has been shown to be
extremely effective to slowly and steadily improve all three of these
For treatment of dyslipidemia and
obesity, drugs are more potent but have significantly more side effects, in
comparison with herbs. However, the higher potency of the drugs is not
necessary an advantage because these conditions are chronic in nature and
require persistent and long-term treatment, not aggressive and short-term
treatment. Therefore, long-term evaluation will often show comparable efficacy
of both treatments. For fatty liver, herbal treatment is superior, especially since
there are no treatment options available in Western medicine. Lastly, it is
extremely important to remember there is no magic bullet. Without commitment to
changing diet and lifestyles, use of either drugs or herbs will have limited
effectiveness. The practitioners and patients must work together to achieve
significant and sustainable clinical results.