Cholisma (ES)™

TCM herbal formula for dyslipidemia with fatty liver and obesity — antihyperlipidemic; antiobesity; hypoglycemic; hepatoprotective; dissolves dampness; eliminates phlegm; invigorates blood circulation; clears heat; prevents plaque buildup; promotes bile secretion and fat digestion

⚠️ Contraindicated during pregnancy. Contains Da Huang (Radix et Rhizoma Rhei) — California Prop 65 warning: "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 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 condition." Jue Ming Zi and Da Huang may cause loose stools or diarrhea in those with sensitive GI tracts — reduce to 2–3 capsules three times daily if this occurs. Contains Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) — patients on anticoagulant or antiplatelet therapies such as Coumadin (warfarin) should use with caution or not at all. Long-term use required for maximum results. Establish baseline cholesterol before starting; retest after 1 month, then every 2–3 months.

CLINICAL APPLICATIONS

* Dyslipidemia

§ Hyperlipidemia (high cholesterol and triglycerides levels)

§ Hypercholesterolemia (high cholesterol levels)

§ Hypertriglyceridemia (high triglyceride levels)

* Dyslipidemia with obesity, diabetes mellitus, or fatty liver

Background: Dyslipidemia, obesity, and fatty liver are three closely linked conditions. Dyslipidemia is the abnormal elevation of cholesterol and/or triglycerides in the blood; fatty liver is the excess accumulation of fat in liver cells; obesity is the abnormal increase in body weight. If untreated, these conditions increase risk of diabetes, coronary artery disease, and cardiovascular and cerebrovascular disorders — including atherosclerosis, arteriosclerosis, coronary artery disease, angina pectoris, hypertension, and liver cirrhosis. Fatty liver has no drug treatment in Western medicine — herbal treatment is superior for this condition. For dyslipidemia and obesity, herbs offer comparable long-term efficacy to drugs with significantly fewer side effects.

TCM differentiation: In TCM, cholesterol and triglycerides are excess accumulations of dampness (hyperglycemia) and phlegm in the blood vessels (dyslipidemia), liver (fatty liver), and body (obesity). Long-term stagnation of damp, phlegm, and blood creates heat. Treatment focuses on dissolving dampness, eliminating phlegm, invigorating blood circulation, and clearing heat. Blood-moving herbs ensure proper nutrient supply and waste elimination to support liver regeneration. Cholisma (ES) differs from Cholisma by adding herbs specifically targeting fatty liver, obesity, and blood glucose — use Cholisma for dyslipidemia without these complications.

Dosage note: Take the last dose 1 hour before bedtime — cholesterol synthesis is most active at night.

Key herb-level clinical data:

— Ze Xie (Rhizoma Alismatis / Alisma): remarkable antihyperlipidemic effect — clinical studies demonstrate effectiveness for dyslipidemia, hypercholesterolemia, arteriosclerosis, and fatty liver; resolves dampness

— Jue Ming Zi (Semen Cassiae / Cassia Seed): lowers LDL; increases HDL; lowers blood pressure without serious adverse effects; clinical study 1: cholesterol normalized in 98 of 100 patients within 6 weeks; clinical study 2: 48 patients — cholesterol reduction 95.8%, triglycerides reduction 86.7%, beta-lipoprotein reduction 89.5%; clears heat; weight loss formula component (Jue Ming Zi + Ze Xie + Shan Zha and others: 79 of 96 patients achieved successful weight reduction)

— Ge Gen (Radix Puerariae Lobatae / Kudzu Root / Pueraria): antihyperlipidemic — enhances LDL-receptor activity, increases hepatic breakdown, decreases cholesterol synthesis; hypoglycemic — oral decoction lowers blood glucose levels; puerariafuran — preventative effect against diabetic complications including cataracts; clinical study: formula with Shan Zha + Dan Shen + Ge Gen — 90% effective rate in 30 patients with elevated cholesterol; clears heat

— Shan Zha (Fructus Crataegi / Hawthorn Berry): antihyperlipidemic — enhances LDL-receptor activity, increases hepatic breakdown, decreases cholesterol synthesis; activates blood circulation; eliminates blood stasis; prevents plaque buildup on vessel walls

— Yu Jin (Radix Curcumae / Curcuma / Turmeric Root): potent antioxidant and antihyperlipidemic — comparable effect to Mevacor (lovastatin) for decreasing plasma cholesterol, triacylglycerol, and LDL; lowers plasma and liver content of cholesterol and triglycerides; activates blood circulation; eliminates blood stasis

— Da Huang (Radix et Rhizoma Rhei / Rhubarb Root): lowers plasma and liver content of cholesterol and triglycerides; promotes bile secretion; aids fat digestion; dispels damp-heat accumulation in Liver and Gallbladder; ensures healthy liver and gallbladder function; see California Prop 65 warning above

— Yin Chen (Herba Artemisiae Scopariae / Capillaris / Artemisia Scoparia): antiobesity — reduces body weight and inhibits lipid accumulation in subjects fed a high-fat diet; lowers plasma and liver content of cholesterol and triglycerides; promotes bile secretion; aids fat digestion; dispels damp-heat in Liver and Gallbladder; ensures healthy liver and gallbladder function

— Huang Qin (Radix Scutellariae / Scutellaria / Baical Skullcap): clears heat; supports liver function

— Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae / Salvia / Red Sage Root): activates blood circulation; eliminates blood stasis; improves microcirculation; prevents plaque buildup on vessel walls; supports liver regeneration by ensuring proper nutrient supply and waste elimination; caution with anticoagulants

— Hai Zao (Sargassum / Seaweed): eliminates phlegm; softens hardness

WESTERN THERAPEUTIC ACTIONS

* Antihyperlipidemic / cholesterol and triglyceride reduction — Ze Xie (dyslipidemia, hypercholesterolemia, arteriosclerosis, fatty liver); Jue Ming Zi (LDL↓, HDL↑, 98/100 patients 6 weeks, 95.8% cholesterol reduction / 48 patients); Ge Gen + Shan Zha (LDL-receptor↑, hepatic breakdown↑, synthesis↓, 90% / 30 patients); Yu Jin (comparable to lovastatin — cholesterol↓, triacylglycerol↓, LDL↓); Da Huang + Yin Chen + Yu Jin (plasma and liver cholesterol↓, triglycerides↓)

* Antiobesity — Yin Chen (body weight↓, lipid accumulation↓, high-fat diet); Jue Ming Zi + Ze Xie + Shan Zha (79/96 patients weight loss with diet and exercise)

* Hypoglycemic — Ge Gen (blood glucose↓, puerariafuran prevents diabetic cataracts)

* Hepatoprotective / fatty liver treatment — Ze Xie (fatty liver); Da Huang + Yin Chen (bile secretion↑, fat digestion↑, damp-heat dispelled from Liver and Gallbladder); Dan Shen (liver regeneration support via blood circulation)

* Antiatherosclerotic / cardiovascular — Dan Shen + Yu Jin + Shan Zha (blood stasis elimination, plaque prevention, smooth blood flow)

CHINESE THERAPEUTIC ACTIONS

* Resolves dampness (Ze Xie)

* Eliminates phlegm; softens hardness (Hai Zao)

* Activates blood circulation; eliminates blood stasis; prevents plaque buildup (Dan Shen, Yu Jin, Shan Zha)

* Clears heat; dispels damp-heat from Liver and Gallbladder (Jue Ming Zi, Da Huang, Yin Chen, Ge Gen, Huang Qin)

* Promotes bile secretion; aids fat digestion; ensures healthy liver and gallbladder function (Da Huang, Yin Chen)

DOSAGE

Standard: 3–4 capsules three times daily on an empty stomach. Take the last dose 1 hour before bedtime — cholesterol synthesis is most active at night. Preventative dose: 2 capsules twice daily on an empty stomach. Long-term use required for maximum results.

Supplementary formulas: High cholesterol and triglycerides without fatty liver or obesity — use Cholisma instead. Obese patients with excess appetite — add Herbalite. Diabetes mellitus — add Equilibrium. Deficient-type hypertension with dizziness or vertigo — add Gastrodia Complex. Excess-type hypertension with anger or flushed face — add Gentiana Complex. Coronary heart disorders — add Circulation. Excess heat throughout the body — add Gardenia Complex. Hepatitis or other liver dysfunction — add Liver DTX.

Nutrition: Increase cholesterol-lowering foods: apples, bananas, carrots, cold-water fish, dried beans, garlic, grapefruit, olive oil, and fibers such as bran and oats. Consume large quantities of fresh fruits and vegetables. Eat small, frequent meals throughout the day — eat slowly and chew thoroughly. Increase niacin — lowers total cholesterol by up to 18%, increases HDL by up to 32%, lowers triglycerides by up to 26% (slow-release form preferred). Other beneficial supplements: vitamin B5, vitamin C, vitamin E, chromium picolinate, lecithin, and coenzyme Q10. Decrease: beer, wine, cheese, aged and cured meats, sugar, and greasy or fried foods. Avoid red meat, fatty foods, processed or fried foods, soda, pastries, pies, doughnuts, candy, and other sweets. Reduce seafood.

Tao of Nutrition (Dr. Maoshing Ni and Cathy McNease): Make soup with diced artichoke hearts, sliced ginger, and ½ head of cabbage — eat a bowl daily. Drink one glass daily of pureed asparagus juice including the pulp with 1 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 2 months. Incorporate pinto beans and other high-fiber, folate-rich beans regularly.

Lifestyle: Drink tea daily, especially after meals, to decrease absorption of fatty foods — pu-er, black, oolong, or green tea. Avoid alcohol and tobacco — they increase cholesterol buildup and hardening of arteries. Exercise regularly — improves energy levels, normalizes metabolic functions, reduces fat, and burns calories. Change dietary and exercise habits to avoid rebound weight gain. Do not lose weight drastically — rapid weight loss is hazardous and more likely to lead to rebound weight gain.

CASE STUDY

— 57-year-old female: Enlarged liver; history of hepatitis and cholecystectomy; shortness of breath; upper body edema; elevated liver enzymes; Spleen qi deficiency with phlegm. Liver DTX + Cholisma (ES) for 5 months. Result: liver returned to normal size with no discrete mass; liver enzyme levels returned to normal; overall condition improved; no issues since.

Related Reading

Also see: Cholisma – for high cholesterol and triglycerides without fatty liver or obesity | Herbalite – for obesity with excess appetite | Equilibrium – for diabetes mellitus and high blood glucose | Gastrodia Complex – for hypertension with dizziness or vertigo | Gentiana Complex – for hypertension with anger or flushed face | Circulation – for coronary heart disorders | Liver DTX – for hepatitis and liver dysfunction | Gardenia Complex – for excess heat | Cardiovascular & Blood Pressure Support Collection | Liver, Kidney & Detox Support Collection.