Hi Tyson,

I have muscles spasms. The ones I get all over are from the Mestinon, I think (more like twitching). The ones I get in my feet, calves and sometimes hips are from the prednisone, I think. Those are really painful, and make my feet go into contortions.

Are you taking vitamin D3 and calcium? Make sure you take those because the pred. blocks absorption of D3 and robs the bones of calcium. I take 1000 units of D3 and 1500mgs of calcium. I just found out I have a vitamin D deficiency, so I'll prolly be upping my D3 to 2000 units per day for a few days, then alternate back to 1000 units for three days, and so on, for a couple of months, then I'll check again. I think you should maybe get your levels checked too because I think a deficiency might play a part in the spasms/cramps. Also, a lot of people with chronic illness (especially cancer and autoimmune diseases) have very low levels of vitamin D.

I know what you mean about the paradox of getting all the side-effects of pred. but not the benefits. I think that many people with MG might not benefit from pred., though, just because of the kind of antibodies that are responsible for their weakness. Some antibodies just don't respond to it. It's just a guess on my part (so take it with a grain of salt), but I also have a similar situation.

I read somewhere, or maybe read it here (can't remember) that if you don't do well on pred., you prolly wont do well on Imuran since they both suppress the same sort of antibodies, so this is something to ponder/address with your doc. when thinking about the next treatment you're going to try.

Hope this helps a bit, and keep on keeping on!
Nicky