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How Does the Liver Change When We Get Older?
In treating chronic
viral hepatitis, age is an unfavorable factor for healing. Conventional
treatment criteria even listed that when the patient is 65 or older, IFN
based treatment is contraindicated.
Why is aging an unfavorable factor and what happens in the liver while we
age? In order to answer this question, we should know how the liver
changes with age. When we get older, not only our appearance changes but
at the same time, the anatomy and physiology of the internal organs also
change. For example, the liver undergoes very obvious changes when we get
older.
First, the blood
supply to the liver reduces with age. After 25 for male and 20 for female,
the blood supply to the liver is reduced 0.3 ~ 1.5% every year. The blood
flow through the liver at the age of 60, compare to 20, is reduced to 40
to 50%. The blood flow brings in oxygen and nutrients, and also carries
out the metabolites and toxins. When the blood supply to the liver is
reduced, the liver's metabolic and detoxification ability is also reduced.
This ultimately reduces the liver’s ability to repair damages from
inflammation caused by virus, alcohol, or chemicals.
Second, the number of liver cells also reduces sharply after the age of
60. When we reach age 80, our liver has only 50% of the cells compared to
age 40. The nucleus of the liver cells also show aging changes, such as
doubling or becoming multinuclear. With aging, the liver becomes harder
and the weight of the liver also reduces. The average weight of the liver
for a person age 90 is only 51.8% of a person at age 30. So when we get
older, there are less liver cells to carry out the important functions
that keep us healthy. Plus, the phagocytic function of the Kupffer cell of
the liver is also reduced to about 67%. This is an important immune
function to filter the microorganisms from the nutrients gathered from the
intestine. Thus, we are also more susceptible to infections when we are
older.
Because the above aging changes, for older people, to recover from chronic
hepatitis is more difficult than younger patients. So for patients older
than 60, the treatment should be gentle and comprehensive.
With Chinese medicine, we focus heavily on supportive treatment, such as
improving micro-circulation of the liver to increase the blood infusion to
the liver and to promote phagocytosis of Kupffer cells, to help the liver
heal.
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