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What Causes Myasthenia Gravis To Get Worse?

Myasthenia gravis is generally a manageable condition. However, when the patient is exposed to certain factors, the symptoms of myasthenia gravis get severe.

What Causes Myasthenia Gravis To Get Worse?

What Causes Myasthenia Gravis To Get Worse?

Myasthenia gravis is the condition characterized by the weakening of the muscles. Thus, any factors that further weakens the muscles causes worsening of the myasthenia gravis. The trigger for worsening this condition may work in a variety of ways. They may either directly affect the muscles or may reduce the concentration of acetylcholine in the body. These triggers may also enhance the immune system, and this may further lead to worsening of the symptoms. Following are the triggers that may worsen the symptom of myasthenia gravis-

Rigorous Exercise- Myasthenia gravis is the condition in which muscles become weak. Performing rigorous exercise worsens the symptoms. Also, repetitive muscle movements also aggravate the symptoms. (1)

Stress– Stress worsens the symptoms of myasthenia gravis. Severe stress causes the release of the indigenous glucocorticoids in higher concentration. Alterations in the level of catecholamines due to the effect of stressors result in the exacerbation of myasthenia gravis. (1)

Pregnancy- During pregnancy, the women feel more fatigue and weakness which may lead to severe symptoms of myasthenia gravis. Pregnancy also increases the risk of developing a myasthenia gravis crisis. (2)

Infection- Immunosuppressants given during the treatment of myasthenia gravis suppresses the immune system resulting in an increased risk of infection. It has been found that infection worsens the symptoms of myasthenia gravis. Infection may also cause breathing difficulty in the patient.

Poor Emotional Health- Poor emotional health such as anger, frustration and anxiety results in aggravation of symptoms of myasthenia gravis. The condition is triggered due to the release of various chemicals in the body. (2)

Surgery- The stress generated during surgery and the complication of the surgery acts as a trigger for myasthenia gravis symptoms. The study concludes that the risk of developing complications during surgery is higher in myasthenia gravis patients as compared to normal patients.

Environment- Environmental factors such as humidity, high temperature, and change in weather trigger the symptoms of myasthenia gravis. (1)

Immunization- Although rare, but in some patients, immunizations from some viral infections may increase the symptoms of myasthenia gravis. (2)

Unmanaged Chronic Illness- Untreated or poorly treated chronic conditions such as the disease of heart and kidney worsen the symptoms of myasthenia gravis.

Medications- Various medications trigger or worsen myasthenia gravis. These medications should be avoided in these patients. Medications include antibiotics such as ciprofloxacin, clindamycin and aminoglycosides, beta blockers, calcium channel blockers, chlorpromazine, diazepam, and phenothiazines. (2)

Immuno-Enhancers- Various vitamin and mineral supplement improves the immune system of the body thereby increasing the severity of the disease. Further, these supplements interact with the functioning of immunosuppressants.

Fatigue- Fatigue in myasthenia gravis reduces the quality of life and very often worsens its symptoms. To prevent fatigue in myasthenia gravis, it is advised to take sufficient rest. (1)

Exposure To Harmful Chemicals- Exposure to chemicals and toxins also interferes in the natural neuromuscular process resulting in worsening of symptoms. These chemicals include insecticides and other industrial chemicals. (1)

Bright Light- Prolong exposure to bright light sometimes acts as a trigger for myasthenia gravis symptoms.

Low Level Of Potassium- Low level of potassium and underactive thyroid gland worsens the symptoms of myasthenia gravis.

Quinine Water- Consumption of water containing quinine aggravates the symptoms of myasthenia gravis. This tonic water contains a large amount of magnesium which is known to increases muscle weakness.

Hot And Heavy Foods- Hot and heavy diet cause discomfort in the throat due to the weakening of throat muscles. The patient may have difficulty breathing due to food congestion.


Various triggers aggravate the condition of myasthenia gravis. The major factors include fatigue, stress, poor emotional health, heavy and solid diet, chemical exposure, quinine or tonic water and rigorous exercise.


  1. https://www.myastheniagravis.org/about-mg/what-makes-mg-worse/
  2. https://www.medscape.com/answers/1171206-92581/what-factors-trigger-or-worsen-exacerbations-in-myasthenia-gravis-mg

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:June 24, 2021

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