Vitamins to Avoid with Myasthenia Gravis

In this article, we will take a close look at the relationship between vitamins and the progression of Myasthenia Gravis (MG), a chronic autoimmune disease that affects the neuromuscular junction. We will discuss the potential benefits and risks of vitamin D and B6 supplementation in MG patients, and why it's crucial to consult with a healthcare professional before starting any new vitamin regimen.
Frederika Malichová

Frederika Malichová

Neuroscientist at the University Of Cambridge.

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Vitamins to Avoid With Myasthenia Gravis

When dealing with Myasthenia Gravis, it's crucial to avoid certain vitamins.

High doses of Vitamin D can exacerbate symptoms, as it may overstimulate the immune system. Similarly, Vitamin B6 should be used cautiously, as it can interfere with certain medications used to treat the condition. Always consult with a healthcare professional before starting any new vitamin regimen.


What Is Myasthenia Gravis ?

Myasthenia gravis (MG) is a chronic autoimmune disease.

It is marked by the production of autoantibodies that target certain proteins (like AchR, MuSK, or rapsyn). These autoantibodies then disrupt the normal functioning of the neuromuscular junction [1, 2].

Therefore, the disease is considered a peripheral nervous system autoimmune disease.

MG affects primarily the neuromuscular junction and leads to fluctuating skeletal muscle weakness. This weakness of the muscles worsens with their use and improves when they are at rest [3, 4, 5].

The clinical symptoms of MG can vary as in different individuals, the muscle groups affected may differ to varying degrees [3].

The most commonly involved muscles include the eye, facial, oropharyngeal (throat), trunk, and limb muscles [3].

The core symptom of MG is fatigable muscle weakness. This weakness may affect muscles from the ocular, bulbar, and respiratory to limb muscles [1].

MG usually affects young women and older individuals but can present at any age [4]. The prevalence of the disease is 150-200 cases per million [1].

Do Vitamins Affect The Progression Of Myasthenia Gravis ?

Investigation of the effects of vitamins on patients with MG is a topic of ongoing research.

For instance, Vitamin D is known to be involved in the modulation of the immune system. Concerning MG, a meta-analysis found that the overall mean of Vitamin D in MG patients is 4.69 ng/ml lower than control levels [6, 7].

Interestingly, a case report has been documented, in which an MG patient completed a high-dose vitamin D treatment. In this case study, in addition to increased vitamin D serum levels (400 to 700 ng/mL) [8], they reported a remission of a severe stage of MG after the treatment. However, this is a single case and such a treatment approach is not yet proven.

However, a different randomization study did not find any effect between circulating vitamin D and MG [9]. Therefore, more research needs to be done to determine the role of vitamin D.

Further, another supplementation called Glyconutrient supplementation has also been studied regarding its potential effects on MG progression.

Glyconutrient supplementation consists of sugars supporting the body’s production of glycoproteins.

A pilot study found that dietary support and glyconutrient supplementation may provide psychological benefits to patients with MG and improve their Quantitative myasthenia Gravis Score referring to improved daily living, energy, endurance, productivity, and quality of life [10].

Are There Any Vitamins One Should Avoid When Affected By Myasthenia Gravis ?

According to available scientific evidence, there are no claims made suggesting that individuals with MG should avoid certain vitamins. However, it's important to note that the relationship between vitamins and MG is complex and can vary depending on individual circumstances.

However, melatonin, which is a hormone but can be taken as a supplement, should be avoided [11]!

If anything, according to some studies, vitamin D has been found to have a significant role in autoimmune diseases like MG [12, 7, 9]. Individuals affected by MG tend to have lower levels of vitamin D compared to healthy individuals [7]. In addition, vitamin D supplementation has been reported to improve fatigue in MG patients [12]. However, other studies did not find any association between vitamin D levels and MG [9].

Although vitamin supplementation looks relatively promising, melatonin which can be taken as a supplement has been reported to trigger worsening of MG. It is likely that what triggered the exacerbations of MG was melatonin's effect on the immune system [11].

Therefore, individuals with MG should avoid melatonin, and such supplementation should be consulted with a healthcare provider.

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Frederika Malichová

Frederika Malichová

Frederika is a postgraduate researcher at the University of Cambridge, where she investigates new biomarkers for Frontotemporal Dementia and other tauopathies. Her research has been published at prestigious conferences such as the Alzheimer’s Association International Conference 2023. She obtained her BSc in Biomedical Sciences from UCL, where she worked closely with the UK Dementia Research Institute.