Myasthenia gravis flare-ups: Figuring out your triggers

Last updated May 23, 2025, by Susie Strachan
Fact-checked by Patrícia Silva, PhD

 

If you have myasthenia gravis (MG), the unpredictability of flare-ups may leave you uncertain about what each day might bring.

Understanding what causes MG flare-ups can give you more control by helping you recognize patterns, avoid common triggers, and respond early when your symptoms begin to change.

Building daily habits like checking in with your body, tracking your symptoms, and adjusting your activity level can help you stay one step ahead. Over time, this awareness can bring more stability to your routine and support a better quality of life while living with MG.

Understanding myasthenia gravis flare-ups

MG flare-ups — also called relapses — are temporary periods when your symptoms become more intense, affecting your daily life in different ways.

Some flare-ups can be managed at home with rest and self-care, while others may need medical attention. Knowing the difference can help you stay safer and feel more in control.

Common symptoms you may experience during a flare-up include:

• drooping eyelids (ptosis)
• double vision (diplopia)
• slurred or nasal speech
• difficulty chewing or swallowing
• weakness in your arms, legs, or neck
• fatigue that worsens with activity
• shortness of breath or shallow breathing
• muscle weakness that intensifies as the day progresses.

Flare-up vs. crisis

While flare-ups can be uncomfortable and disruptive, they typically don’t involve a risk of respiratory failure, which sets them apart from a myasthenic crisis.

A myasthenic crisis can happen when your MG symptoms become severe and muscle weakness affects your breathing, requiring immediate medical attention and possibly hospitalization.

Recognize common triggers

Not all people with MG react to the same things in the same way. Your triggers may differ from someone else’s. Identifying your own triggers can make it easier to manage symptoms and reduce the risk of serious MG complications.

Some frequently reported MG flare-up triggers are:

• infections, such as a cold or flu
• physical or emotional stress
• overexertion or fatigue
• hot or cold weather, as well as high humidity
• missed medications or changes in your treatment
• certain medications, including some antibiotics and blood pressure medications
• lack of sleep or disrupted rest
• hormonal changes such as menstrual periods and pregnancy
• exposure to pesticides, household cleaners, and other chemicals
• drinking alcohol.

Track your personal triggers

Once you know the most common triggers, the next step is to learn which ones affect you personally.

Keeping track of your daily routines, symptoms, and how you feel can help uncover patterns, especially if your symptoms change without warning.

A symptom diary or wellness tracker app can be helpful. Try noting things like:

• what you ate and drank
• activities and physical effort
• emotional stress or mood
• weather conditions
• any missed medications or schedule changes
• the timing and severity of your symptoms.

Over time, you may notice patterns between certain factors and flare-ups. Recognizing these patterns can help you make small, everyday changes that support your well-being.

Build a flare-up awareness routine

Creating a daily routine to check in with your body can help you stay in tune with your needs and make necessary adjustments throughout the day.

Morning check-in

Start with a morning check-in by taking a few minutes to notice how your body feels.

• Are your eyelids drooping more than usual?
• Do your arms or legs feel heavier?
• Is your speech a little slower?

These small changes can signal that you need to take things slower that day.

Set a daily baseline

Instead of aiming to meet yesterday’s activity level, set a flexible baseline that matches how you’re feeling today. This might mean choosing one or two key activities for the day, rather than your full to-do list.

Waiting until you’re exhausted can signal you’ve overdone it. Building in short rest breaks throughout the day, such as five or 10 minutes of sitting, can help prevent flare-ups before they escalate.

Ask for support

Finally, it’s OK to ask for support. Whether it’s help with housework, meals, or errands, leaning on others can help you stay well.

MG symptoms can be unpredictable, and being honest about your needs is not a weakness. Instead, it’s a strength that helps protect your energy.

What to do when a flare-up starts

When you first notice the signs of a flare-up, pause and listen to your body. Pushing through fatigue can make things worse, so taking a moment to rest can help you manage your MG symptoms better.

Start by focusing on your well-being with a few practical steps.

• Take short breaks throughout the day to allow your muscles to recover.
• Stay hydrated, especially during warmer weather or if you’re more active, as dehydration can worsen fatigue.
• Heat may intensify MG symptoms, so if you’re feeling overheated, cool down with a cool shower, air conditioning, or a damp towel around your neck.

If your symptoms continue to worsen despite these steps, reach out to your healthcare provider. Contact them if you’re experiencing:

• increased difficulty swallowing or speaking
• shortness of breath or trouble breathing
• severe muscle weakness affecting your daily activities.

Getting in touch early can help prevent a flare-up from progressing into a myasthenic crisis, which requires urgent treatment.

Create a support group

Connecting with others who understand your experience can offer emotional support, practical advice, and a sense of community.

Consider joining an MG support group, either online or in your community. These groups offer a space to share experiences, exchange advice, and learn about practical strategies others use to manage flare-ups.

In addition to connecting with MG peers, remember to involve the people closest to you, such as your friends, family, and caregivers. Educating them about MG and your personal triggers can make life more manageable and reduce stress during flare-ups.

You can work together to create a flare-up response plan. This can include:

• recognizing the early signs of a flare-up
• listing healthcare providers and emergency contacts
• outlining your medication regimen and any adjustments during a flare
• identifying your preferred rest methods and locations.

Having a clear plan in place can help your support network be ready to assist when a flare-up happens, giving you more peace of mind.

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Myasthenia Gravis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.