The Liver in TCM

Traditional Chinese Medicine (TCM) considers organs as broader “systems” that are centered around the physical organs we are more familiar with in Western medicine but have more dynamic and complex functions. In this philosophy, the organ systems connect throughout the whole body through the 12 meridians—the channels through which energy (qi) flows—and these channels of energy also serve as the foundation for therapies like acupuncture.

The liver and gallbladder (LV/GB) organ systems are connected to the wood element, Spring, and the color green; to sour tastes and sprouted, steamed, stir fried, or fermented foods; and to emotions of anger and frustration (stuck qi) and guilt/depression (deficiency).

Western medicine primarily views the liver as the organ of detoxification, which is important for metabolism, digestion, hormone health, and immune modulation. In TCM, the liver organ system stores the blood and govern the circulation of qi (energy) in the body. The liver is also responsible for supporting digestion/absorption (spleen system/”the gut”), reproductive functions (kidney system/”hormones”), and the regulation of emotions (shen/“nervous system”). Thus, the liver works everyday not only to clean and detox the blood, but also to detox our emotions. Since the regulation of ‘qi’, or vital life force, is necessary for the proper functioning of all organ systems. Thus, when liver ‘qi’ becomes stagnant or stuck, a number of other imbalances can begin to occur. The liver is also said to house the hun, or soul, and thus is considered to play an important role in spiritual and mental/emotional health. An imbalanced liver is commonly associated with emotions of anger, resentment, irritability, and inability to “go-with-the-flow”. Additionally, excess feelings of anger and stress may contribute to dysregulated liver function.

Thinking about the connections between physical and mental/emotional symptoms from the TCM perspective is a positive and eye-opening challenge that may reveal patterns often overlooked in Western systems. It is not necessary to fully understand the philosophies of Traditional Chinese Medicine to benefit from or begin to apply this approach towards healing to your own life.

Begin to notice how symptoms and imbalances in TCM are bidirectional: the symptoms tend to indicate an existent imbalance and also contribute to furthering the imbalance.

In today’s fast-paced society, liver ‘qi’ stagnation is a common imbalance, particularly in individuals who overexert themselves (“work hard, play hard”), rarely taking time to rest. The time from 11 pm to 3 am is associated with the liver/gallbladder, which is when the liver purifies the blood and detoxes emotions. Commonly waking up or suffering from insomnia when trying to fall asleep during this time is an indication of some liver imbalance. At the same time, not sleeping well also negatively affects liver health: sleep–wake disturbances have been connected to chronic liver disease.

To illustrate this more specifically, think about a night when you had too much to drink or went to bed frustrated.

Did you wake up around 1–3 am, unable to fall back asleep?

From a TCM perspective, your liver was overloaded and struggling to perform it’s detoxification functions.

Liver Imbalances

When the liver becomes imbalanced, the flow of qi is disrupted, which can result in more extreme or abnormal emotions, such as anxiety, guilt/depression, irritability, and anger/resentment.

Anger is the main emotion associated with the liver in TCM, and this relationship is bidirectional: consistent anger is said to negatively effect the liver, and increased irritability is also a common indicator of liver imbalances. As the organ responsible for regulating the circulation of blood and detoxing hormones, the liver must be considered in relation to hormone imbalances, especially estrogen dominance, as this suggests that the liver is unable to properly detox estrogen from the body and/or is overloaded by stress hormones. PMS and menopause symptoms, which include mood swings and increased irritability, are considered to be more extreme when the liver is overburdened or clogged. Adding a mindfulness routine or reflecting on triggers for frustration and anger are thus beneficial practices for supporting the liver. Sweating and movement, whether it is more intense exercise or lighter stretching, are also beneficial to the liver: sweat helps release toxins and movement promotes drainage in our lymphatic system, supporting the liver by opening up the detox pathways.

Eating for Liver Health

In TCM, each organ system is connected to a color, season, taste, cooking style, time of day, emotion, sense organ, climate, etc. Understanding these associations can help us regulate imbalances within the body, and many of these connections are actually quite common sense.

Logically, the color associated with Spring and the liver is green. Leafy greens and other green vegetables that are common in early spring, like sprouts, herbs, asparagus, and artichokes, are said to balance the LV/GB systems. Modern scientific research on nutrition and functional medicine can also provide us with evidence that validates these long-believed concepts from TCM. Fresh green vegetables are high in chlorophyll, which can help neutralize heavy metals and other toxins, cleansing the bloodstream. Many leafy green and cruciferous vegetables—like broccoli, cabbage, and brussels sprouts—are also high in fiber and glucosinolate, which aids in the production of natural enzymes and can help to flush carcinogens out of the body. Basically, the green vegetables that grow in spring are naturally balancing for our bodies as we transition from winter, a season when we traditionally eat more rich and heavy foods and become more sedentary with the colder weather. 

The liver also likes sour taste, and this too can be connected to the seasons and traditional food preservation techniques. Pickled and fermented foods, which have a sour taste, would have normally been made in the summer with ripe vegetables and left to rest all winter in a cool cellar. Many of our ancestors would have naturally eaten pickled or fermented vegetables at the beginning of the spring months when other vegetables were not yet available. Now, we can make “quick pickles” and enjoy these foods throughout the year, to the delight of our livers! Adding 1 tbsp of pickled or fermented veggies to your meals is an easy way to subtly support your liver function and gut health. In general, spring is the optimal season to cleanse and support the liver in preparation for the summer months by incorporating liver-supportive foods like leafy greens and fermented vegetables, practicing mindfulness and stress-reducing activities, and practicing light movement to move stagnation in the detox pathways.