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    Written by Chris Bellanger, BHSc in Nutritional Medicine

    Central to both Western and Traditional Chinese Medicine (TCM), the liver plays a crucial role in our overall health, affecting physical, emotional, and metabolic well-being. While Western science understands the liver mainly as a detoxification and metabolic powerhouse, TCM offers additional perspectives on emotional health, stress management, and holistic vitality. (1)

    The integration of these two systems provides a well-rounded approach to maintaining liver health and preventing disease in general. 

    In this article, we’ll explore the liver’s role from both Western and TCM perspectives and how traditional Chinese medicine integrates with modern medicine, despite the predation of several more recently understood concepts like polypharmacy and preventative medicine. 

    The Liver in Modern Western Medicine 

    Our modern understanding of the liver is as a multifunctional organ responsible for detoxification, metabolism, protein synthesis, and nutrient storage. Damage to the liver, whether through pharmaceutical drugs, chronic disease, or poor lifestyle choices, can have severe implications on our health. (5, 6, 8)

    • Detoxification: The liver detoxifies harmful substances, converting metabolic waste into less harmful forms to be excreted through bile or urine. (4)
    • Metabolism of fats, carbohydrates, and proteins: The liver produces bile for fat digestion, converts excess glucose into glycogen for storage, and processes amino acids from proteins for energy or protein synthesis. (4)
    • Protein synthesis: The liver produces essential proteins like albumin and connective tissues, which regulate fluid balance and clotting factors crucial for blood coagulation. (4)
    • Nutrient storage: The liver stores vitamins and minerals, including vitamins A, D, B12, iron, and copper, and helps regulate blood glucose by storing and releasing glycogen. (4)
    • Bile production: Bile, essential for digesting fats and fat-soluble vitamins, is produced in the liver and stored in the gallbladder, supporting digestion. (4)
    • Hormonal regulation: The liver metabolizes hormones like insulin and estrogen, helping maintain homeostasis and hormonal balance. (4)

    Given these critical functions, maintaining liver health is essential for systemic well-being. Impaired liver function can lead to chronic conditions such as non-alcoholic fatty liver disease (NAFLD), cirrhosis, and liver cancer. (1, 2, 3, 5, 6)

    Liver in Western and holistic medicine

    The Liver in Traditional Chinese Medicine: Emotional and Energetic Regulation

    TCM offers a holistic view of the liver, emphasizing its role in physical processes and emotional and psychological health. According to TCM, the liver governs the flow of Qi (vital energy), the regulation of blood, and emotional balance. This central insight hints at the profound connection between emotional and physical health from the TCM perspective. (1)

    Holistic Approach: TCM's holistic view of the liver’s role in emotions, blood flow, and energy distribution mirrors modern understandings of how interconnected our bodily systems are. 

    Liver and Emotional Regulation: Integration of Mind and Body

    The undeniable connection between liver health and emotional regulation may not be discussed enough. It is, however, a topic worth exploring—one that has been prevalent since ancient times.

    The TCM Perspective

    The liver is closely linked to emotional health in TCM. Thousands of years ago, TCM recognized that emotional stress and anger could lead to health problems by disrupting the liver's role in regulating energy and emotions. 

    This understanding foreshadowed today’s holistic approach to treating chronic stress, which includes lifestyle changes and stress reduction techniques similar to what TCM has long emphasized. By underscoring emotional balance and stress management, TCM provides a template for how mental health is integral to overall wellness. (9)

    The Western View 

    Modern medicine has recently established links between stress, emotions, and physical health. The liver is part of the body’s stress response system, working with the nervous system and hormones like cortisol (the "stress hormone"). 

    Chronic stress can lead to problems like high blood pressure, muscle tension, headaches, digestive issues, and mental health disorders - symptoms that are closely linked to the liver’s role in hormone metabolism and detoxification in both Western and TCM frameworks. Stress management and emotional health are now recognized as crucial parts of maintaining physical health. (7, 9, 19)

    Liver's role in blood

    Liver’s Role in Blood

    How does the perception of the liver’s role in blood differ in Western medicine compared to TCM? Let’s find out.

    Insights from TCM

    TCM recognizes the liver’s role in blood storage and circulation, understanding that imbalances in liver function could lead to muscle weakness, vision problems (like dry eyes), and fatigue—symptoms now associated with conditions like anemia or liver disease in Western medicine. The concept of “liver blood deficiency” anticipated the modern understanding that liver health directly impacts energy levels, muscle strength, and overall vitality. (1)

    The Western View 

    In Western medicine, the liver is crucial for producing proteins that help with blood clotting, regulating blood sugar, and filtering toxins from the bloodstream. It also stores glycogen, the energy that nourishes muscles and tissues. A healthy liver ensures balanced blood flow and energy distribution throughout the body. (4)

    Herbal Remedies for Liver Health

    Herbs like Salvia miltiorrhiza(Dan Shen), Artemisia annua (Qinghao), and countless others comprise the Chinese herbal materia medica. 

    A few examples of modern research demonstrating efficacy include an extract from Dan Shen (lithospermic acid), which was liver-protective (3, 10), and artemisinin isolated from Qinghao, which won the Nobel prize for its antimalarial activity. (3, 11)  Glycyrrhizic acid extracted from Gancao  (Licorice root) was protective against alcohol-induced liver injury. (3, 12)

    Today, Western medicine and modern pharmacology are increasingly interested in the role of herbs in supporting health, recognizing their benefits. (14)

    Meridian Systems and Fascia: Same Concept, Different Names?

    TCM conceptualizes health through the flow of Qi along meridians, or channels that connect internal organs and tissues. Disruptions in this flow, especially in the liver meridian, can lead to various health problems.

    The liver meridian is central to regulating Qi flow throughout the body. Blockages or stagnation along this pathway can result in emotional stress, digestive issues, and weakened muscles. (1, 9)

    While Western medicine doesn’t recognize meridians anatomically, they can be likened to the nervous and circulatory systems, which similarly carry signals and nutrients to different parts of the body. Meridians may, in fact, be the same thing as fascial planes (connective tissue layers) that transmit mechanical signals throughout the body and are focused on in Western therapies like myotherapy and osteopathy.  (1, 18)

    Conclusion: Merging Ancient Wisdom with Modern Medicine

    The liver plays a pivotal role in both Western and Traditional Chinese Medicine, governing detoxification and metabolism and emotional and energetic balance. 

    TCM’s emphasis on prevention, stress management, and holistic health was ahead of its time, aligning closely with modern Western wellness and disease prevention trends. The integration of herbal remedies, emotional well-being, and natural therapies makes TCM not just an ancient practice but a forward-thinking approach to health. 

    As Western medicine continues to explore mind-body connections, the wisdom of TCM remains remarkably relevant, offering valuable insights for maintaining liver health and overall vitality.

    Article References: 

    1. Liu, Z. W., Shu, J., Tu, J. Y., Zhang, C. H., & Hong, J. (2017). Liver in the Chinese and Western Medicine.Integrative Medicine International, 4(1–2), 39–45. https://doi.org/10.1159/000466694 
    2. Ding, X., He, X., Tang, B., & Lan, T. (2024). Integrated traditional Chinese and Western medicine in the prevention and treatment of non-alcoholic fatty liver disease: future directions and strategies.Chinese Medicine, 19(1). https://doi.org/10.1186/s13020-024-00894-1 
    3. Fu, K., Wang, C., Ma, C., Zhou, H., & Li, Y. (2021). The Potential Application of Chinese Medicine in Liver Diseases: A New Opportunity. Frontiers in Pharmacology, 12. https://doi.org/10.3389/fphar.2021.771459 
    4. Kalra, A., Yetiskul, E., Wehrle, C. J., & Tuma, F. (2023, May 1). Physiology, Liver. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK535438/ 
    5. Low, E. X. S., Zheng, Q., Chan, E., & Lim, S. G. (2020b). Drug induced liver injury: East versus West – a systematic review and meta-analysis. Clinical and Molecular Hepatology, 26(2), 142–154. https://doi.org/10.3350/cmh.2019.1003 
    6. Jahromi, M. K., Daftari, G., Farhadnejad, H., Tehrani, A. N., Teymoori, F., Salehi-Sahlabadi, A., & Mirmiran, P. (2023). The association of healthy lifestyle score and risk of non-alcoholic fatty liver disease.BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-15816-3 
    7. Lippman, D., Stump, M., Veazey, E., Guimarães, S. T., Rosenfeld, R., Kelly, J. H., Ornish, D., & Katz, D. L. (2024). Foundations of Lifestyle Medicine and its Evolution.Mayo Clinic Proceedings Innovations Quality & Outcomes, 8(1), 97–111. https://doi.org/10.1016/j.mayocpiqo.2023.11.004 
    8. Furman, D., Campisi, J., Verdin, E., Carrera-Bastos, P., Targ, S., Franceschi, C., Ferrucci, L., Gilroy, D. W., Fasano, A., Miller, G. W., Miller, A. H., Mantovani, A., Weyand, C. M., Barzilai, N., Goronzy, J. J., Rando, T. A., Effros, R. B., Lucia, A., Kleinstreuer, N., & Slavich, G. M. (2019). Chronic inflammation in the etiology of disease across the life span. Nature Medicine, 25(12), 1822–1832. https://doi.org/10.1038/s41591-019-0675-0 
    9. Gaur, R. (2024). A Brief History: Traditional Chinese Medicinal System.Pharmacological Research - Modern Chinese Medicine, 100387. https://doi.org/10.1016/j.prmcm.2024.100387 
    10.  Chan, K. W. K., & Ho, W. S. (2015). Anti-oxidative and hepatoprotective effects of lithospermic acid against carbon tetrachloride-induced liver oxidative damage in vitro and in vivo. Oncology Reports, 34(2), 673–680. https://doi.org/10.3892/or.2015.4068 
    11. Tu, Y. (2016). Artemisinin—A Gift from Traditional Chinese Medicine to the World (Nobel Lecture). Angewandte Chemie International Edition, 55(35), 10210–10226. https://doi.org/10.1002/anie.201601967 
    12. Jung, J., Lee, Y., Kim, S. H., Kim, K., Kim, K., Oh, S., & Jung, Y. (2015). Hepatoprotective effect of licorice, the root of Glycyrrhiza uralensis Fischer, in alcohol-induced fatty liver disease. BMC Complementary and Alternative Medicine, 16(1). https://doi.org/10.1186/s12906-016-0997-0 
    13. Gaur, R. (2024b). A Brief History: Traditional Chinese Medicinal System.Pharmacological Research - Modern Chinese Medicine, 100387. https://doi.org/10.1016/j.prmcm.2024.100387 
    14. Marshall, A. C. (2020). Traditional Chinese Medicine and Clinical Pharmacology. In Springer eBooks (pp. 455–482). https://doi.org/10.1007/978-3-319-68864-0_60 
    15. Zhang, B., Zhao, J., Wang, Z., Guo, P., Liu, A., & Du, G. (2021). Identification of Multi-Target Anti-AD Chemical Constituents From Traditional Chinese Medicine Formulae by Integrating Virtual Screening and In Vitro Validation.Frontiers in Pharmacology, 12. https://doi.org/10.3389/fphar.2021.709607 
    16.  Huang, Z., Miao, J., Chen, J., Zhong, Y., Yang, S., Ma, Y., & Wen, C. (2022). A Traditional Chinese Medicine Syndrome Classification Model Based on Cross-Feature Generation by Convolution Neural Network: Model Development and Validation. JMIR Medical Informatics, 10(4), e29290. https://doi.org/10.2196/29290 
    17.  Yuan, B. (2022). What Personalized Medicine Humans Need and Way to It ——also on the Practical Significance and Scientific Limitations of Precision Medicine.Pharmacogenomics and Personalized Medicine, Volume 15, 927–942. https://doi.org/10.2147/pgpm.s380767 
    18. Fascial neuromodulation: an emerging concept linking acupuncture, fasciology, osteopathy and neuroscience | European Journal of Translational Myology. (n.d.). https://www.pagepressjournals.org/bam/article/view/8331/8331 
    19. Feng, G., Xu, X., & Lei, J. (2023). Tracking perceived stress, anxiety, and depression in daily life: a double-downward spiral process. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1114332 



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