Living With Myasthenia Gravis: Energy, Heat, Infections and Safety

By Anna Curran, RN, BSN, PHN · Last reviewed October 2026

Living with myasthenia gravis means learning to work with your muscles, not against them. Planning your day around your energy, staying cool, avoiding infections and checking every new medicine can help you have more good days. Knowing the warning signs of a crisis keeps you safe.

MG weakness changes from day to day and even hour to hour. That can be frustrating. The good news is that small, steady habits can make a real difference. Here are practical ways to protect your strength.

Living With Myasthenia Gravis: Plan Around Your Energy

MG weakness gets worse the more you use a muscle and better with rest. Most people feel strongest earlier in the day. You can use this pattern to your advantage.

Do the hard things first

According to Mayo Clinic, it helps to plan chores and errands for the times of day when you have the most energy. For many people, that is the morning. Save lighter tasks for later.

Rest before you are worn out

Take short breaks during activities instead of pushing until you are exhausted. Break big jobs into smaller steps, such as cleaning one room a day instead of the whole house.

Let tools do the work

Mayo Clinic suggests using electric tools to save energy. Some ideas:

An electric toothbrush
An electric can opener
A shower chair
A stand that holds your hair dryer
Keeping items you use often within easy reach

Make home safer

Weak legs can raise your risk of falling. Mayo Clinic recommends:

Grab bars or railings near the tub and stairs
Removing loose rugs
Keeping floors and outdoor paths clear

Eating When Chewing and Swallowing Tire You Out

MG can weaken the muscles you use to chew and swallow. Meals can get harder as they go on. These tips from Mayo Clinic may help:

Eat when your muscles feel strongest.
Chew slowly and pause between bites.
Eat several small meals instead of a few big ones.
Choose soft foods over hard or raw ones.

If you take pyridostigmine, ask your doctor or pharmacist how to time your meals with your doses. If you choke often, cough while eating or have food coming back through your nose, tell your doctor. A swallowing test or a speech therapist may help.

Coping With Double Vision

If you have double vision, Mayo Clinic suggests wearing an eye patch while reading, writing or watching TV. Switch the patch to the other eye now and then to reduce strain.

Stay Active, Gently

Regular, gentle exercise may help some people with MG, according to NINDS. Good choices include walking, stretching and working with a physical therapist. A physical therapist can design a plan that builds strength without wearing you out.

Always check with your doctor before starting a new exercise plan. Stop and rest if your weakness gets worse or you feel short of breath.

Beat the Heat

Heat can make MG weakness worse. The Myasthenia Gravis Foundation of America (MGFA) lists heat as a common trigger. Here are ways to stay cool:

Plan outdoor time for early morning or evening.
Use air conditioning or a fan. A fan with a water mister can help.
Try a cooling vest or carry instant cold packs.
Take a cool bath or shower if you start to feel overheated.
Eat foods with lots of water, like watermelon, cucumbers and salads.

Protect Yourself From Infections

Illness and infection can make MG weaker, and NINDS lists infection as a trigger for myasthenic crisis. Some MG medicines also lower your body’s ability to fight germs.

Simple steps can help:

Wash your hands often, especially before eating.
Stay away from people who are sick when you can.
Call your doctor early if you have a fever, cough or other signs of infection.

Ask about vaccines

Vaccines can help prevent some infections. Talk with your neurologist about which ones are right for you. If you take medicines that weaken your immune system, you may need to avoid live vaccines. If you take a complement inhibitor, Mayo Clinic notes that you will need a meningococcal vaccine or antibiotics to prevent a serious infection. Your doctor will guide you.

Medicines That Can Worsen MG

Some medicines can make MG weaker, and some can even trigger it. The MGFA keeps a list of medicines to avoid or use with caution. Commonly listed ones include:

Some antibiotics: fluoroquinolones (like ciprofloxacin and levofloxacin), macrolides (like azithromycin and erythromycin) and aminoglycosides (like gentamicin). Telithromycin should not be used in MG.
Botulinum toxin (Botox and similar injections)
Magnesium given by IV
Some heart and blood pressure medicines, including beta blockers and procainamide
Some malaria and arthritis medicines, including chloroquine, hydroxychloroquine and quinine
D-penicillamine
Statins (cholesterol medicines)
Some cancer immunotherapy drugs called checkpoint inhibitors
Some anesthesia medicines used during surgery

This does not mean you can never take these medicines. Sometimes the benefit is worth the risk, and your doctor will watch you closely. Never stop or change a medicine on your own. Talk with your doctor or pharmacist first.

Before any new prescription, over-the-counter product or supplement:

Tell every doctor, dentist and pharmacist that you have MG.
Ask your pharmacist to check new medicines against your MG.
Tell your surgical team about your MG well before any surgery.

Manage Stress and Sleep

Stress can make MG symptoms worse, according to Mayo Clinic. A few simple ways to ease stress include:

Slow, steady breathing
Progressive muscle relaxation
Calming music
Journaling about your day
Spending time with people who lift you up

Good sleep also helps your body recover. Keep a regular bedtime and a cool, dark room. Learning about MG and joining a support group can help you and your family feel less alone.

Be Ready for an Emergency

An emergency plan gives you peace of mind. The MGFA suggests keeping a packet with:

Your full medicine list, including over-the-counter drugs and supplements
Contact information for your doctors
Emergency contacts
Your medical history
A copy of the MGFA cautionary drug list

Carry a medical ID card or wear an alert bracelet that says you have MG.

Call 911 or go to the ER right away if you have:

Shortness of breath, or trouble breathing when lying flat
Fast, shallow breathing
A weak cough or trouble clearing saliva
Trouble swallowing that is getting worse
Trouble holding your head up along with breathing problems

These can be signs of a myasthenic crisis.

Call your doctor soon if your usual symptoms are slowly getting worse, you have new double vision or trouble chewing, or you think a new medicine is making you weaker.

Frequently Asked Questions

Can you live a normal life with myasthenia gravis?

Many people do. According to NINDS, most people with MG have a normal life expectancy. With treatment and some changes to daily habits, many people live full, active lives.

Is exercise safe with myasthenia gravis?

Gentle exercise like walking and stretching may help some people. Check with your doctor first, start slowly and rest when you feel weaker.

Why do I feel worse in hot weather?

Heat is a known trigger for MG weakness. Staying cool with fans, air conditioning, cold packs and cool showers can help.

What should I tell my dentist or surgeon?

Tell them you have MG and share your full medicine list. Some anesthesia and antibiotic medicines need extra care in people with MG.

The Bottom Line

Living with myasthenia gravis gets easier when you plan around your energy, rest before you are worn out and stay cool. Avoiding infections and checking every new medicine with your doctor or pharmacist can help prevent flares. Keep an emergency plan ready, and call 911 right away for any trouble breathing or swallowing.