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I was recently diagnosed in October with MG from an EMG, but I don’t have AcHR antibodies

November 25, 2025
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A MGteam Member

What kind of symptoms are you experiencing?
Muscle cramps and twitching come from your muscles being over worked. And no you don't have to do much for that to happen. Pickle juice fixes that.
I've changed my diet to eat foods that can handle the meds.
If you don't have food allergies that should be a quick fix.
Look up which food cannot be tolerated with the meds and just eat everything else as you like. One hour before you take your meds..
Diarrhea stomach cramps nausea happen when you take your mestinon on an empty stomach or you've eaten foods that can't withstand the meds.
MG requires a delicate balance on our system.
Do you walk a lot?
Or have to do stairs?
Are you eating breakfast or just feeding the hunger?
Taking supplements and meds can cause nausea or Diarrhea or vomiting so we have to eat food that can handle the meds ad aren't on the no no list.

November 25, 2025 (edited)
MGteam

Has anyone else experienced symptoms worsening after starting Mestinon (pyridostigmine bromide), and what other treatment pathways have worked for seronegative MG?

Some people do find pyridostigmine side effects challenging. Common side effects include:

* Stomach cramps and nausea
* Diarrhea
* Increased sweating
* Muscle Show Full Answer

Has anyone else experienced symptoms worsening after starting Mestinon (pyridostigmine bromide), and what other treatment pathways have worked for seronegative MG?

Some people do find pyridostigmine side effects challenging. Common side effects include:

* Stomach cramps and nausea
* Diarrhea
* Increased sweating
* Muscle twitching
* Excessive salivation

These side effects can be bothersome enough that doctors may prescribe additional medications like glycopyrrolate or hyoscyamine to help manage them.

Since you don't have AChR antibodies, you have seronegative MG. Treatment options for seronegative MG are generally similar to those for antibody-positive MG, though they're tailored to your specific needs. Other treatment options your neurologist might consider include:

* Corticosteroids like prednisone, which can improve symptoms within days or weeks
* Immunosuppressants such as azathioprine, cyclosporine, or tacrolimus
* Intravenous immunoglobulin (IVIg) therapy
* Plasma exchange (plasmapheresis)
* Thymectomy if appropriate

It's worth noting that research shows people with seronegative MG may have different treatment responses. One study found that 10 percent of seronegative individuals reached remission or had symptom improvements, compared to higher rates in those with detectable antibodies.

If pyridostigmine isn't working well or causing difficult side effects, talk with your neurologist about adjusting your treatment plan. They can help find an approach that better manages your symptoms.

November 25, 2025

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