Hi Dave,

I think that your neurologist's approach of gradually going up with the dose is very wise.

I can understand wanting to feel great fast, but I think that with MG it is much better to slowly feel a little better each day.

When I first met my current neurologist I was surprised at his very slow and gentle (almost homeopathic) approach with every change in medications or even food supplements.

But, for the first time in 6 years, under his care my "crazy" fluctuations and dramatic changes became much less severe and for the first time I experienced a very slow and gradual uphill trend instead of downward slope.

He told me that from his experience with MG he doesn't like dramatic improvements as those are many times followed by quite as dramatic worsening. (at least from my personal experience this is very true).

I think you should just keep on slowly going up, adding 1/2 pill to your dose every few days and after your body has adjusted to the previous dosing. This way you will eventually find the safest and most effective dose.