Triggers that may bring on symptoms of myasthenia gravis include stress, infection, and heat. Understanding your triggers can help you take steps to avoid them.

Myasthenia gravis (MG) is an autoimmune disorder where your immune system mistakenly attacks the connection between your nerves and muscles. This can lead to muscle weakness in the arms, hands, fingers, and legs, or cause breathing difficulties.

While there’s no cure for MG, developing a solid treatment plan can help slow disease progression and address your symptoms. Part of MG management should include understanding and taking steps to avoid certain triggers that can cause your symptoms to flare.

If you do experience an MG flare, your treatment plan should include steps to help manage any accompanying symptoms.

MG triggers can vary from person to person, but here are some common causes.

When you get sick, your immune system has to work harder to fight off the foreign invader. This increased immune activity can lead to worsening MG symptoms.

In extreme cases, an infection can trigger an MG crisis. A crisis occurs if MG makes it difficult to breathe. You will need emergency treatment if you are not able to breathe due to MG.

You may not be able to avoid all infections, but you can take some steps to help prevent getting sick, such as:

  • washing your hands regularly
  • avoiding contact with other people who are sick
  • avoiding heavily crowded areas
  • washing and disinfecting surfaces in your home or office regularly
  • discussing vaccinations with your doctor
  • wearing a mask (such as an N-95) in public

Immunizations help protect you from getting sick with an illness, such as the flu, measles, or COVID-19. If you do get sick, being vaccinated may also help reduce the risk of severe infection.

Some evidence suggests vaccines can trigger an MG flare-up. However, the benefit of the vaccine usually outweighs the risk of an MG flare-up.

A 2022 review looked at vaccine use in MG. Findings noted a few cases where COVID-19 vaccines led to an MG flare, but overall, the risk is minimal for most vaccinations. As a result, the researchers suggest most people with MG should stay on top of recommended vaccinations.

If you’re concerned about any immunizations affecting MG, talk with your doctor. They can give you vaccine recommendations based on your personal health.

During hotter months, you may find your MG symptoms worsen. Heat is a common trigger of MG flare-ups, making it more difficult to manage during the summer.

If you find that heat triggers your MG flares, taking steps to keep yourself cool can help. You can start by:

  • limiting outside activities during the hottest parts of the day
  • staying in air-conditioned areas
  • sticking to the shade when outdoors
  • wearing loose, comfortable clothing that does not trap heat
  • making sure you have medications or therapies on hand in case of a flare-up

Overexertion can lead to MG flare-ups in some people. If you find your symptoms worsen after exercise, when walking long distances, or doing any activities that strain your muscles, you may want to change your approach.

Some tips to help prevent overexertion include:

  • taking breaks during long periods of activity
  • building up slowly to longer distances or heavier loads when exercising
  • making sure you’re well-rested
  • knowing your limits, and also letting anyone you’re with know about them

Stress, particularly severe stress, can also trigger a flare of MG symptoms. Stress is difficult to avoid, but taking some time to learn stress management techniques may help prevent it from bringing on an MG flare.

To help keep stress at bay, you can try:

  • exercising regularly
  • practicing deep breathing exercises
  • trying meditation
  • participating in talk therapy or other forms of therapy
  • avoiding high stress jobs or situations

Pregnancy can trigger MG flares. So, if you have MG and you’re pregnant or trying to conceive, you’ll need to take a few precautions.

According to a 2018 study, if you have MG, you should work with a multidisciplinary care team to address potential treatment concerns when it comes to pregnancy. Researchers also recommend avoiding exertion and taking steps to ward off infections, such as urinary tract infections, when pregnant with MG.

If you are pregnant or plan to conceive, your care team will help you take the necessary steps to help keep you healthy.

MG can occur alongside several different health conditions, including:

  • thyroid disease
  • diabetes
  • hypertension
  • respiratory diseases
  • heart disease

Proper management of these — or any other other — health conditions can help prevent MG flares. If you notice any new or worsening symptoms, talk with your doctor to figure out the best treatment options for you.

People who have MG are advised to avoid certain medications that can trigger a flare-up. That includes a range of medications, from beta-blockers to Botox injections.

If you know you react negatively to certain medications, you can avoid taking them and tell the caregiver you have reactions to them.

If you discover a medication causes your MG to flare, let the prescribing doctor know. They can make adjustments and determine better options for you.

Surgery is another potential trigger for MG flare-ups due to the stress it puts on your body.

When discussing surgery, you may want to discuss your flare-up risk with a doctor or surgeon. They may be able to help you make a plan to help prevent symptom flares.

It may also influence their treatment recommendations and be a consideration for whether a procedure is the best treatment for you.

Various triggers can flare up MG symptoms that affect your ability to move your body or breathe.

While triggers vary from person to person, common MG triggers include factors like stress, infection, heat, and overexertion. Understanding which triggers may bring on an MG flare can help you take steps to avoid them — and, in turn, reduce symptoms.