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Real members of MGteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Hi, I have been feeling twitching and slight trembling in my hands and frequent cramps in the legs. Does this happen to anyone else ?

A MGteam Member asked a question 💭

I was diagnosed in September 2025 and am currently on Pyridostigmine (360 mg per day) + other things for GI, etc. Will appreciate feedback please.

March 25
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Reactions
A MGteam Member

Yes, yes and yes! All three. Currently taking 160 mg of Mestinon and 10 mg of steroids. Drives me crazy!!!

March 31
A MGteam Member

Thank you Kay.

March 25
A MGteam Member

Amit
Have your magnesium levels checked? I've had this for over 30 years.
Only the past 5 years I've had crapping and twitching because I've been trying to keep my magnesium, potassium, and iron levels up. I figured out recently that my magnesium levels were too high for a person with myasthenia gravis.
The more I tried to be like a normal person 's level the more twitching and cramping I had.
My numbers are better at 1.6 1.7. anything higher than that. The twitching and cramping comes on pretty strong. Good luck on finding your answers. This is a snowflake disease but I think it's worth checking
Have a wonderful day! ❤️

March 25
MGteam

Are you experiencing muscle twitching, trembling in your hands, and leg cramps with myasthenia gravis?

Yes, these symptoms do happen to others with MG. Muscle twitches (called fasciculations) can occur in any muscle with myasthenia gravis, though they're less common than weakness. These involuntary twitches can affect your Show Full Answer

Are you experiencing muscle twitching, trembling in your hands, and leg cramps with myasthenia gravis?

Yes, these symptoms do happen to others with MG. Muscle twitches (called fasciculations) can occur in any muscle with myasthenia gravis, though they're less common than weakness. These involuntary twitches can affect your hands and other areas of your body.

The leg cramps you're experiencing are actually quite common with pyridostigmine. Studies show that between 30-40% of people taking this medication report muscle cramps as a side effect. While pyridostigmine helps combat muscle weakness by preventing the breakdown of acetylcholine, it's also linked to causing muscle cramps and pain.

The pattern of discomfort often follows your MG symptoms - starting in areas like the eyes and face, then potentially spreading to the neck, arms, and legs as you're experiencing. Here are some strategies that have helped other MGteam members manage cramps:

- Gentle stretching and conscious exercise (without overdoing it)
- Massage of affected muscles
- Applying heat or cold to cramping areas
- Staying hydrated and maintaining electrolyte balance

Since you were recently diagnosed and these symptoms can be bothersome, it's worth discussing with your healthcare provider. They can evaluate whether your pyridostigmine dosage needs adjustment or if other factors might be contributing to your symptoms.

A MGteam member wisely said, "Listen to what your body is telling you" - so keeping track of when these symptoms occur can help guide your treatment discussions.

March 25

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