I have found this list to be very helpful to both me and people around me.  We need those around us to understand what make the symptoms worse and to be able to avoid these as much as possible. 

Noticing and avoiding myasthenia gravis triggers is one thing you can do to manage your disease. These factors can make MG worse:

• Fatigue, insufficient sleep


• Stress, anxiety


• Illness


• Overexertion, repetitive motion


• Pain


• Sudden fear, extreme anger


• Depression


• Extreme temperatures (hot or cold weather, hot showers or baths, sunbathing, saunas, hot tubs)


• Humidity


• Sunlight or bright lights (affects eyes)


• Hot foods or beverages (affects mouth and throat)


• Some medications, including beta blockers, calcium channel blockers, and some antibiotics


• Alcoholic beverages


• Quinine or tonic water


• Low potassium levels or low thyroid levels


• Some chemicals, including some household cleaners, insecticides and pet flea sprays


• Exposure to chemical lawn treatments

Infections and respiratory illnesses can produce increased weakness that lasts for a while after the illness is gone. The stress of surgery can make MG temporarily worse. The disease may intensify during certain times of a woman’s menstrual cycle.

Drugs to avoid

Commonly-used medications like ciprofloxacin or certain other antibiotics, beta-blockers like propranolol, calcium channel blockers, Botox, muscle relaxants, lithium, magnesium, verapamil and more, can worsen the symptoms of myasthenia gravis.

Any time you have surgery, your medical team needs to fully understand your medical history. Because some anesthesia can worsen MG, your surgeon and anesthesiologist will want to be prepared to manage your symptoms. Click here for information about Anesthesia and MG (article written by Kourosh Rezania, MD, University of Chicago) that is important to share with your doctors.

The University of Illinois at Chicago College of Pharmacy website describes medications that can make your MG worse. You also can find a list of medications to avoid on the Myasthenia Gravis Foundation of America website at www.myasthenia.org.

http://www.myastheniagravis.org/about-mg/what-makes-mg-worse/

MYASTHENIA GRAVIS—THE SNOWFLAKE DISEASE

Myasthenia Gravis (MG) is a neurological disorder. It causes fluctuating weakness of the voluntary muscles of the body and can include a drooping eyelid, blurred or double vision, slurred speech, difficulty chewing and swallowing, weakness in the arms and legs, and difficulty breathing. Symptoms can change from day to day—even hour to hour, sometimes making MG difficult to diagnose. MG affects each person so differently it sometimes is called “the snowflake disease.”