Although myasthenia gravis fatigue cannot always be avoided, certain strategies may help reduce symptom flare-ups.
Strategic Pacing
“Because of the nature of the disease, patients have a limited amount of energy to use throughout the day. They need to plan ahead and use strategies to maximize their energy and minimize fatigue,” says Roda.
Planning activities around times when energy is highest can make a big difference.
Many people with myasthenia gravis find it helpful to schedule demanding tasks earlier in the day.
Du also recommends resting before activities that require significant muscle use.
“Until the disease is well controlled, it’s important to understand your body’s limitations and avoid overusing muscles,” she says.
Lifestyle Adjustments
Environmental changes can also help reduce fatigue. For example, maintaining a cooler environment can help prevent heat-related worsening of symptoms, Du says.
Breaking large tasks into smaller segments and taking regular breaks can also help conserve energy, says Roda.
Find ways to make repetitive tasks easier. For example, using electric tools such as an electric toothbrush or a can opener will keep those tasks from draining you.
Eye Care
Eye symptoms are often among the earliest signs of myasthenia gravis. Weakness in the muscles controlling eye movement can lead to drooping eyelids (called “ptosis”) or double vision.
Rest can temporarily improve muscle strength in myasthenia gravis. “When ptosis worsens, closing the eye or using an eye patch can temporarily improve eyelid muscle strength,” Du says.
For people who can still safely drive, resting your eyes before driving may help, says Roda.
Mealtime Pacing
“Chewing and swallowing are repetitive activities that can potentially cause muscle fatigue,” says Du.
- Eat when you feel strongest.
- Take smaller bites.
- Eat smaller, more frequent, meals.
- Eat more slowly.
- Choose softer foods later in the day.
Medication Timing
Many people with myasthenia gravis take pyridostigmine (Mestinon), a medication that improves nerve-muscle communication.
Pyridostigmine typically starts working within about 30 minutes and lasts roughly four hours, Du says. “It’s a good idea to plan more strenuous activities — including meals — during this window,” she says.