Noone knows the difference! If I ask my GP which it is, he replies"yes". I have had several misdiagnoses due to the complications of MG. When I had difficulty swallowing, I TWICE had a Shatsky's Ring procedure, where they shoved an expander down my throat to expand the sphincter between my esophogus and stomach. It was almost 8 years before I recognized that was my MG that was causing it. I am now having hand (& foot)problems, and cannot distinguish between arthritis & MG problems. I will be 89 in 2 months & if I go to geritrician, he will be 40 years younger than me, and will not know which end is up. I have been living with MG for the past 35 years & haven't croaked yet! Symptoms come & go, and you are lucky if you recognize them on your own. Most MD's will tell you they have several patients with the disease, but after a while, you recognize that you are the only one.