Sorry you are having so many health issues. The hallmarks of MG are double vision with muscle weakness. Usually the eye muscles are affected first. They were with me. I had only occasional ptsosis. Most of the time my eyes just trembled or the muscles were jittery. One eye is noticeable more saggy than the other (eyelid, eyebrow and under eye).

There are a lot of overlapping symptoms with MG and CFS. And MGers often have another auto-immune disease like Sjogrens. IF I were you, I would ask for the ACH and Musk antibody test. If they were negative, I would ask for the single fiber EMG, the diagnostic test for sero negative MG.

My muscle weakness was always helped with ice and I can do more activity after rest or early on the day. I can not tolerate the heat at all and can barely walk any distance in the heat. I think I had MG creeping on me for years.

Does your neck just hurt or is it weak, has it dropped? Have you had any chewing or swallowing problems? Any stumbling? My MG progressed slowly until I had surgery and then I had a great exaccerbation. I saw specialist after specialist for a year until I finally got a diagnosis by going to a big teaching hospital.

I could tell mestinon was working within a half hour of taking my first pill. I have not experienced any major side affects with it and I am taking 450 -540 mg a day.

Let us know how you make out.
Good luck
kathie