Do you know someone who’s been diagnosed with myasthenia gravis? Maybe you’ve even noticed someone who has some tell-tale characteristics, like drooping eyelids, limited facial expressions, or slurred speech. Myasthenia gravis diagnoses are becoming more common in recent years for a variety of reasons. In this article, we’ll cover some of the causes and potential solutions for this autoimmune disorder.
What is Myasthenia Gravis?
Myasthenia gravis (MG) is an autoimmune neuromuscular disease in which the immune system attacks acetylcholine receptors at neuromuscular junctions (where the nerves and muscles meet). It creates acetylcholine-receptor (AChR) antibodies, preventing this important neurotransmitter from acting on the central nervous system.
Acetylcholine is the primary neurotransmitter of the parasympathetic (rest-and-digest) arm of the nervous system. It affects muscle contraction, mental sharpness, blood flow, heart rate, and more.
Because it affects muscle contraction, many myasthenia gravis symptoms are related to muscle weakness. The main muscles affected by this autoimmune disease are those around the eyes, which is why drooping eyelids are a classic sign of MG.
Types of Myasthenia
“Myasthenia” means muscle weakness and refers to a group of neuromuscular conditions, which includes myasthenia gravis. There are a few additional types of myasthenia: 
- Neonatal myasthenia gravis – Neonatal myasthenia is a temporary condition in which one out of ten babies born to women with MG develop it themselves. It usually goes away after a few months with treatment.
- Ocular myasthenia – Ocular myasthenia is a form of MG in which the muscles that control the eyes and eyelids are weak and tire quickly.
- Lambert-Eton myasthenic syndrome – Labert-Eton myasthenic syndrome (LEMS) is a rare autoimmune condition that affects nerve-muscle communication. Symptoms usually begin in the limbs.
- Congenital myasthenic syndrome (CMS) is similar to but different than myasthenia gravis. Rather than an autoimmune condition, CMS is an inherited disorder of the neuromuscular junction that causes muscle weakness. CMS doesn’t respond to the same allopathic treatments as myasthenia gravis (steroids, surgery, etc.).
Symptoms of Myasthenia Gravis
Some of the most common signs and symptoms of myasthenia gravis are the following: 
- Weakness of the eye muscles (ocular myasthenia gravis)
- Drooping of one or both eyelids (“ptosis”)
- Double vision (“diplopia”)
- Changes in facial expression
- Slurred speech (dysarthria)
- Difficulty swallowing
- Muscle weakness – arms, hands, legs, neck
- Tumor on the thymus gland (thymoma)
A myasthenic crisis is a sudden worsening of MG symptoms. It’s a life-threatening event that builds up to the point of respiratory failure.
How is MG Diagnosed?
A doctor or neurologist will diagnose myasthenia gravis after doing specific tests. They most often use physical examinations, blood tests, and imaging. 
- Physical and Neurological examination – Muscle strength and tone, sense of touch, coordination, and eye movements.
- Repetitive nerve stimulation – Stimulating the nerves repeatedly to tire the muscles and observe the response.
- Single fiber electromyography (EMG) – This is the most sensitive test for MG and detects subtle issues with nerve-to-muscle transmission.
- Blood tests – Blood testing acetylcholine-receptor (AChR) antibodies, muscle-specific tyrosine kinase-seropositive (MuSK) antibodies, or antibodies against other proteins. Abnormal antibodies are a classic sign of autoimmune disease.
- Diagnostic imaging – like CT scans or MRIs to check for tumors.
The primary goal in mainstream diagnosis is to find what’s causing MG so the doctor can prescribe the most appropriate medication.
Mainstream Treatment of Myasthenia Gravis
For mainstream health care professionals, which we call “fireman” doctors, treatment of myasthenia gravis involves the usual tools: drugs or surgery. While an actual fireman will use a hose to put out the fire, a mainstream “fireman doctor” will use medications to reduce the inflammation or destruction. Medicines used for MG include the following: 
- Anticholinesterase medications: Cholinesterase inhibitors like pyridostigmine (Mestinon) or neostigmine slow the breakdown of acetylcholine at the neuromuscular junctions. They can improve muscle strength.
- Immunosuppressants: These drugs suppress the immune response, reducing symptoms. Examples include azathioprine, cyclosporine, methotrexate, tacrolimus, or mycophenolate mofetil, prednisone, and other corticosteroids. Suppressing the immune system reduces symptoms, but is it a good idea long-term?
- Monoclonal antibodies: Rituximab (Rituxan) and eculizumab are examples of monoclonal antibodies administered by infusion. Rituximab is used for rheumatoid arthritis, but doctors also use it for MG. Eculizumab has a black box warning from the FDA about the possibility of it causing meningitis.
Other interventions include:
- Intravenous immunoglobulin (IVIg) therapy – IVIg is used to improve muscle strength.
- Plasma exchange (Plasmapheresis) – Plasma exchange is the machine removal of antibodies from the blood. Side effects include a drop in blood pressure.
- High-dose intravenous immune globulin – An injection of antibodies from healthy donors that redirects the immune system. It works by binding to antibodies that cause MG and removing them from circulation.
Of course, these medications have harmful side effects; short term, long term, or both. Many people don’t do well with these treatment options, which are usually designed to chronically suppress the immune system. Those patients are referred to as “treatment-refractory,” meaning they are treatment intolerant.
In extreme cases, there may be a need for a thymectomy – surgical thymus removal. According to the National Institute of Neurological Disorders and Stroke (NINDS), about half of those who have their thymus gland surgically removed have long term complete remission of the MG. 
What Causes Myasthenia Gravis? Trauma, Toxins, & Thoughts
The concept of the 3 Ts originally comes from the field of chiropractic. However, it also applies to autoimmune diseases like myasthenia gravis. These three factors place stress on the nervous system, which then translates throughout the body. Here’s how trauma, toxins, and thoughts contribute to myasthenia gravis.
Trauma (Physical Stressors)
Autoimmune diseases more frequently occur in those who have a higher Adverse Childhood Events (ACE) score.  They are also often triggered by some sort of traumatic event. “Traumas” can include acute infections, injuries, and violence, and other physical stressors.
- Childhood trauma
- A traumatic injury
- Sexual assault/rape
- Car Accident
- Being a witness to violence or natural disaster
- Military combat –PTSD
- Death in the family
- Severe illness or infection
- Having a baby –major stress on the body
Toxins (Biochemical Stressors)
Toxins are biochemical stressors in the body. They can be from synthetic chemicals, natural toxins from mold or bacteria, and even natural cortisol and oxidative stress.
- Medications: We know medications have side effects, but not everyone realizes they can create new conditions like myasthenia gravis. A Scandinavian study admitted the existence of “drug-induced myasthenic syndromes.” Over 40 drugs are known to trigger or aggravate myasthenic syndromes like MG.  One of them is statins, which doctors prescribe to control cholesterol. 
- Chemicals: Organophosphates in nerve gas, pesticides, and insecticides may also trigger or aggravate myasthenia gravis. 
- Infections: Infections can serve as the “last straw” that triggers MG. Even the original SARS-CoV-2 infection is associated with new onset of myasthenia gravis. 
- Vaccines: Vaccines can also trigger MG, including flu shots, HPV vaccine, AND the newly introduced experimental injections falsely referred to as COVID-19 vaccines.  A 2021 source case report revealed an incidence of a MG crisis following a Moderna-produced COVID-19 injection. 
Toxins absolutely can contribute to autoimmune diseases like myasthenia gravis, but it doesn’t happen for everyone. While genetics are always an underlying contributing factor, stress levels can push you over the top. That’s where the subject of “thoughts” comes in.
Thoughts (Mental and Emotional Stressors)
When we talk about “thoughts” as trigger of disease, we’re referring to chronic mental and emotional stress. We can also tolerate intermittent stress like needing to slam on the brakes to avoid a car accident. However, staying in a constantly triggered state is a pattern that contributes to inflammation and dis-ease. How do these three T’s lead to dis-ease? It all goes back to the Swiss Watch Principle.
The Swiss Watch Principle and Myasthenia Gravis
One of the pillar teachings of The Wellness Way is that the body is made up of systems that work together like the gears inside a Swiss watch. Just like those gears, each system of the body affects all the others. One of those big gears is the gut.
Gut Dysbiosis & Leaky Gut
“All disease begins in the gut,” according to Hippocrates, a physician in ancient Greece. That’s especially true of any kind of autoimmune disease. The semi-permeable lining of the gut directly interacts with the immune system. If it becomes “leaky” due to inflammation and damage, food enters the bloodstream before it’s fully broken down, setting off alarms in the immune system. Read more about the concept of leaky gut here.
Myasthenia, Food Allergies, and The Immune Response
We already established that the gut plays a key role in the immune response, so it’s important to avoid aggravating the gut lining. That’s where food allergy testing comes in. Eating foods you’re allergic to triggers an immune response and inflammation of that one-cell thick lining of the GI tract. Then the immune cells attack the tissues of the body, creating an autoimmune dis-ease.
What most people don’t realize is that you cannot just eliminate the most common allergenic foods and assume you’re not triggering inflammation. You’d be surprised at how many people find they are allergic to innocent foods like black pepper, rice, and even lettuce.
Taking stress off the immune system by making dietary changes lowers inflammation allows the body to return to balance. Then it can respond more appropriately to real toxins and pathogens like mold toxins and bacteria.
Where to Start With Myasthenia Gravis
As with any autoimmune condition, it’s crucial to lower inflammation. That said, you need to find out what’s causing inflammation, which can be different for each person. Here are a few thoughts on where to start:
- Get Your Food Allergies Tested – Don’t guess; test! Not everyone has the same allergies. Some people do fine on chicken eggs, some tolerate only duck eggs, and some don’t tolerate either!
- Test Your Gut health – Find out what’s causing a leaky gut and allowing the autoimmune process to continue.
- Eat a Non-Inflammatory Diet – This will be different for each person based on food allergies, carbohydrate tolerance, and ability to digest certain foods.
- Take the Herbs and Supplements Recommended – Herbs and nutritional supplements can also help to lower inflammation and support the gut in healing.
Chinese herbal medicine may be a helpful for improving myasthenia gravis symptoms:
- One common herb used in traditional Chinese Medicine (TCM) is astragalus. In a 2009 randomized controlled trial, astragalus was studied alongside prednisone to treat myasthenia gravis patients. Astragalus was as effective as the prednisone for reducing symptoms, and more effective than the prednisone for optimizing the ratios of CD4+/CD8+ T cells in the immune response. 
- Another popular TCM herb is white peony. White peony may help myasthenia by lowering inflammation and supporting immune balance, alleviating symptoms. 
- A third TCM herb to consider for myasthenia gravis is rehmannia. Rehmannia has been used for thousands of years to help balance the immune response and improve “yin deficiency” conditions like allergies, infections, inflammation, and cancer. Recent studies are confirming that a compound in rehmannia improves autoimmune conditions. 
Some other herbs and supplements that may be helpful for MG include omega-3 fatty acids, vitamin D3, green tea extract, cat’s claw, and turmeric. Your Wellness Way practitioner can help determine which one(s) will be best for you.
How The Wellness Way Can Help
Getting autoimmune diseases like myasthenia gravis under control is all about lowering the traumas, toxins, and thoughts triggering the immune response and then restoring the gut. That’s why we test to find which factors are causing the immune system to ramp up. You don’t know what you don’t know… that’s why testing is crucial. The great news is that those with myasthenia gravis can have an excellent quality of life. They just need to take steps to support their body in healing. Make an appointment at a Wellness Way clinic today!
- Different Types of Myasthenia | myaware
- Myasthenia Gravis | National Institute of Neurological Disorders and Stroke (nih.gov)
- Myasthenia Gravis Treatment | Everyday Health
- Cumulative childhood stress and autoimmune diseases in adults – PubMed (nih.gov)
- Drug-induced myasthenic syndromes – PubMed (nih.gov)
- Statins can induce myasthenia gravis – PubMed (nih.gov)
- Intermediate myasthenia syndrome following acute organophosphates poisoning–an analysis of 21 cases – PubMed (nih.gov)
- Myasthenia Gravis Associated With SARS-CoV-2 Infection – PubMed (nih.gov)
- New-onset myasthenia gravis after mRNA SARS-CoV-2 vaccination: a case series | SpringerLink
- A Case of COVID-19 Vaccine Causing a Myasthenia Gravis Crisis – PubMed (nih.gov)
- [Effect of compound astragalus recipe on lymphocyte subset, immunoglobulin and complements in patients with myasthenia gravia] – PubMed (nih.gov)
- Total glucosides of paeony: A review of its phytochemistry, role in autoimmune diseases, and mechanisms of action – PubMed (nih.gov)
- Acteoside promotes B cell-derived IL-10 production and ameliorates autoimmunity – PubMed (nih.gov)
- Acteoside ameliorates experimental autoimmune encephalomyelitis through inhibiting peroxynitrite-mediated mitophagy activation – PubMed (nih.gov)