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Pyridostigmine causing more weakness?

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Old 08-05-2018, 04:41 PM   #1
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Default Pyridostigmine causing more weakness?


I am new here. My doctors feels that is it likely that I have MG and started me on a low dose of Pyridostigmine. Just 1/4 of a tablet will cause a significant increase in muscle weakness, but only on the left side of my body. 1/2 of a tablet will cause even more overall muscle weakness and this time on both sides of my body except, oddly, for my neck and jaw which feel stiff. I feel so much worse on Pyridostigmine than I do off of it. These symptoms start less than an hour after taking it and last about 5 hours or so. It makes no sense to me. Anyone have this happen to them or have an idea of what is going on?

My symptoms while not on medication are double vision, trouble swallowing, weak heavy muscles, trouble breathing at times, extreme fatigue etc. However, the muscles in my face do not droop. I have a high/positive acetylcholine binding antibody level and am awaiting EMG results.
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AnnieB3 (08-06-2018)
Old 08-05-2018, 10:15 PM   #2
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Hi TeyB22

Welcome to NeuroTalk .

The MG forum is very active so I am sure that you will get lots of support and good suggestions from other members.

Best wishes.
Knowledge is power.
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AnnieB3 (08-06-2018)
Old 08-06-2018, 10:32 AM   #3
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Hi, TeyB22. Welcome!

I'd be interested to know what the EMG results reveal.

Mestinon does kick in after about 20 - 30 minutes. Mestinon wears off 2-1/2 hours after taking it (not 5). The effects can last longer in some people. Have your liver and kidneys been checked lately? They are responsible for the clearance of drugs in the body.

Your response to Mestinon doesn't make sense to me either. Are you taking the tablets? Taking the syrup is a pain, but that's what I take so that I can titrate the doses easier.

Do your neck and jaw feel stiff all of the time, or just after taking Mestinon?

Have you been checked for other basic things like vitamin B12 and D, thyroid, ECG, and a comprehensive metabolic panel (where they can check liver and kidney function)?

There are some people who do not respond well to Mestinon. I have no idea if that is the case for you. When you took Mestinon, were you just sitting around, not doing anything? Moving around?

Some people with high antibody levels need other drugs to improve weakness. I just hope that your doctor will come up with a plan soon.

If you become worse, please go to the ER. They can evaluate other signs, with tests such as O2 level, arterial blood gas, breathing tests, and a good clinical exam. MG can become rapidly worse, especially in the beginning when the disease is not adequately treated. Don't let that scare you—only empower you. An MG crisis can be life-threatening.

Whatever you do, stay out of the heat. That can make someone with MG much worse.

I hope you will figure out what is going on with the Mestinon. The drug is very good, without many side effects for most people (I don't have any). I hope you aren't anxious about taking the drug. Anxiety can increase muscle weakness.

Let us know what else you need help with, or if you just want to talk!

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muscle, muscles, pyridostigmine, trouble, weakness

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