What factors worsen myasthenia gravis?

• A. Exercise and infection
• B. Sleep deprivation and medications
• C. High-sodium diet and dehydration
• D. Vaccination and sunlight exposure

Answer: (A)

In myasthenia gravis, weakness worsens with use of muscles and with systemic stress like infections because the neuromuscular transmission is already impaired by antibodies blocking acetylcholine receptors. When muscles are used repeatedly, the available acetylcholine receptors become insufficient to sustain contraction, so fatigue and weakness increase with activity. Infections add stress and inflammatory factors that further disrupt transmission and can precipitate worsening symptoms or a myasthenic crisis.

Sleep deprivation and certain medications can aggravate symptoms in some individuals, but exertion and infection are the most consistent and classic triggers. A high-sodium diet and dehydration, as well as vaccination and sunlight exposure, aren’t typically linked to worsening MG in the way that activity and infection are.