Myasthenia gravis (MG) may cause a host of symptoms, but it doesn’t always stop at muscle weakness. This autoimmune disorder is associated with other diseases. Your treatment plan may also come with side effects that raise your risk of complications. It’s important to be aware of what they are so you can manage your risk.

In this article, we’ll talk about how myasthenia gravis may be related to other conditions. These include high blood pressure, diabetes, osteoporosis, cardiovascular disease, and aspiration pneumonia.

We’ll also cover how your doctor may manage these risks to help you live a healthier life. Be sure to talk to your primary care provider or neurologist (nervous system specialist) about any questions or concerns you have.

How Does Myasthenia Gravis Develop?

Myasthenia gravis is an autoimmune condition caused by autoantibodies. These specialized immune system proteins mistake the body’s own cells and tissues as foreign invaders. Autoantibodies tell your immune system to attack other proteins, hurting you in the process.

People with myasthenia gravis have antibodies that attack proteins in the neuromuscular junction (NMJ). The NMJ is the space where muscles and nerves connect to one another. If you have myasthenia gravis, you may test positive for:

• Acetylcholine receptor (AChR) autoantibodies
• Muscle-specific kinase (MuSK) autoantibodies
• Low-density lipoprotein receptor-related 4 (LRP4) autoantibodies

To treat myasthenia gravis, doctors use medications to dampen the immune system — such as corticosteroids. These immunosuppressive drugs stop your body from making autoantibodies that attack your nervous system.

Unfortunately, you may experience some side effects or even develop a new health condition from corticosteroid treatment. Other diseases may develop from myasthenia gravis itself.

High Blood Sugar and Diabetes With Myasthenia Gravis

Studies have found that people with myasthenia gravis are more likely to develop diabetes than those without. A large study from Taiwan found that myasthenia gravis raises the risk of diabetes by 26 percent. The study authors noted this risk may be due to certain treatments — like corticosteroids.

It’s well-known that corticosteroids can cause high blood sugar levels and diabetes. Specifically, corticosteroids can:

• Interfere with your cells’ ability to use insulin (the hormone your cells need to use glucose for energy)
• Stop your fat cells and muscle cells from absorbing glucose
• Make the liver release more glucose into the bloodstream

The same study from Taiwan found that people with MG who didn’t take steroids did not have an increased risk of developing diabetes. On the other hand, researchers found taking steroids for MG raised the risk of diabetes by 46 percent.

Managing Type 2 Diabetes

Type 2 diabetes can be managed with a combination of medications and lifestyle changes. In most cases, stopping your steroid treatment should bring your blood sugar levels back down to normal. However, some people may continue having high blood sugar even without taking steroids.

Your doctor can recommend lifestyle changes and medications, including:

• Regularly checking your blood sugar levels
• Eating a healthy diet and limiting sugar and carbohydrates
• Getting 30 minutes of exercise most days
• Using insulin injections or medications to make your cells more sensitive to insulin

Osteoporosis With Myasthenia Gravis

People with myasthenia gravis have an increased risk of developing osteoporosis. This is a bone-thinning disease that raises your risk of fractures or breaks. Osteoporosis develops because your bones break down faster than they build new tissue.

Bone thinning is common in older age, but certain conditions and medications can make it worse. The same study from Taiwan showed people with myasthenia gravis are nearly two times as likely to develop osteoporosis as people without MG. For those who had taken corticosteroids for myasthenia gravis, the study showed they were 2.37 times as likely to develop osteoporosis. The authors noted that people with MG ages 30 to 44 had the highest risk.

Myasthenia Gravis as a Direct Cause of Osteoporosis

Researchers also believe that osteoporosis in myasthenia gravis may be caused by muscle weakness. Your bones can become weak and thin if you don’t get enough movement and exercise.

Complications of myasthenia gravis that lead to osteoporosis and injuries include:

• Mobility problems that make physical activities and exercise difficult
• Ocular (eye) problems like ptosis (drooping eyelids) and double vision that raise your risk of falls and bone breaks
• Lack of vitamin D from less exposure to sunlight leading to poor bone health

Managing Osteoporosis

To help slow osteoporosis, your doctor may recommend taking vitamin D and calcium supplements. Exercise also helps strengthen your bones and muscles. Your doctor can refer you to a physical therapist to learn more about exercises for myasthenia gravis.

Cardiovascular Disease With Myasthenia Gravis

Some people with myasthenia gravis also develop heart problems.

Thymomas and Heart Disease

Heart problems seem to affect those with a thymoma (tumor on the thymus gland). The thymus is an important immune system organ that makes new immune cells. Overall, thymomas affect 10 percent to 15 percent of those with myasthenia gravis.

One study found most people with MG and thymomas also have autoantibodies that attack muscles, including the heart muscle. This creates inflammation that leads to heart disease. If you have a thymoma, your doctor can remove your thymus with surgery — known as a thymectomy.

Imbalanced Cholesterol Levels

Studies have found people with myasthenia gravis may have dyslipidemia. This refers to an imbalance of fats in the blood — like cholesterol and triglycerides. When you have dyslipidemia, you’re more likely to have heart disease and your risk of a heart attack or stroke increases.

Doctors typically treat dyslipidemia with medications known as statins. However, statins can make myasthenia gravis symptoms worse. Instead, your doctor may first recommend changing your diet and getting more exercise. If these changes don’t help or aren’t possible for you, other medications are available.

High Blood Pressure

Hypertension (high blood pressure) is a common side effect of corticosteroid medications. Some studies show it tends to be more common for men with myasthenia gravis. If untreated, high blood pressure increases the risk of various diseases, including heart disease, kidney disease, and brain hemorrhage.

Aspiration Pneumonia With Myasthenia Gravis

Myasthenia gravis causes muscle weakness that makes it difficult to perform basic functions. Some people have bulbar weakness, which affects the muscles in the jaw and neck. This can cause trouble with chewing and swallowing food.

Accidentally inhaling food or liquid into your lungs can lead to aspiration pneumonia. This bacterial lung infection can become dangerous if left untreated. Weak lung muscles also make it difficult to breathe and clear away mucus, bacteria, or food particles.

Studies suggest that between 16 percent and 41 percent of people with myasthenia gravis develop pneumonia at some point. It’s important to let your doctor know if you’re experiencing any symptoms of an infection. With aspiration pneumonia, you may notice:

• Wheezing or shortness of breath
• Fatigue or severe tiredness
• Chest pain or discomfort
• Coughing up pus (white discharge) or blood
• Bad-smelling breath

Preventing Aspiration Pneumonia

You’ll need to take extra precautions to lower your risk of infection while living with myasthenia gravis. Be sure to let your doctor know if you’re accidentally breathing in food or drinks.

To prevent aspiration pneumonia, your doctor may suggest:

• Taking small bites and thoroughly chewing your food to avoid choking
• Drinking thickened liquids that are easier to swallow
• Sitting upright while eating
• Brushing your teeth regularly to stop bacterial growth in your mouth

Maintaining Your Overall Health With Myasthenia Gravis

When living with an autoimmune disease like myasthenia gravis, it’s important to take care of your overall health. Be sure to attend regular checkups with your doctor to monitor your blood pressure and blood sugar levels.

Let your doctor or neurologist know if you begin experiencing any new symptoms — whether or not they seem connected to your disease. By addressing your symptoms sooner, you can continue living a healthy life with myasthenia gravis.

Find Your Team

On MGteam, the social network for people living with myasthenia gravis and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with myasthenia gravis.

Has your myasthenia gravis led to any other health conditions? What symptoms did you experience? How did your doctor treat them? Share your experience in the comments below, or start a conversation by posting on your Activities page.