Comeonthen, I'm glad you've already been keeping a record and providing the doctors with it. It sounds as if they've been willing to use that record and haven't just ignored it, and that definitely looks as if they're at least taking your symptoms seriously.

I looked back over your previous posts and found that in 2015 you mention having had several MRIs, and you mention having seen more than 12 doctors over the past 3.5 years.

Given that record of so many visits to doctors, I thought it might be time to try something different for a while, but you've already tried my suggestion. Now here's another:

In 2018 you mention that you had a single-fiber EMG test with abnormal results--twice, pointing to asymptomatic MG. You also mention that you didn't try the pyridostigmine the doctor suggested.

Since this diagnosis or pre-diagnosis of MG is the only clear finding you seem to have had so far, why not return to the doctor who was willing to prescribe the pyridostigmine and give it a try? It's possible that you have MG and the symptoms you have been having are evidence that it's acting up.

Pyridostigmine is one of the standard treatments for MG:

Myasthenia Gravis Fact Sheet | National Institute of Neurological Disorders and Stroke

I can't say anything helpful about the white spots on your MRI except that the number of white spots found doesn't seem to matter so much as their location and appearance. MS is a difficult disorder to diagnose, though, and there are those who have MS without any MRI lesions. I've had 5 MRIs, and on some of them there has been no exact count of the lesions. It is just noted that they are present and indicative of MS.