There are approximately 60,000 patients with myasthenia gravis in the United States. Although once a severe and often fatal illness, myasthenia gravis can now be managed with several partially effective therapies. Management involves a graded approach, beginning with cholinesterase inhibitors for mild symptoms and advancing to immunomodulating medications for more severe weakness.
Myasthenia gravis treatment with
Very little research is available regarding the alternative treatment of MG.
Creatine, a nutrient involved in increasing muscle mass and strength has been found to be helpful.
Effects of resistance exercise and creatine
supplementation on myasthenia gravis: a case study.
Stout JR. Exercise Science Department, Creighton University, Omaha, NE. Med Sci Sports Exerc. 2001.
The purpose of this case study was to determine the effects of 15 wk of resistance exercise and creatine (Cr) supplementation on body composition, training volume, peak strength, and complete blood chemistry in a patient with myasthenia gravis. The patient was a 26-yr-old man who was taking prednisone and azathioprine for his condition. The patient self-administered 5 g of creatine per day in addition to resistance exercise 3 times per week. Fasting blood samples were obtained and body weight (BW) and fat free mass were measured before and after training and Cr supplementation. In addition, isokinetic (Cybex II) peak strength for leg extension (LE), leg flexion (LF), and volume load (repetition x mass lifted) for the first and last resistance training session were determined. After creatine supplementation and training, the results demonstrated increases in BW (6%), fat free mass (4%), upper body volume load (37%), lower body volume load (15%), and peak strength for LE (37%) and LF (12%). Moreover, blood chemistry values remained within normal limits for the duration of the 15-wk study. These data suggest that resistance exercise plus creatine supplementation may promote gains in strength and fat free mass in patients with myasthenia gravis. myasthenia gravis.
Int J Neurosci. 2015. Low antioxidant status of serum bilirubin, uric acid, albumin and creatinine in patients with myasthenia gravis. Oxidative stress and low antioxidant status play a major role in the pathogenesis of inflammatory and autoimmune diseases. Myasthenia gravis (MG) is an autoimmune condition targeting the neuromuscular junction, and its antioxidant status is still controversial. Our study aimed to investigate the correlation between the clinical characteristics of MG and the serum antioxidant status of bilirubin (Tbil, Dbil and Ibil), uric acid (UA), albumin, and creatinine. We measured serum antioxidant molecule levels of bilirubin (Tbil, Dbil and Ibil), uric acid, albumin and creatinine in 380 individuals, including 166 MG and 214 healthy controls. We found that MG patients had significantly lower serum levels of bilirubin (Tbil, Dbil and Ibil), uric acid, albumin and creatinine than healthy controls, whether male or female. Moreover, it was also shown in our study that uric acid, albumin and creatinine levels in patients with MG were correlated with disease activity and classifications performed by the Myasthenia Gravis Foundation of America (MGFA). Our findings demonstrated that serum levels of bilirubin (Tbil, Dbil and Ibil), uric acid, albumin and creatinine were reduced in patients with MG. This suggested an active oxidative process in MG patients who had low antioxidant status.
Probiotics, friendly bacteria
Ann N Y Acad Sci. 2018. Gut microbiota and probiotics: novel immune system modulators in myasthenia gravis? The alteration of gut bacteria composition (dysbiosis) could contribute to the development of immune-mediated diseases by influencing the immune system activation and driving the pro- and anti-inflammatory responses in order to promote or counteract immune reactions. Probiotics are nonpathogenic microorganisms able to interact with the gut microbiota and provide health benefits; their use has been exploited to dampen immunological response in several experimental models of autoimmune diseases. Here, we focus on the relationships among commensal bacteria, probiotics, and the gut, describing the main interactions occurring with the immune system and recent data supporting the clinical efficacy of probiotic administration in rheumatoid arthritis, multiple sclerosis, and myasthenia gravis (MG) animal models.
PLoS One. 2012. Prophylactic effect of probiotics on the development of experimental autoimmune myasthenia gravis.
Zhongguo Zhong Yao Za Zhi. 2009
Research advances of Huperzia serrata.
Qiancengta, a traditional Chinese medicine produced from the whole plant of the club moss Huperzia serrata, has been used for a long history in China for treatment of a number of ailments, including contusions, strains, swellings, schizophrenia, myasthenia gravis and noworganophosphate poisoning. It has become known worldwide as a medicinal plant since Chinese scientists discovered huperzine A from it in the 1980s, which is reversible, potent and selective acetylcholine esterase (AChE) inhibitors by in vitro and in vivo pharmacological, and produce definite effects in the treatment of Alzheimer's disease. Now, Qiancengta is popular in all over the word for his famous pharmacological actions. For further exploitation this valuable resource under protection of nature environmental, its biological and ecological features, pharmaceutical active ingredients, artificial propagation and in vitro tissue culture, were reviewed, and the sustainable use of Qiancengta natural resource through plant biotechnology was put on the agenda.
Clinical effect of Tripterygiitotorum combined with prednisone and its effect on serum IL-6 level in treating patients with myasthenia gravis
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2002.
To explore the clinical effect of Tripterygiitotorum (T II) combined with prednisone in treating patients with myasthenia gravis (MG) and the changes of immune function after treatment. Sixty-eight patients with myasthenia gravis were randomly divided into two groups, the 36 patients in the treated group were treated with T II plus prednisone and the 32 in the control group were treated with prednisone alone. The therapeutic effect, serum interleukin-6 (IL-6) and peripheral B lymphocyte levels were observed. The therapeutic effect in the treated group was significantly higher than that in the control group. There were significant decrease in serum IL-6 and peripheral B lymphocyte in both groups after treatment, with the decrements more significant in the treated group. The therapy of T II plus prednisone is superior to that of prednisone alone in treating myasthenia gravis, it has a more potent effect of immunosuppression.
J Clin Neurosci. 2018. Low serum vitamin D levels in patients with myasthenia gravis.
Am J Case Rep. 2016. Remission of Severe Myasthenia Gravis After Massive-Dose Vitamin D Treatment. This is a case report of a patient with severe and refractory myasthenia gravis (MG) who followed a "high-dose vitamin D treatment", a massive-dose treatment (80,000 to 120,000 IU/day) promoted by a medical center in Brazil (but still not proven), and she had her first complete remission after this type of treatment with increased vitamin D serum levels (400 to 700 ng/mL). This case report may reinforce the reported correlation between vitamin D level and disease severity and introduces a possible new use for vitamin D as a potential target for treating autoimmune diseases. We recommend large, double-blind, placebo-controlled, randomized studies using high-dose vitamin D treatment for refractory autoimmune diseases to reliably assess this pharmacotherapy target for these diseases.
Eur J Neurol. 2012. Vitamin D deficiency in patients with myasthenia gravis and improvement of fatigue after supplementation of vitamin D3: a pilot study. Patients with MG without previous vitamin D3 supplementation were started on vitamin D3 supplementation (cholecalciferol) 800 IU/day.
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Ocular myasthenia gravis -- What are the optimum nutrition interventions needed? I have a patient who wants to use natural methods.
I have not studied in detail the treatment of ocular myasthenia gravis with natural methods but will keep my eyes open for such research.
Thanks for the great website and all the information. I
am wondering if you are familiar with MG-Tab? Their claim is awesome. I am a
male 59 years old, diagnosed with OMG in October 05, looking for HOPE. I've
ordered, but not yet received their pills.
A. We had not heard of this product. According to their website, "MG Tab is a completely guaranteed and clinically proven herbal treatment for Myasthenia Gravis. It consists of a formulation consisting of purely natural ingredients based on the Unani (Greek) system of herbal medicine blended together in a specific proportion to fight and treat Myasthenia Gravis. Thousands of patients have been successfully treated with MG Tab over the past few years. MG Tab is a completely outstanding product and there is absolutely no alternative to its unique formula. Had the effectiveness of MG Tab not been proven beyond any doubt, it would not be possible for us to make such a bold claim. The exact proportion of each ingredient has been deliberately kept secret to avoid imitations of our confidential formula. Treatment with MG Tab is very rapid given the nature of the disease and obvious results can be noticed within three months (90 days) of use. A slightly longer period is required for serious myasthenia gravis cases and treatment can last up to four months (120 days). The main ingredients of MG Tab tablets are:
Styrax Benzoin Dryand
Terminalia Chebule (Yellow)
We find these claims difficult to believe. A search of published studies did not reveal any involving Mg-Tab. We have not seen any studies with the individual ingredients and myasthenia gravis. Plus, the company selling this product is breaking the law by making claims that their product can cure or treat an illness. You could take a gamble and buy it, but don't be surprised if you don't get your money back if you return an empty bottle.
My doctor is Wolfgang Grisold in Vienna / Austria.
After he made TENSILON test and ANTIBODY test, which both were positive, he has
diagnosed Ocular Myasthenia Gravis in 2007. He prescribed me than Mestinon 60 mg
3x1, what I have started with. Now I am taking Mestinon 60 mg 4x1, and have
problems and side effects. I know that steroids and immunosuppression are
jouries in unknown, without subsequent possibility to get back on the beginning,
before taking them. From your web site I have learned that you might have some
alternative therapy which could be more effective than present one. So, I am
writing to you with hope that your medication could be right one for my
I have not studied this topic well enough mostly because there is so little research on natural ways to treat this condition.
Can taking CoQ10 (30-50mg daily) reduce the amount of
Mestinon needed for Myasthenia Gravis (ocular)?
I have not seen such studies, so I don't know.
Myasthenia gravis symptoms
This syndrome causes fluctuating skeletal muscle weakness that worsens with use and improves with rest. Myasthenia gravis symptoms involve eye, facial, oral and pharyngeal, axial, and limb muscles in varying combinations and degrees of severity. Initial symptoms include muscle weakness, particularly in the eyes, face and neck. Patients may have difficulty swallowing, chewing or speaking, and may have double vision. Others are fatigue, especially later in the day which can be aggravated by emotional stress, systemic illness such as a viral respiratory infection, menstrual cycle, pregnancy, hypothyroidism or hyperthyroidism, and other factors.
Myasthenia Gravis Cause, diagnosis
The reasons are many, divided initially between those rare congenital myasthenic syndromes, which are genetic, and the bulk of myasthenia gravis, which is acquired and autoimmune. Therapeutic considerations differ for early-onset myasthenia gravis, late-onset, and MG associated with the presence of a thymoma. Most myasthenia gravis patients can be treated effectively, but there is still a need for more specific immunological approaches. It is possible that certain medications, such as statin drugs used to lower cholesterol levels, could aggravate this condition.
The basic abnormality in myasthenia gravis is a reduction in acetylcholine receptors (AChRs) at neuromuscular junctions due to the effects of autoantibodies that are directed against the AChRs in most patients, or against neighboring proteins involved in the clustering of AChRs (MuSK, LRP-4, or agrin).
J Autoimmun. 2014. Diagnostic and clinical classification of autoimmune myasthenia gravis. MG is characterized by muscle weakness and abnormal fatigability. It is an autoimmune disease caused by the presence of antibodies against components of the muscle membrane localized at the neuromuscular junction. In most cases, the autoantibodies are against the acetylcholine receptor (AChR). Recently, other targets have been described such as the MuSK protein (muscle-specific kinase) or the LRP4 (lipoprotein related protein 4). Myasthenia gravis can be classified according to the profile of the autoantibodies, the location of the affected muscles (ocular versus generalized), the age of onset of symptoms and thymic abnormalities. The disease generally begins with ocular symptoms (ptosis and/or diplopia) and extends to other muscles in 80% of cases. Other features that characterize MG include the following: variability, effort induced worsening, successive periods of exacerbation during the course of the disease, severity dependent on respiratory and swallowing impairment (if rapid worsening occurs, a myasthenic crisis is suspected), and an association with thymoma in 20% of patients and with other autoimmune diseases such as hyperthyroidism and Hashimoto's disease. The diagnosis is based on the clinical features, the benefit of the cholinesterase inhibitors, the detection of specific autoantibodies (anti-AChR, anti-MuSK or anti-LRP4), and significant decrement evidenced by electrophysiological tests. In this review, we briefly describe the history and epidemiology of the disease and the diagnostic and clinical classification.
J Clin Neurosci. 2014. Statins can induce myasthenia gravis. The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins, are commonly prescribed for prevention of cardiovascular morbidity. A rare side effect of statin medication is the induction of autoimmune illnesses, including myasthenia gravis (myasthenia). Here we present two patients with seropositive myasthenia that developed 4 weeks after initiation of atorvastatin, increasing the total reported patients to seven. Reviewing recent literature we highlight the connections between statins, auto-immunity and myasthenia. Statins may favour T-cell phenotypes that reduce cell-mediated immunity but could increase antibody-mediated humoral immunity.
Standard medical treatment
Symptomatic treatment with acetylcholinesterase inhibitors is helpful, but many also require immunosuppressive drug therapy. Antigen-specific therapy is being tested in experimental disease models.
Myasthenia gravis is arguably the best understood autoimmune disease, and its study has also led to fundamental appreciation of mechanisms of neuromuscular transmission. MG is caused by antibodies against the acetylcholine receptor (AChR), which compromises effective synaptic transmission. It is clear that AChR antibody destruction of the postsynaptic surface is dependent on complement activation. A muscle-specific kinase has been recently found to be an antigenic target in myasthenia gravis patients without antibodies against the AChR. Autoantibody production in myasthenia gravis is a T-cell-dependent process, but how a breakdown in tolerance occurs is not known. In myasthenia gravis there is an interesting differential involvement of muscle groups, in particular, the extraocular muscles.
I am so impressed with your expertise and knowledge. Your articles are invaluable. I am a female patient with Myasthenia Gravis and I have suffered tremendously because of this disorder. I had a thymectomy twenty five years ago and still have symptoms of MG. I came across MG-tab in one of your articles and I have researched through the internet, but could not find a site for it, or any web that sells such supplements. I would greatly appreciate it If you could tell me how to go about that, as I am desperate to find a way to treat this disorder naturally. Thank you so much for all your help and all the great information you have offered us through your newsletters.
A. This was an email from someone who mentioned it but we cannot find a source of sale either.
I have Myasthenia Gravis. I had a thymectomy and I am in
remission the last 10 years. I had a dark blood analyses and discovered that I
have quite a few vitamin and mineral deficiencies with high cellular toxicity. I
also have rhematoid arthritis and fibromyalgia, which are under control, but
every now and then, I have a very small flare. I find it hard to find info which
is evidence based, on the use of natural remedies and herbs, as I am currently
completely chemical free. I had a naturalist prescribing me Milk Thistle,
Aswanganda and Devils claw, family of cats claw. I follow a B+ blood group diet,
which helps a lot. Can you please advise me on the safety of the above mentioned
herbs, and possibly assist me with a list of herbs / supplements which are
beneficial for MG and which is contraindicated? There is a lot of different
opinions, and I am looking for info that is evidence based.
A. I hope the info in this article helps and I will update it as more info is published on natural ways to treat myasthenia gravis.
I was diagnosed with MG since 2006 and I have been
searching for some herbs other than my medications called pyridostigmine. I take
my medication once in the morning after breakfast but then in the late
afternoon, I felt tired, I have to lay down for at least half an hour and feel
better when I get up. Back in 2007, the hospital gave me some adverse
medications knowing that I have MG which, unfortunately, caused ischemic stroke
when I was only 42. After that, half of my life was pretty much destroyed. I've
read your helpful article and there is one herb that I am interested in knowing
more called ashwagandha. Is this particular herb for MG?
A. I am not aware of studies regarding the benefits of ashwagandha as a natural treatment for myasthenia gravis.