At 120 mg, you might be flooding the neuromuscular junction with too much acetylcholine. 110 mg is "normally" the max. Please talk to your neuro about going down to 90 mg. and taking Mestinon more often during the day. That higher dose might be affecting your throat muscles.

"Newbies" tend to go into a cholinergic crisis when they first have MG (too much Mestinon and acetylcholine). They can also go into a myasthenic crisis (not enough acetylcholine) before they are diagnosed and treated.

Mestinon kicks in after about 30 minutes. The drug wears off about 2-1/2 hours after taking it. So we have about 2 good hours of use.

I take the drug every 3 hours (sometimes sooner) around the clock. Yup, MG wakes me up.

If you drink coffee, that might affect the dose as well. Caffeine is a cholinesterase inhibitor and can cause an overdose of acetylcholine in combo with Mestinon.

I hope you have a good conversation with your neuro!

Annie