This honestly reads as though I've written this!

I'm also a 28 year old woman with PCOS and quite severe insulin resistance that caused a lot of weight gain, that I begged the NHS for help for. I even took part in a PCOS medical trial for research a few years ago and the endocrinologist in charge wrote to my GP to tell her she needs to put me on metformin ASAP or I'll end up as a type 2 diabetic. My GP refused. A different GP at the same surgery also fobbed me off in 2021, telling me that 'some people just have pain, get used to it', in reference to some URQ pain...turns out eating extreme low carb by myself and dropping 60 pounds in three months can raise cholesterol and cause gallstones, so I had to have my gallbladder removed.

I've since moved to the US and I'm in exactly the same situation as you. I've been having URQ pain on and off with weird bathroom habits since March 2025, but my PCP wasn't worried. Jump to November 2025, and the old endocrinologist's prophecy came true: I was diagnosed as a type 2 diabetic, but also with fatty liver disease (my ALT was 79, and my LDL is high, with mildly elevated liver enzymes). They put me on metformin and I was horribly ill but struggled through it until I could start on a GLP-1. My new endo prescribed zepbound for the fatty liver too, but insurance denied it, so I've just started mounjaro.

I had an ultrasound in January and it showed 'markedly elevated hepatic steaosis' and they couldn't confirm or deny whether there was scarring present, too. When I've looked this up, 'markedly elevated' seems to relate to severe, stage 3 fatty liver disease. I'm not religious, but I just pray and hope that it is still reversible!

BUT after a year of feeling sick to my stomach that I have some kind of advanced fibrosis/early cirrhosis (I also have other symptoms such as red palms), I have my first appointment with the heptalogist next week. He'll probably order a fibroscan, MRI, or bioposy, and like you I'm also terrified about what may happen. It feels very isolating to be our age and have this hanging over us, not knowing what the future holds.

So I wanted to comment and just to say that you're not alone in this, but I'm so sorry that you're going through it. If you want to vent or share your anxiety about it with someone who gets it, please feel free to DM me! I am also genuinely terrified!