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Piercing pain in mid chest. Cramps in calf muscle or stomach muscle. Tayo hasn't worked. Musculoskeletal pain?

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Internal Medicine Specialist
Practicing since : 1998
Answered : 1579 Questions
Age: 25
Height: 161cm (5'3")
Weight: 58Kg


I am suffering from a diffuse chest pain from past 4 weeks. On friday (4 weeks ago), I had strong pain, inside the left portion of chest. Pain continued for almost 10mins and then went off. I did not felt any sweating or any other sensations, expect piercing pain. After that I had consulted cardiologist, who carried out 2D-echo, tredmill stress test, lung function tests, and blood test. Finding were as follows:

- Tredmill test : normal
- 2D echo : normal
- lung function: normal
- Blood test : Vit D3 - 9.24ng (deficiency), Vit B12 - 220, Hb : 11.2 (I am thalasemia minor) Rest of the blood parameters normal.

He then adviced me to take tablets Tayo 60K (60,000IU dose of vitamine D3) once in a week, and Nervigen (Methykcobalamin - 750 mcg, etc..) tablets once a day.

It has been three weeks since then. However, I am still getting the sensation of pain in chest. Two types of senseations are observed :

1) Mild-piercing pain inside the left-middle portion.
2) Sudden diffused pain anywhere in the chest, at random times. Especially when sitting idle.

I will not get any pain if I am climbing staircases, cycling, running, etc.

Daily, I will ride a bicycle to office which is 3Km away from my house. And nothing, except mild pain just below the ribcage (non-consistent and random) is felt. Besided this, seldom (once in a three-four days) I will get cramps in my left calf muscle (after walking couple of kilometers) or stomach muscle (after streching/yawning).

- No drinking/smoking/tobacco.
- Breakfast between 9 to 10 am. Lunch at 1pm. Light snacs and/or tea/coffee at 4pm. Dinner between 8-9pm. Mostly vegan diet. EGG once/twice in a week.

Therefore, I would like to know your opinion on this. Is the treatment correct? Is it required to carry out further investigations? Is it only musculoskeletal pain or something else is wrong ?

Posted Sat, 21 Apr 2012 in General Health
Answered by Dr. Jasvinder Singh 3 hours later

Thanks for posting your query.

In view of the symptoms that you have described and the blood test and TMT ECHO; the pain seems to be muscular in origin and vitamin D deficiency is the possible culprit.

However the dose of vitamin D needs to be slightly more. You need to take one XXXXXXX of vitamin D in milk or curd daily for 10 days, then weekly for 10 weeks and then monthly for one year.

Your oral formulation as the oral absorption of vitamin B12 is usually not that good. 2ml injection of vitamin B12(methycobal) is given intramuscularly in the gluteal region daily for one week, then alternate day for two weeks and then weekly for three months.

I will also suggest taking a deworming agent like albendazole 400 mg stat and another tablet after 3 days empty stomached under a medical guidance.

Deworming is important as worms in the intestine are notorious in producing vitamin B 12 deficiency.

Discuss about these possibilities and recommendations with your physician. You may take these supplements under his/her guidance.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Please accept my answer in case you have no follow up query.

Wish you good health.

Above answer was peer-reviewed by
Follow-up: Piercing pain in mid chest. Cramps in calf muscle or stomach muscle. Tayo hasn't worked. Musculoskeletal pain? 14 hours later
Thank you very much Dr. XXXXXXX I will show your reply to physician and do the needful.

I have couple of queries :

- What should I take in my regular diet so as to prevent B12 and D3 deficiencies ? I don't eat non-veg, except egg (3-4 times a week) and prawns(once in a month).
- Usually how much time it takes for these symptoms to disappear, after I start the treatment ? (considering that, it is already 4th week of the treatment)
- Will it be advisable to do the blood test now for checking the present level of D3/B12 ? (or it will show artificially high level due to supplements ?)
- Are there any specific exercises that I can do to get better ?
- If the deficiency would have been there from long time (since I used to get calf/stomach muscle cramps from almost a year), will it cause any permanent damage to my health ?

Answered by Dr. Jasvinder Singh 12 hours later

Thank you for writing back.

Egg and prawns are a good source of Vitamin B12. The main source of Vitamin D is adequate sunlight exposure. At least 1 hour of daily exposure is required. The symptoms will improve in 2 weeks.

I presume it is not required to do the blood tests of vitamins B12 and D3 presently. Any exercise is good for you. A brisk walking for 45 min daily at least 5 days a week is minimally recommended. There shouldn't be any permanent damage to tissues because of the same.

I sincerely hope this helps.

Take care.
Above answer was peer-reviewed by
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