I have to believe it's just the stress on the bodies/muscles that are involved with being social beings that causes the increased symptoms. I have never been a terribly social person, nor an athlete in any sense of the word. However, when things were at their worst, I was lousy at any social activity, physical challenge and even could have an immediate reaction to a relatively minor event like someone cutting me off in traffic, the doorbell ringing, etc.

Since having the high dose cytoxan, those things are pretty much a non-issue. I can socialize with ease, and even drink a couple of glasses of wine with no decrease in function. Physical activity still is an issue from long term deconditioning, but not in the way it was with bad MG. It's more like normal fatigue.

It's very frustrating, and very isolating. However, it indicates that MG is active within your body, and you may need to examine your treatment strategy if you desire to not have it impact you so much (and even that gives no guarantee that it won't happen.)

Hope this helps.