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 Herbs and Supplements
Creatine, a nutrient involved in increasing muscle mass and strength has been found to be helpful.

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Myasthenia Gravis Symptoms
Myasthenia gravis is a syndrome of 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 of myasthenia gravis include muscle weakness, particularly in the eyes, face and neck. Patients with myasthenia gravis may have difficulty swallowing, chewing or speaking, and may have double vision. Other myasthenia gravis symptoms are fatigue, especially later in the day. Symptoms of myasthenia gravis 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
The causes of myasthenia gravis 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 myasthenia gravis, and myasthenia gravis 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.

Altered Biochemistry of Myasthenia Gravis
Myasthenia gravis is arguably the best understood autoimmune disease, and its study has also led to fundamental appreciation of mechanisms of neuromuscular transmission. Myasthenia gravis 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.

Myasthenia Gravis Research Update
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 Jun;33(6):869-72.
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. METHODS: 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. RESULTS: After creatine supplementation and training, the results demonstrated increases in BW (6%), fat free mass (4%), upper body volume load (37.0%), lower body volume load (15.0%), 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. CONCLUSION: 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.

[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 Mar;22(3):175-7.
Department of Neurology, Affiliated Hospital of Luzhou Medical College, Sichuan
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. RESULTS: 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 (P < 0.05), 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.

Myasthenia Gravis questions
Q. 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 main ingredients of MG Tab tablets are:

Withania Somnifera
Colchicum Luteum
Styrax Benzoin Dryand
Ammonium Chloride
Terminalia Chebule (Yellow)
Samilax China
     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)."
     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.

Q. Ocular myasthenia gravis--What are the optimum nutrition interventions needed ?  I have a patient who wants to use natural methods.
   A. I have not studied the treatment of ocular myasthenia gravis.