Which factors are known triggers that can worsen MG symptoms?

• A. Vitamin deficiency
• B. Activity, heat, and stress
• C. Cold exposure only
• D. Aerobic exercise after therapy

Answer: (B)

The main idea here is that myasthenia gravis causes weakness that worsens with use and other stressors on the neuromuscular system. When muscles are used or stressed, there’s less reliable transmission of signals across the neuromuscular junction, so weakness becomes more pronounced. Heat makes this problem more noticeable because higher temperatures further impair the already fragile transmission at the junction. Emotional or physical stress can also tip the balance toward more fatigable weakness, likely by increasing overall fatigue and potentially influencing immune activity. Put together, activity, heat, and stress create conditions that commonly provoke flares in MG.

Vitamin deficiency doesn’t specifically trigger MG flares, and cold exposure isn’t a reliably established trigger for the majority of people with MG. Aerobic exercise after therapy isn’t a recognized trigger and, with proper management, supervised exercise can often be tolerated.