The name myasthenia gravis means grave loss of muscle strength. This disease, another of many said to be increasing rapidly, is marked by exhaustion and progressive paralysis, which may affect any part of the body but most frequently involve the muscles of the face and neck. Double vision, drooping eyelids, frequent choking, and difficulty in breathing, swallowing, and talking, shown by imperfect articulation, stammering, and stuttering, are common symptoms.

Prisoners held in Singapore during World War II developed what appeared to be myasthenia gravis; partial paralysis caused choking, drooping eyelids, blurred and double vision, and difficulty in speaking and swallowing. They recovered completely after being given large amounts of yeast and liver over a long period. A report from the Mayo Clinic tells of a 39-year-old who had had myasthenia gravis for five years yet who made a spontaneous recovery two weeks after a toxic thyroid was removed. In such a case, the nutritional requirements are so tremendously decreased that the effect is the same as adhering to a highly improved diet.

Remarkable recoveries from myasthenia gravis have been reported when patients were given a diet high in protein, vitamin E, all the B vitamins, and, for a short period, milligrams of manganese at each meal. All the classical symptoms and other forms of partial paralysis disappeared within a few weeks. Each of these people had enlarged thymus glands, typical of adrenal exhaustion and/or a severe pantothenic-acid deficiency, but the enlarged glands "virtually melted away" when the diet was improved. The results were said to have been "rapid and astonishing."

Studies with radioactive manganese show that enzymes involved with muscular contraction contain this nutrient, and that the amount in human blood increases when muscles are damaged. The lack of manganese causes abnormalities of the muscles and nerves in experimental animals and muscular weakness and poor coordination in livestock. Although the amount needed by humans has not been established, wheat germ and whole-grain breads, the richest natural sources, may well be emphasized by persons suffering from such muscle weakness.

When given separately, cholin, pantothenic acid, and vitamins Bl, B2, B6, C, and E have been reported to have been helpful in treating myasthenia gravis. No studies seem to have been made in which diets adequate in all nutrients have been used. Blurred vision and some mild symptoms of myasthenia have been' produced in men deficient in vitamin B6 and pantothenic acid; and monkeys lacking vitamin B1 have developed symptoms identical to those seen in myasthenia patients.

In myasthenia gravis, some defect occurs in the production of a compound that transmits nerve impulses to the muscles. This substance, made in the nerve endings from cholin and acetic acid and known as acetylcholin, is under normal circumstances constantly broken down and reformed. In myasthenia gravis it appears to be produced in too meager amounts and/or cannot be reformed readily. The disease is usually treated with medication that retards the breakdown of acetylcholin, but unless the diet is made adequate, this approach is another example of beating a tired horse.

An entire battery of nutrients is necessary for the production of acetylcholin: vitamin Bl, pantothenic acid, potassium, and many others. A lack of cholin itself causes a marked under production of acetylcholin and results in muscle weakness, damage to the muscle fibers, and extensive scarring; and it is accompanied by the urinary loss of a substance, creatine, which invariably shows that muscles are being destroyed. The daily cholin intake in America is said to be less than one-fifth of the estimated requirement. Although it, can be made from the amino acid methionine provided a high-protein diet is eaten, folic acid, vitamin B12, and other B vitamins are necessary before the amino acid can be transformed into the vitamin.

Vitamin E increases the liberation and utilization of acetylcholin, but, if under supplied, an enzyme essential to the formation of acetylcholin is destroyed by oxygen. Again muscle weakness, damage, scarring, and loss of creatine occur, but giving vitamin E rectifies the situation.

Because the onset of myasthenia gravis almost invariably follows prolonged stress and is aggravated by drugs known to increase body requirements, an anti-stress diet unusually rich in every nutrient is indicated. Lecithin, yeast, liver, wheat germ, and eggs are excellent sources of cholin, and each should be taken daily in six small, high-protein meals generously supplemented with vitamin E, the anti-stress formula, magnesium, B-complex tablets high in cholin and inositol, and perhaps manganese. Salty foods should be eaten temporarily, and potassium increased by a generous intake of fruits and vegetables. When swallowing is difficult, all foods can be liquefied in a blender and liquid supplements used.

If the diet is completely adequate, such "rapid and astonishing" 56 improvement so frequently follows that there seems little justification for the belief that nothing can be done for myasthenia gravis.

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