Hello mrratty. Welcome to Neurotalk. Sorry you have MG and I'm glad mestinon is helping. My MG symptoms are mostly ocular and 180 mg/day of mestinon helps me also. Some days I don't feel I need as much. Other days, even the full dose doesn't completely eliminate symptoms. I think that's just the nature of MG. I was diagnosed last January and I'm learning to work around the ebb and flow without trying to fight it.

Your mestinon dose is very common although some people take greater or lesser amounts. Many people feel the drug wears off in about 3 hours. My neuro has condoned taking 30mg doses every two hours and I often do that to stabilize the relief. Doubling your current dose sounds like a lot. If you take too much mestinon it can actually cause muscle weakness. The 1st symptom of too much drug is muscle twitching. If you haven't read about that you can find information here: http://www.mestinon.com/

Many people use coffee or tea to work through a weak period. Apparently, caffeine has an action similar to mestinon on acetylcholine enzymes. It works for me.

It's no fun being newly diagnosed with this disease. I think stress and fear may be your worst enemy at this point. I wish you good luck finding your way with MG.