Can Myasthenia Gravis Go Into Remission?

I am currently in remission, defined by the Myasthenia Gravis Foundation of America as "a person [who has] no signs or symptoms of the condition for at least 1 year."¹

My last MG flare-up ended in July 2024. Since then I’ve had no MG symptoms or any other physical indications of MG (except for maybe a positive blood test for ACh Receptor Antibodies (AChR+ MG)).

What is my body like now, following 4 years of MG flare-ups?

My first MG symptom appeared in January 2020. For four years I never once thought that I could achieve normal muscle strength and endurance again. When my remission started it was startling to me to suddenly regain full control of my voluntary muscles with only normal fatigue limiting my activities.

I’ve noticed during this remission that the muscles that were damaged by repeated flare-ups have been gradually returning to full function and strength. For example, I always suffered dysarthria and dysphagia during flare-ups.

I noticed that my tongue’s strength and range of motion had continued to improve (slightly but noticeably) since July 2024 and now seems totally normal. My neurologist had told me that there was a good chance that the damage would be permanent, but luckily that doesn’t seem to be the case for me. Apparently damaged ACh receptors can regenerate.

What should I expect?

I’m now approaching the two-year mark of this symptom-free period. I have no idea what happens next. Is this remission permanent? Or do I still have to be careful of those triggers that used to set off my flare-ups or exacerbations?

If symptoms return, will they be the same ones, or will I suffer weakness in other new muscle groups? Will I remain symptom-free until I die of old age? There are so many questions, but so little information available for finding any reliable answers.

I’ve spent six years mentally preparing myself to endure MG for the rest of my life. At this time I still assume that MG symptoms can reappear any time, any day. However, I no longer let that defeatist mentality fully control me like it did pre-July 2024. Sure, I could wake up tomorrow slurring and unable to swallow, but I refuse to let the thought of that possibility rule me. I refuse to live in fear.

Did I do something that initiated remission?

I think so! Actually, I credit two things that possibly put me into remission. First, in early 2024 I started Azathioprine (Imuran) and subsequently switched to Mycophenolate mofetil (CellCept).

These drugs are part of a class of immune suppressants that my immune system seems to respond to. The timeline for achieving efficacy (of this class of drugs) fits the timeline of my remission’s start (approximately 6 months). I had to switch from Imuran to CellCept only because liver damage was starting to show up in blood test results.

Second, I had completely overhauled my daily diet. If you look inside my fridge, you’ll only find raw, fresh, and organic (when possible) fruits, vegetables and juices. I derive my protein and grains from other wholesome sources. I rarely have any food that is processed or ultra-processed.

I had to mix in a lot of willpower and discipline, but I no longer have any unhealthful cravings (i.e., for delicious and addictive junk food). I even had my nutrition plan approved by a registered Kaiser nutritionist.

So, is it the MG drug, or is it the changed diet that possibly supports this remission? Or is it both? Well, the only way to find out would be by the process of elimination, and I’m definitely NOT going to do that test!

How do I feel mentally now that I’m in remission?

In some ways I feel lucky to have MG, as it forced me to radically change my health and eating behaviors for the better. I spent many months doing research, trying to learn as much as possible about both MG and nutrition, and right now I feel like all that effort has paid off well for me, as manifested by my full remission.

I now feel much healthier than I did six years ago, just before my MG first reared its ugly head. I’m convinced that these changes I’ve described will add years to my lifespan.