I have had MG for 5 plus years now. My current dosage of mestinon is 5-6 30 mg tablets daily. About a month ago, My primary care doctor diagnosed me with pre diabetis, and recommended that I lose 20 pounds, which I did. My chewing started to get weaker. I went to the neurologist, she upped my prednisone to 60 mg daily. The chewing didn't improve, she wanted me to to to 120mg per day. I barely tolerated the 60 mg dosage. I did not try the higher dosage. Swallowing is good, very little mussle weakness, no eye droop. My question Is it normal for chewing to continue to be weak?

Hi,
Just a note to say it may be pretty normal, or at least for some. I was diagnosed about 7 mos ago, and take 60 mil mestinon 3 times a day. Most the time my chewing (which was one my main symptoms) is fine. But, there are times, maybe twice a week that I can tell it is a bit week. Honestly, not enough to be an issue to me. Just can tell a little. That is about all I can really offer you. I sort of chaulk it up to the fact that nothing is perfect. lol
FRED H

I may be wrong, but if I understand correctly you lost 20 pounds in one month?
Such a rapid weight loss can lead to electrolyte imbalance and nutritional deficiencies, which can definitely make MG worse.

To me it doesn't make much sense to increase the steroid dose, when you have pre-diabetes, unless you have severe or life-threatening symptoms.

I think your decision not to increase it further is very sensible.

I would try to take mestinon about 30 minutes before each meal, eat soft food/small and more frequent meals for a while and let your body gradually recover.

Make sure you diet is well balanced and that you have a good intake of potassium.