S, Have you had a brain MRI? Have you been checked out by a cardiologist? Any ECG's of your heart recently?

It might be MG but don't rule out other possibilities. Guillain-Barre begins in the legs.

When I had an undiagnosed B12 deficiency, I had symptoms of weakness like you describe but it was usually after doing an activity. For example, I walked down a couple flights of stairs and almost couldn't walk afterwards. I sat for 20 minutes and was then better.

My B12 deficiency was making me tired but it was my undiagnosed MG making me weak. Though a B12 def. can make MG worse because you need B12 to make acetylcholine (ah-seat-ill-co-lean) in the body.

So MG weakness can come and go quickly if you are not in a generalized state yet.

Has your internist/primary doctor run some basic tests like a CBC (anemia), thyroid, B12 or other things that could cause weakness? They can also do an ECG of your heart. Heart problems can cause weakness.

If you get to the point where you can't move, breathe well or can't swallow, that's the time to get yourself to the ER. Don't drive! If you have MG, that's the point where it's an emergency. It doesn't matter if you haven't been diagnosed yet. At that point, you need care.

Your situation reminds me of the old story about the frog in boiling water. If you drop a frog in boiling water, it will try to jump out quickly. So would I. If you put the frog in lukewarm water and then slowly bring it to a boil, it gets "used to" the warmth and boils to death. Gross but a useful way to think about MG weakness.

If you use your right arm drying your hair, you may not notice the weakness right away. A couple hours later, all of a sudden your right arm is weak. You might think it's "all of a sudden" when the activity that began the reduction of the acetylcholine in your arm started two hours ago. You simply "ran out" of it at that one moment in time.

You may be in an MG stage where you recover more quickly than, say, I do. Some MGers recover quickly while others take longer. Or it takes more drugs. It is not a predictable disease and how it presents and progresses is different for everyone.

I've had MG my entire life (diagnosed at age 41). When I was younger, I adapted by not doing as much physically. It wasn't until about age 39 that I began not to "bounce back" as quickly as I used to. And now I get weaker more quickly and need more time to recover. That's one reason why I didn't respond sooner. I knew I'd have to type more than usual and I wasn't up for it!

Does that help explain MG? Crap, even after having it for years, it is not easy to cope with.

I hope you get some answers soon. Keep asking questions and don't assume anything. Trust your instincts. And just because a doctor doesn't know what's wrong doesn't mean something isn't.

Annie