Does crest syndrome always have noticeable symptoms?

Yes: Stands for auto-immune disease including calcinosis, reynauds disease, esophageal dysphasia, scleroderma, and telangictasias. All of which give rise to very noticeable and problematic symptoms. Seek care with a rheumatologist.

Not necessarily: No, milder forms of crest syndrome are diagnosed late as the symptoms from one or more of the five conditions within crest are not noticeable.