Brief Answer:
In most probability the pain describe is not cardiac

Detailed Answer:
Hi XXXXX,
I am Dr. Mody and I will be addressing your concern.
As I start I would like to impress upon the fact the the chest pain which would occur at rest and decrease with activity is most likely NOT cardiac, due to very simple logic that if there is a blockage and you exercise or workout that the heart will not be able to compensate and the anginal symptoms should improve.
So now what may be the reason for . Two other possibility is stomach and muscular.

However as it's lingering on off since 5 years now, I would say it's more towards gastritis with maybe reflux.
So how do we move forward.
Firstly complete your b12 and d3 supplement, as both may result in Non specific pains .
Secondly to rule out cardiac you may have a treadmill stress test done.
For stomach, you may opt for upper git endoscopy and treat . Or directly start on meds with like style modifications for atleast 3 weeks
A pulmonary function test to rule out rare origin of pain form the lung (pleuritic pain) may help.

Now why such extensive work up?
5 years is a pretty long time for a symptom to keep on nagging and we should sort it out once and for all.
Lastly the reason for you being underweight should be evaluated, as less absorption from intestine would result in all the symptoms
I would be happy if you can send me all the reports done till now Nd describe the pain in more detail with regards to time of day, association with food, characteristics and if you have any any any medical problems or you are taking any kind of medicine.

Lastly though rare, peripheral vascular disease and complete workup for autoimmune disease should be done (your symptoms may favour raynauld phenomenon)
Regards Dr Priyank Mody

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Brief Answer:
Continue supplement, improve diet, S. And, rpt cbc after 3 months

Detailed Answer:
Hello, XXXXX. I went through all your reports.
The normal Angio and mri brain and spine rules out anything serious. So based on the systemic symptoms you have (involving different body parts) , we have to find out a systematic cause.
Some of my observations
1) mcv raised with normal hemoglobin, for sure apart from b12, supplement folic acid, pyridoxine and other essential vitamins as mostly it is due to its deficiency in your diet, repeat cbc after 3 months. May get a hematologist consult late sos after the report
Do you have absorption from git tract normal, that is your stool normal I consistency and frequency.
Which medication are you on, including homeopathy and ayurveda
2) anti ccp virtually rules out rheumatoid arthritis. Another I would like you to do is atleast serum ANA, as a screening for other autoimmune disease
3) particularly I don't suggest any cardiac evaluation at present
4) all the symptoms you suggested do suggest a entity called FIBROMYALGIA, do discuss it with your doctor on the next visit
5)rule out common infections prevelant in your .
All further clarification or you would like to add on other symptoms feel free to ask.
Hoping I could help
Regards Dr Priyank Mody

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Brief Answer:
Rheumatologist for raynauld s, or a good physician

Detailed Answer:
Hello XXXXX,
Generally raynauld would be best managed by a XXXXXXX physician, as it's a symptoms and we should try to find the cause. However the speciality for it is rheumatologist as most of the cause for it are autoimmune.

Lastly though your symptoms fit into the entity, but raynauld per say is very rare. In my practice of 8 years have seen less than 10 classical raynauld.
However considering your weight and generalised symptoms one should rule out all systemic possible causes.
All the best for life and if needed you are free to drop a msg or contact me through HCM.
Do rate for other people s reference.
Regards Dr Priyank Mody

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