Are your eyelashes falling out too? Do you feel lifeless? Is that myasthenia gravis?

Do you sometimes feel like you're fine when you wake up in the morning, but as the day goes on, your body starts to lose energy? Especially when your eyelids feel heavy and droopy, your words get slurred when you speak, or you find it difficult to even lift an arm or leg? If these are familiar to you, it's important for you to be aware of the condition we're talking about today, called Myasthenia Gravis , or MG for short.

Simply put, what is Myasthenia Gravis?

This is an autoimmune disease that can last a lifetime. Simply put, our body's defense system, the immune system, mistakenly starts attacking healthy parts of our own body. In MG, this attack targets the connections between our nerves and muscles.

Imagine, our brain tells a muscle, "Okay, now you're going to contract." This message should travel along the nerves and reach the muscle. But in someone with MG, the "receptors" where this message is carried are disrupted by their own immune system. It's like losing the signal when you try to make a phone call.

As a result, the signals sent to the muscles become weaker as they are used, and the muscles gradually lose their strength. But after a short period of rest, they return to normal. This is the most distinctive feature of MG. Although this condition can occur at any age, it is most common in women under the age of 40 and men over the age of 60.

Why does our body do this to itself? What are the reasons?

It's not exactly known why the immune system attacks our own neuromuscular junction in this way. But the main reason is that the body produces antibodies against the receptors that receive the neurotransmitter acetylcholine. This acetylcholine is the "messenger" that carries the message that tells the muscles to contract. So when this messenger's place of action is blocked, the muscles don't work properly.

Some people also develop antibodies against other proteins. Although it is thought that this may have a genetic influence, many people with MG do not have anyone else in their family who has the disease.

Also, the thymus gland , an organ in the upper chest, has been found to be involved. This gland is enlarged in some people with MG. Researchers believe that sometimes this gland misinforms the body and causes it to produce these unwanted antibodies.

What are the main symptoms that can be seen?

The symptoms of MG vary from person to person. Some people may develop symptoms suddenly. Others may develop them gradually. Let's take a look at the main areas affected and what the symptoms are.

How do you know for sure that this is a disease?

If you have these symptoms, you should first see your family doctor. If he or she suspects this, he or she will refer you to a neurologist. He or she will ask you about your symptoms and perform a physical examination. In addition, there are several tests that can be done to confirm the diagnosis:

• Blood tests: Check your blood for those harmful antibodies (acetylcholine receptor antibodies) we talked about earlier.
• Edrophonium test: This test checks to see if a medicine temporarily increases your muscle strength. If there is a sudden increase in strength, it could be a sign of MG.
• Neurostimulation tests: A small needle is inserted into a muscle and the speed of nerve signals is measured. This can be used to see how quickly a muscle weakens when it is repeatedly used (electromyography).
• Ice pack test: An ice pack is placed on a drooping eyelid for a few minutes to see if the eyelid lifts. This can give an idea of ​​the condition because the cold temporarily improves neuromuscular communication.
• Imaging: Once the diagnosis is confirmed, a CT scan or MRI scan may be done to check for any problems with your thymus gland, such as a tumor (thymoma).

What are the treatments available?

MG is a disease that cannot be completely cured, but it can be very successfully managed. Your doctor will choose the most suitable treatment for you based on the severity of your symptoms, your age, and your overall health.

1. Muscle-strengthening drugs: The first line of treatment is drugs like pyridostigmine. These work by increasing the amount of acetylcholine at the neuromuscular junction. This drug provides strength within 15-30 minutes of taking it, and it lasts for about 3-4 hours.

2. Immune system suppressors: Many people need these medications because the disease is caused by our own immune system. First, steroids like prednisone are given, and then other medications like azathioprine are switched. These can take several months to show results.

3. Thymectomy: Whether or not there is a tumor in the thymus gland, surgical removal of it greatly reduces symptoms in some patients.

4. IV Therapy: This treatment is given in cases where symptoms are very severe, or in cases such as myasthenia crisis.

• Plasmapheresis: A special machine removes harmful antibodies from your blood and returns healthy plasma to your body.
• IVIG therapy: By administering antibodies (immunoglobulin) taken from healthy donors to the body, it temporarily alters the function of the immune system.
• Monoclonal antibodies: These are specialized antibodies made in a laboratory that target and attack specific parts of the immune system that are malfunctioning.

How should you take care of yourself?

Along with medical treatment, you can get great relief from small changes in your lifestyle.

• Get good nutrition: Eat several small meals throughout the day rather than one large meal. Eat your main meals when you have the most energy. Talk to your doctor about taking muscle-strengthening medications before meals.
• Exercise, but know your limits: Although exercise can give you long-term strength, avoid overexertion. Ask your doctor or physical therapist what exercises are right for you.
• Rest when you feel tired: Continue with your daily routine. But as soon as you start to feel tired, take a break. Listen to your body.
• Know what triggers the disease: Some people may experience an increase in MG symptoms when they are sick, when they are stressed, during menstruation in women, and due to certain medications. Talk to your doctor about this.

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