Myasthenia Gravis

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myastheniaDescription - This is not a common disease (about 10/million people). It is an autoimmune condition where the body immune system attacks the body tissues (like rheumatoid arthritis, lupus and many others). In myasthenia gravis (MG) the immune white blood cells ( B, T and plasma cells) produce antibodies which block the signal from the nerves to skeletal muscle. The signalling compound which is blocked is acetyl choline. This causes weakness, fatigue, difficulty in speaking, chewing and swallowing and drooping eyelids. The cause for MG is unknown.

What Doctors can do

  • Give cholinesterase inhibitors ( Mestanon, neostigmine, pyridostigmine) which block the breakdown of the acteyl choline at the nerve ending, because it stays around for longer some of the signal gets through.
  • Immunosuppressive drugs to try to suppress the immune system which is causing the disease (prednisone, azathiaprin, cyclosporie). Other treatments showing promise include intravenous imunoglobulins, mycophenolate, and rituximab
  • For severe attacks plasmapheresis and immunoglobulins - to wash out and neutralise some of the antibodies causing the disease - these only give short term benefit
  • Thymus gland removal. As the T lymphocytes come from the thymus gland in the chest, and many patients with MG have thymus abnormalities, in some patients the thymus is removed. Sometimes this is helpful but not always (about 1/3 are 'cured', 1/3 are much better on less medication and 1/3 have no benefit. click here.).  A more recent trial has shown that the effects of thymectomy do make a mild improvement, but did not stop the disease, and patients still reequired steroid and other drugs, and cast doubt on its benefits, especially with the newer treatments becoming available.

What you can do

  • Exercise is a 2 edged sword, it can lead to exhaustion if overdone, but regular gentle exercise is beneficial for the muscles and general wellbeing. Listen to your body
  • Food - watch what you eat and see if anything consistently worsens the MG symptoms. Milk and milk products may do this. But if foods do not affect your symptoms, and you enjoy them, then by all means eat them, despite what some web site says.
  • Eat foods rich in potassium as this may help muscle function - bananas and fruits, fish and poultry.
  • Alcohol in moderation should not cause any problems, but if you feel worse don't drink, but never more tan a glass or two.
  • Coffee among other things has a mild anticholinesterase activity like Mestanon. This could make you feel better and stronger, but could also increase some of the mestanon side effects (cramping and diarrhoea). Like most things it is trial and error with Myesthenia, if it helps and you like it, have some coffee, if you feel worse stop.
  • Avoid STATIN drugs - these can make the symptoms much worse

Nutritional supplements -

  • A good multivitamin multimineral makes sure the tissues have all the nutrients they need. Many people with MG find eating difficult so a good multi is essential. Minerals like manganese, the B and C vitamins ( some Japanese prisoners in the war developed MG simply because of starvation of vitamins) (The USANA Cellsential * multi contains some phytonutrients which help the cells to switch on anf off processes when required.  Might they help in MG?  Nobody knows, but it can do no harm and is worth a try)
  • CoEnzyme Q10 is essential for energy transfer inside the cells and can be beneficial in people with muscle and other fatigue symptoms. The dose needs to be at least 100mg per day of quality Q10.
  • Calcium and magnesium are essential for nerve and muscle function so a good intake, especially of magnesium (500mg/day) seems wise.
  • Vitamin D is becoming increasingly appreciated in patients with immune diseases. people with MG have lower vitamin D levels (click here) , thus it is wise for anyone with an immune disease especially MG to take plenty of vitamin D 8000 - 10,000iu daily.
  • Fish oils are helpful for nerve structure and function, and may be helpful, but make sure they are pure oils with no toxins or mercury.

Other compounds like low dose naltrexone have been suggested but I have little information on this.  Discuss with your doctor before considering it.

The Nutritional supplements I use and recommend to my patients

Supplements I recommend :

For Myasthenia Gravis patients - USANA - Cellsentials, Biomega, Active Calcium plus, Coquinone and vitamin D -

Other therapies

There are a number of other therapies which you might like to look at.  They have not been specifically included with this disease because some are a form of treatment which is applicable to most diseases and many focus on the mind, body, spirit, and the universe. These include - acupuncture, Ayurvedic medicine, energy healing, homeopathy, naturopathy, prayer, visualisation and some people with this condition might like to look at these topics (I have described them more fully on another page on this website click here .) With my personal experience and reading, I do not think that I can comment of whether one or a number of these might help.    They fit well with most conventional and complementary treatments and I suspect some or even all of them can be extremely powerful - if performed by an experienced practitioner.    My only caveat is that if in the course of one of these therapies, you are given potions or herbs, do check with your health practitioner that they will not interfere with other treatments or drugs you are receiving.

Nutritional supplements

I believe in today's world that nutritional supplements are so necessary as to be an essential component of any form of both prevention and treatment. Not only is today's food lacking in nutrients because of the way it was grown and processed, but also most of us make the wrong choices in diet. It is virtually impossible to obtain optimal levels of most of the vitamins, minerals and other nutrients although many people try to do so, and even then fresh produce is not available all year round. *There are many quality supplements available on the market, including –Thorne, NFS, Douglas Labs, Xtend Life, True Star Health, USANA, and Metagenics. There are others, but do your due diligence before choosing one. USANA Health Sciences has added a new adjunct to its multivitamin and multi mineral called CellSentials. These are a patented blend of phyto-nutrients which they believe affects cell signaling and growth, and increases the production of preventative antioxidants within the cell. These should add to the value of the multi, so these are the multivitamin/mineral preparation I recommend.