Edwin, so sorry you are going through this. An MG diagnosis can be overwhelming.

MG waxes and wanes. So it it hard to separate the normal MG fluctuation with the drug cycles of mestinon and pregnisone.

Mestinon is a very short acting drug. For me it takes a half hour to be effective and starts wearing off between 3 and 3.5 hours after the dose. SO are you experience the worst symptoms more than 3 hours after your last dose? I take it an hour before my big meal so I do not have swallowing issues. I also schedule my physical activities around my mestinon dose so I am the strongest.

Most people take mestinon 3 or more times a day because it is short acting. I take 60 mg 4 times a day and the 180 mg time release at night. Could it be your doses are too far apart and your MG symptoms are breaking through? I would note how long since your last dose when you experience the MG symptoms and tell your doctor. He may have you take mestinon more frequently.

Pregnisone is a strong drug and some people do not tolerate it well. I myself and being weaned off pregnisone and I am down to 35 mg a day now. I think my body tolerated very well and I noted a marked improvement immediately too.

SOme people experience weakness from pregnisone initially and then improvement. As I decrease the dose, I can see an initial increase of symptoms and muscle pain and then after a few days on the lower dose, it starts to subside.

Eye symptoms for me seem the least predictable and show the least improvement.

I hope this helps,
kathie