At 54, my GP said I had the menopause, but it was fatty liver disease ...Middle East

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When Belinda Whitlock repeatedly visited her GP for fatigue, nausea and unexplained stomach pain in 2024, she was told that, as she was 54, the cause was obvious – the menopause.

The fatigue was so severe that she went straight to bed after work and stopped going out with friends. Whitlock, a health and social care worker from Scunthorpe, put her extreme tiredness down to working full time and studying for a degree, but knew deep down that something wasn’t right.

Despite being prescribed hormone replacement therapy, her health did not improve, but the HRT led to an expected diagnosis. The hormonal medication caused vaginal bleeding, leading to a referral for an ultrasound. But during the scan, the sonographer examined her abdomen instead of carrying out a transvaginal scan – and spotted signs of a fatty liver.

At first, Whitlock didn’t understand the gravity of the findings, but a follow-up specialist liver scan showed that she had advanced liver fibrosis – where scarring builds up in the liver, stopping it from working as it should.

Whitlock had stage F3 liver fibrosis, meaning she was on the cusp of irreversible cirrhosis, which may have required a liver transplant. The liver fibrosis was caused by a condition called Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), which is also known as fatty liver disease. An estimated one in four UK adults could be affected by fatty liver disease,  and one in 20 could have the more advanced stage of the disease, often without knowing it.

Whitlock, a non-drinker who lost her mother to liver cancer in 1989, immediately feared the worst. “I thought I was going to die and leave my four children without a mother. My mum was only 46 when she died, and now I had liver damage too. I was terrified.”

She felt helpless and her GP admitted they knew very little about liver conditions. Eventually she called the helpline of a charity, Liver UK. “I was crying like a baby. They told me about how diet and exercise could really help me, and I was determined to try and help myself as much as possible.”

According to Liver UK, the biggest misconception about MASLD is that it is caused by an excessive consumption of alcohol when, in reality, MASLD can occur in people who drink little to no alcohol. The people most at risk of developing MASLD include those who are overweight or living with obesity, particularly if they carry excess weight around their waist. A diet high in saturated fat, sugar and ultra-processed foods, combined with a sedentary lifestyle, can also increase the risk. 

Liver disease has few early symptoms, and when they do appear, they can be vague and non-specific, such as fatigue, feeling generally unwell, pain under your ribs, and trouble sleeping. Pamela Healy OBE, chief executive of Liver UK, says: “Because MASLD often develops silently, many people may not realise there is a problem until significant damage has occurred. Earlier identification gives people the opportunity to take action to improve their liver health and reduce their risk of serious complications.” 

Whitlock’s liver consultant wasn’t hopeful she’d be able to reverse the condition, but said there was a chance she might be able to stop the scarring from progressing. She was determined to get better, though, and made drastic lifestyle changes, adopting a Mediterranean diet and cutting out all takeaways.

“The diagnosis gave me a real shock and was the ultimate motivation to overhaul my health,” she says. “I’ve been on diets before and yo-yoed in the past, but this was different. I was on a mission to get better, so I didn’t stop or give up this time.”

Due to her family history, Whitlock was on six-monthly checkups with a liver doctor and had regular scans to monitor her condition. One marker measure, liver stiffness, reveals the extent of scarring. Normal results are usually between two and seven kilopascals (kPa). When Whitlock was diagnosed, her result was 13.3 kPa, which indicated severe scarring. As she lost weight, her numbers gradually went down, but her most recent result, two years after diagnosis, is 4.5 kPa, within the normal range.  

Whitlock has now lost a staggering 10 stone in two years and has been discharged by the liver clinic, with her doctors absolutely astounded by her dramatic reversal of disease. But she’s not become complacent, and her mission to stay as healthy as possible continues. She also regularly speaks at public events about her health journey, saying, “My experience has ignited a passion in me to provide a guiding light for others who may be struggling in silence.”

Despite having symptoms of liver damage for two years before diagnosis, it took an accidental finding to start her on the road to recovery, so Whitlock says, “If you feel that something isn’t right, and you’re being fobbed off, keep going back to your GP, demand to be taken seriously or get a second opinion. Getting a diagnosis has helped me understand what is happening with my liver and, importantly, what I can do to protect my health. Without knowing what was happening, I would never have had the opportunity to make the changes I needed to my diet and lifestyle, which have ultimately helped save my life.”

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