Hi, Ren. I think what you're talking about is how acetylcholine becomes "denatured" with heat. This issue of acetylcholine sounds simple but it's so complex that you really need a biochemist to explain it all. While I was going to be one, but went into the arts instead, I am not that knowledgeable on all the details.

The bottom line for most people here is that Heat is MG's enemy. That's pretty much all they need or want to know.

Acetylcholine and Acetylcholinesterase are sort of like water and antiduretic hormone (ADH). Too much water in the body and the antidiuretic hormone backs off. Too little and it kicks in. I wish the mechanism was the same for not enough acetylcholine. Our body is set up to protect against getting too much acetylcholine but not when we get too little of it.

Heat does increase production of acetylcholine, thereby increasing production of acetycholinesterase. That little enzyme eats up acetylcholine really fast. Because we don't have a lot of receptors for acetylcholine to go into, we need it to stay in that neuromuscular junction longer to give our muscles the chance to get as much of it as possible. And when that damn enzyme increases, we get even less of it.

There are other drugs too, like Benadryl and Atropine, that do the opposite of Mestinon. There is a list of drugs at www.myasthenia.org that you can look at that are relatively contraindicated in MG. They reduce acetylcholine while things like Mestinon, caffeine and nightshade foods inhibit acetylcholinesterase, thereby increasing acetylcholine.

It's so much more complicated than I'm saying it but, really, all anyone needs to know are the basics. And to get support for this disease.

I'm not sure I have the energy - or desire - right now to go into the differences between MG and autonomic disorders. I really have a lot going on and it takes brain power I don't seem to have lately. I have a lot more than only MG going on. I have an arrhythmia that kicks in while doing the littlest thing that could progress to V-Tach and V-Fib. So my mind is really elsewhere right now. If that changes, I'll post something, okay? Sorry but my life truly sucks right now.

I hope this info at least helped.

Annie