Tips for Eating and Drinking with Myasthenia Gravis

Sometimes, myasthenia gravis (MG) weakens the muscles involved in eating and drinking. At times, it may be hard to chew and swallow food or drinks, or hold your head up to eat. However, like everything with MG, this is different from person to person and from one flare to the next.

When eating is hard, you can make it easier to get the nutrition you need to stay healthy with a few tips and tricks.

Learn your triggers

It may take some time to learn what combination of eating and drinking habits work for you. Some people find that drinking alcohol makes their symptoms worse. Other people find that drinks with caffeine, such as coffee, tea, and sodas, aggravate their diarrhea.

Many find meat hard to chew or that certain foods make them choke. Others find they need to eat several small meals a day, while others find it works to eat a big breakfast early in the day followed by mini-meals later. Spicy or fatty foods may make the stomach upset caused by some MG drugs worse, or it may not. Learning your food triggers will help you find ways to enjoy meals with more comfort.^1-3

Making eating easier

Your doctor, nurse, or speech therapist may have suggestions for ways to make eating easier when MG makes it hard to chew or swallow. Some common tips include:^1-3

• Leafy greens and other vegetables are a great choice nutrition-wise but may be hard to get into the mouth or hard to chew. Cut all vegetables into very small pieces, mash, or puree before serving.
• If steak is too hard to chew, substitute fish, seafood, or chicken
• Soften dry foods with sauces, broths, or condiments
• Avoid dry, crumbly foods that easily stick in the throat
• Eat slowly and rest between bites as needed
• Explore smoothie recipes to pack in nutrients that you do not have to chew
• Try tilting your head in different directions to see if another head position makes it easier to swallow
• Eat while sitting up in a chair

As with most everything related to MG, an eating tip that works for one person may not work for another. Some people find they need to thicken their food and avoid thin drinks because thicker foods move more slowly down the windpipe and reduce choking. Others find they need to take their MG medicine about 1 hour before eating so they have the muscle strength to chew and swallow.

Eating for weight control

When you have MG, fatigue and muscle weakness can make it hard to exercise or even be active around the house. Steroids, one of the main treatments for MG, often cause weight gain. This can make putting on extra pounds a constant battle for many people with MG. However, a well-balanced diet can combat the tendency to gain weight and boost your energy.

The recommendations for a healthy diet include eating more vegetables and fruits, less fatty meats, smaller portion sizes, and less oil, salt, and sweets.

Nutrition for people with MG

What you eat can help combat some of the side effects of medicines used to treat myasthenia gravis, such as:^1-3

• Eat bananas, potatoes, avocados, and apricots, and drink orange juice to replace the potassium you lose due to diarrhea
• Avoid salty foods, such as frozen meals, canned soups, smoked meats, fast food, and processed foods, to prevent fluid retention
• Avoid fatty, spicy, or high-fiber foods that cause stomach upset or diarrhea
• Choose bananas, white rice, or eggs to help soothe an upset stomach
• Make light soups with vegetables and barley or rice for extra nutrition
• Avoid dairy products like milk, yogurt, or ice cream if these foods make your saliva thicker
• Mix powdered superfoods or protein into a shake or smoothie to get more nutrition
• Take calcium and vitamin D supplements to fight bone loss (osteoporosis). Your doctor can recommend what dose is right for you.

Drinking alcohol is something some people with MG can do in moderation. Alcohol does not usually make muscle weakness worse. However, alcohol can cause slurred speech, loss of balance, and blurry vision in anyone and may make these issues worse in those with MG. Regardless, alcohol contains empty calories that might be better spent on other drinks rich in nutrients like a smoothie or unsweetened orange juice.

Always talk to your doctor or dietitian before adding things like nutritional supplements, vitamins, and protein powders to your diet. Some supplements may react with your MG medicines or make muscle weakness worse.