Krysse, it is pretty common for neurologists to tell their patients to adjust the Mestinon (the generic name is pyridostigmine) themselves, within certain parameters. Mestinon is considered a relatively safe drug, and 30mg (half a pill) two or three times a day is a low dose. Here's what's important to know about Mestinon: first of all, too much can make your symptoms worse. And second, it has a really short half-life. After four to six hours, it's pretty much out of your system. So your father-in-law should pay attention and see how it makes him feel. If he feels strong for the first two or three hours, but weak again for the next three hours, the thing to do would be to increase the frequency, and not the dose.

One sign of too much Mestinon is muscle twitches.

I don't know much about supplements except that MG patients need to be careful with magnesium. Also, there's something out there called huperzine which is marketed to MG patients. It works just like Mestinon (by blocking the enzyme that breaks down the chemical that the nerves use to communicate with the muscles). Taking Mestinon and huperzine together would be like taking a bigger dose of Mestinon (the patient would have to be careful he wasn't getting too much, which would make him weaker).

Abby