Just a quick update:

Thyroid calmed down a bit, and I experimented with different combinations (each form of choline separately, together, with and without pyridostigmine). The best combo I've tried is 150mg each of Alpha-GPC and Citicoline along with 60mg of Pyridostigmine. Typically keeps MG symptoms fairly well under control for about 8 hours, less if I'm feeling very hyperthyroid.

It did turn out to be a tumor, not necrosis. Went through CyberKnife and chemo. Chemo will continue at least until I get a followup scan in a few months to see if the tumor was treated successfully.

With the combination of MG, thyroid and fatigue/weakness from CyberKnife and chemo, I've been in bad enough shape that I often have to use a walker/rollator, and have a handicap parking placard.

Still no definite diagnosis of MG, but a referral has been put in for a single fiber EMG test.