Aggravating Factors for Myasthenia Gravis
Myasthenia gravis is frequently associated with chronic infections of any kind. These infections may cause a myasthenia gravis crisis or exacerbate existing conditions by provoking a T-cell-mediated immune response. Below are other aggravating factors for myasthenia gravis:
- Hormone fluctuation. One study documented a relationship between the female menstrual cycle and myasthenia gravis. Of the women studied, 67 percent reported exacerbation of their symptoms two to three days prior to the menstrual period. These exacerbations frequently required therapeutic changes (Leker 1998). Both progesterone and estrogen levels are lowest at that time of the cycle.
- Pesticides. Many pesticides contain organophosphorus chemicals that inhibit the acetylcholinesterase enzyme. Although these agents may produce a cholinergic crisis in anyone excessively exposed, myasthenia gravis patients on antiacetylcholinesterase medication are especially susceptible. Halides (like chlorine and fluorine) may pose additional risk for myasthenia gravis patients. In one case report, an individual exposed to chlorine gas subsequently developed generalized myasthenia gravis (Foulks 1981). Fluoride is also implicated, and fluoridated water may trigger a myasthenia gravis crisis or contribute to long-term deterioration, with extreme exhaustion and muscle weakness (Waldbott 1998).