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These might include: Persistent fatigue that seems disproportionate to liver disease severity Glossitis (sore, red tongue) or mouth ulcers Shortness of breath and palpitations due to anaemia Difficulty concentrating or 'brain fog' Mood disturbances including irritability or depression It is crucial to recognise that some symptomsparticularly fatigue and cognitive changesare common in both fatty liver disease and B12 deficiency, potentially leading to delayed diagnosis

Cherry-red skin is a clinical feature described in cyanide poisoning although infrequently observed thought to be due to high venous blood oxyhaemoglobin concentration, but there will not be a change in the colour of the urine

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JAMA Psychiatry

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