I missed that second question.

There are some who disagree that someone with MG has a normal amount of acetylcholine "produced" by the body. Without getting you a bunch of articles, which I really don't have the energy for right now (anybody else?), it has to do with the vagus nerve. Interesting nerve, that one is. And you can't separate body parts, like the nerves and muscles. Sort of a yin-yang situation.

Yes, the reason we don't get enough acetylcholine into our muscles is because the neuromuscular junction is damaged. There are fewer places for the acetylcholine to go into to get to the muscles. Mestinon keeps what we have around there longer so that we can use it, otherwise it gets eaten up by the enzyme. Too much acetylcholine in that area, and you have a cholinergic crisis or signs of an overdose.

It's easier sometimes to talk in more basic terms. I like the fact that you "want more, please!" It's good to really "get" all of this.

I should note that, as Alice has said, there are a lot of things that can go wrong in that neuromuscular junction. They don't know everything about it and have not delineated all of the possibilities. Or all of the potential disease states, which is my opinion.

Thanks for asking me to clarify that. My MG is pretty bad right now and I'm not certain my brain is working properly!! I'll have more coffee the next time I answer.

Annie