Managing Your Energy With Myasthenia Gravis: Tips for Self-Care

Living with myasthenia gravis (MG) can wear on you. You may wake up feeling strong and energized — only to feel increasingly weak and tired as the day goes on.

That’s because when you have myasthenia gravis, the more your muscles work, the more tired they can become. It’s called “fatigable weakness.” But there are strategies that can help you conserve your energy.

Neurologist Georgette Dib, MD, shares tips for keeping fatigue at bay when you’re living with MG.

Tips to maintain your energy

Managing myasthenia gravis often means thinking differently about how and when you use your energy.

Dr. Dib says the goal isn’t to stop being active altogether. Rather, it’s about planning ahead, taking breaks and working with your body instead of against it.

1. Use your mornings wisely

Mornings are typically the best time to tackle your to-do list when you have MG. It’s probably the time of day when you’re feeling your best.

Here’s why: Your nerves release a chemical called acetylcholine that tells your muscles to contract. To do that, acetylcholine needs to bind to receptors in your muscles. But when you have MG, your immune system attacks those receptors, and the messages get harder to send as the day goes on.

“As you’re more active throughout the day, your body sends more acetylcholine,” Dr. Dib explains. “The receptors can’t keep up. So, they get blocked, and you notice increasing weakness and fatigue.”

When possible, it can help to run errands, schedule appointments, exercise and concentrate on other must-dos in the morning, before fatigue sets in.

2. Build rest periods into your day

Rest is one of the most important parts of managing MG fatigue. Simply sitting down and taking a break from physical activity can help your muscles recover.

“When you rest, you replenish your energy,” Dr. Dib encourages. “After some rest, your muscles will have more functional receptors available to work again.”

How do you know when it’s time to take a break?

“We typically recommend resting when you reach about 50% of your energy level,” she says. “You can bounce back faster if you rest before you become fully fatigued.”

Another way to look at it? Follow the “30-30 rule”: For every 30 minutes of activity, take 30 minutes to rest.

3. Exercise thoughtfully

Exercise is critical for supporting your heart health, mobility, mood and overall well-being. The key is choosing activities that don’t overtax your muscles.

Try low-impact activities like:

• Walking
• Stretching
• Yoga
• Water exercise or aqua therapy

But safety matters. Instead of walking for two hours straight, you might walk for 30 to 45 minutes, then rest and go for another walk later. Don’t swim alone, and be cautious about activities if your symptoms are flaring or if you’re having trouble breathing.

4. Stay cool

Heat can make myasthenia gravis symptoms worse. That’s because heat can interfere even more with communication between your nerves and muscles.

When possible, try to:

• Stay indoors during the hottest part of the day.
• Use fans or air conditioning.
• Wear lightweight clothing.
• Seek shade whenever possible.

5. Prioritize quality sleep

Quality sleep is the ultimate way to protect your muscles and fight fatigue.

“A good night’s sleep is the best way to restore your energy,” Dr. Dib advises.

Aim for seven to eight hours of sleep each night, and follow these tips to get the full restorative effect:

• Keep consistent bedtimes and wake-up times.
• Sleep in a cool room.
• Use your CPAP machine consistently if you have sleep apnea.
• Elevate the head of your bed or use extra pillows to prop your head and neck up if you have trouble breathing at night.

6. Make daily tasks easier

Saving energy wherever you can may leave you with more stamina for the things you enjoy most.

“Even small tricks can help preserve energy,” Dr. Dib says.

Dr. Dib suggests looking for ways to reduce unnecessary physical strain at home. You can:

• Use a shower chair.
• Keep frequently used items within easy reach.
• Avoid repeated bending or overhead reaching.
• Use electric appliances instead of manual ones.

Assistive devices like walkers or wheelchairs may help during longer outings or travel days to prevent exhaustion and lower your risk of falling.

Above all, be thoughtful about where you’re putting your energy. Maybe some tasks can wait until another day. Or maybe it’s time to ask for help with things that you may have trouble keeping up with on your own, like household chores or yardwork.

7. Consider what you eat and when

Eating can become surprisingly tiring when you have myasthenia gravis, especially if the muscles that help you chew and swallow aren’t cooperating.

Dr. Dib recommends planning meals around your symptoms and medications to help make eating safer and less exhausting.

Try these strategies:

• Time meals with your medication. If you take pyridostigmine (Mestinon®), Dr. Dib advises eating about 30 to 45 minutes after taking it. That’s when the medication is working best. “This can help with weakness that comes with chewing and swallowing,” she explains.
• Choose softer foods if chewing is difficult. Tough meats, popcorn, nuts and other hard-to-chew foods may increase jaw fatigue and raise the risk of choking or aspiration. Dry, crumbly food and thin liquids are hard to swallow controllably, while soft, moist and smooth foods are easier to swallow safely.
• Eat smaller meals if needed. Large meals can get exhausting if your chewing muscles tire easily.
• Focus on balanced nutrition. Getting enough protein and eating a healthy, balanced diet with plenty of antioxidant-rich fruits and vegetables can help support your overall energy and health.

8. Don’t rely on caffeine for energy

When fatigue hits, it can be tempting to reach for another cup of coffee or to crack open an energy drink. A moderate amount of caffeine is usually fine, but overdoing it may backfire.

“Caffeine is a stimulant, but it doesn’t improve the communication between the nerves and muscles,” Dr. Dib explains.

Too much caffeine may also interfere with sleep, making your fatigue worse the next day. Stick to about 400 milligrams of caffeine (about three mugs of coffee) a day.

9. Protect your mental health

Living with a chronic illness can take an emotional toll, especially when your symptoms interfere with the life you want to live.

Surrounding yourself with support can help you feel less isolated and more understood.

“It’s very important to talk to your friends, family and doctors,” Dr. Dib emphasizes. “We’re always here for you.”

Talk with your team about how MG is affecting your mental health. They can suggest support groups, therapy and other strategies to help you manage the emotional burden of your condition.

Some days may feel easier than others. But self-care can help during the rough times.

“There are many treatments and support is available to help you manage your symptoms and maintain a good quality of life,” Dr. Dib reassures.