I have done research regarding the new technologist of CT angiography, which some state is better than regular angiography, especially for women, in detecting small-vessel cardiac blockage. It is also said to be safer than traditional angiographs. For my own peace of mind, I was wondering if this would be a valid test for me to have? If so, is it as good a diagnostic tool as a traditional angiogram, which is invasive and carries certain risks?

DEAR READER: I believe, in you case, CT angiography (study of blood vessels and arteries) is redundant. This procedure is relatively new but has its drawbacks. it is generally considered more accurate than an MRI, is less invasive, more cost-effective and less painful. Some drawbacks to the procedure, however, are possible allergic reaction to the contrast material used or skin damage at the IV site, and the contrast takes up to 24 hours to leave the body. It is not recommended for people with kidney damage. People who are very obese may not fit in the CT machine. It is also not reliable for small, twisted arteries or vessels on organs that move quickly, such as the heart. Blocked vessels and abnormal heart function make it difficult to interpret the results.

In the case of inconclusive or abnormal results, traditional stress tests or angiographies are necessary. Since you have already had a normal stress test, it is not necessary to have CT angiography at this time.

As for your diagnosis of costochondritis (chest pain caused by rib or rib-cartilage inflammation), I believe this is correct. It can be mild or severe and the pain can often be reproduced by pressing on the affected area. This is not a life-threatening condition. Effective treatment includes the use of non-steroid anti-inflammatory drugs (NSAIDs) such as ibuprofen. Pain usually resolves in a few days with treatment but in some patients can last several months. Try using over-the-counter medications to treat the discomfort; if it persists, see your doctor, who may choose to run more tests and prescribe a stronger medicine, such as prednisone.

I had some blood work done more than a year ago and am sharing the results with you. My doctors don’t feel the work needs to be repeated. TSH 3.48, T3 2.8, T4 1.06, rheumatoid factor 8, ANA, 80, potassium 3.8, bilirubin 0.2, and sedimentation rate 2. I hope this helps you.

DEAR READER: Based on your symptoms and lab results I strongly believe that you have hypothyroidism. This means your thyroid gland is not producing enough thyroid hormone to maintain your health. The thyroid gland produces several types of hormone, mainly thyroxine which contains iodine that allows for normal body growth and function.

As for your lab work, your TSH (thyroid stimulating hormone) should be below 4 but anything higher than 2.0 coupled with an abnormal T4 (thyroxine) (4.5-11.2) is a red flag for early-stage hypothyroidism. Your T3 (triiodothyronine) level should be 1.0 to 2.0. Yours is elevated because your body is attempting to fix itself by releasing more of one hormone to compensate for the lack of another. However, this attempt is failing in your case. The ANA is abnormal and in some individuals with thyroid disease can be increased, much as yours is. The other levels are all within normal limits.

I strongly urge you to see an endocrinologist who specializes in glandular disorders such as thyroid disease. He or she should run more tests to get up-to-date results. I suspect, they will clearly point to hypothyroidism. The specialist should also check you for other disorders and forms of thyroid disease such as Hashimoto’s thyroiditis and others.

Treatment is simply thyroid medication taken every day. Once on medication you should start to feel better within a few days.

As an aside, depression is not generally associated with thyroid disease but given your situation and lack of resolution it can be expected. If your depression does not go away once you start to feel better, I recommend you see a psychiatrist or counselor. He or she can work with you and, if necessary, prescribe medication.

To give you related information, I am sending you a copy of my Health Report “Medical Specialists”. Other readers who would like a copy should send a self-addressed 4 ¼“ X 9 ½“ letter-sized stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.