What foods should I avoid with myasthenia gravis?

January 6, 2026 •

4 min read

Over 80% of people with myasthenia gravis (MG) experience difficulty swallowing or chewing, a condition known as dysphagia. Because of these challenges, it is crucial to understand what foods you should avoid with myasthenia gravis to help mitigate symptoms like fatigue and muscle weakness.

Quick Summary

Certain foods can worsen myasthenia gravis symptoms and make chewing difficult. High-fat, processed, sugary, and salty items should be limited, alongside alcohol, which can interfere with medications. Texture is also a key consideration to manage swallowing difficulties.

Key Points

Avoid High-Fat and Processed Foods: These can increase fatigue and contribute to weight gain, putting extra strain on muscles already weakened by myasthenia gravis.
Limit Sugary Foods and Drinks: Excess sugar causes energy spikes and crashes, exacerbating fatigue and making symptom management more difficult.
Minimize High-Salt Intake: Excessive salt can lead to fluid retention, a side effect of some MG medications like prednisone, potentially worsening symptoms.
Steer Clear of Tough, Dry, or Crumbly Foods: Tough meats, dry crackers, and crumbly cookies require excessive chewing, leading to jaw fatigue and increasing the risk of swallowing issues.
Limit or Avoid Alcohol: Alcohol can interfere with muscle function and reduce the effectiveness of myasthenia gravis medications, worsening muscle weakness.
Adapt Food Consistency for Chewing and Swallowing: Focus on soft, moist foods like pureed vegetables, ground meats, and smoothies to make eating easier and safer.
Eat Smaller, More Frequent Meals: This strategy helps conserve energy and prevents the fatigue that can result from chewing larger portions.

Impact of Food on Myasthenia Gravis Symptoms

While no specific food directly causes myasthenia gravis (MG) or its muscle weakness, certain dietary choices can exacerbate symptoms like fatigue and chewing or swallowing difficulties. The energy expenditure required for eating can be significant for someone with MG. Factors like inflammation, weight management, and medication side effects are also influenced by diet and can impact overall well-being.

Foods That Increase Fatigue

Fatigue is a hallmark symptom of myasthenia gravis, and certain foods can cause energy spikes and crashes that worsen this effect. The goal is to maintain stable energy levels throughout the day by focusing on nutrient-dense, whole foods. Eating smaller, more frequent meals can also help manage energy expenditure during mealtimes.

Processed and High-Fat Foods: These foods, such as fried fast food, processed snacks, and sweets, are often high in saturated and trans fats. They contribute to weight gain and can make you feel sluggish, compounding the fatigue already present with MG.

Sugary Foods and Drinks: Excess sugar intake from soda, candy, and sweetened cereals can lead to blood sugar fluctuations, causing a temporary energy boost followed by a significant crash. This roller-coaster effect can be particularly challenging for someone with MG.

Alcohol: Alcohol can interfere with muscle function and interact negatively with MG medications, potentially worsening muscle weakness and overall symptoms. It is generally recommended to limit or avoid alcohol consumption.

Foods That Exacerbate Medication Side Effects

Some medications used to treat myasthenia gravis can have side effects that are affected by diet. For example, corticosteroids like prednisone can cause fluid retention and bone thinning, while some anticholinesterase medicines can cause diarrhea.

High-Sodium Foods: Excessive salt intake can lead to fluid retention, which can be a side effect of prednisone. Processed and canned foods, smoked meats, cured goods, and salty snacks should be limited.

Fatty, Spicy, and High-Fiber Foods (during diarrhea): For those experiencing diarrhea from MG medication, it is best to avoid fatty, spicy, and high-fiber foods. This includes raw vegetables, bran, and certain dairy products, except for plain yogurt which may soothe the digestive system.

Foods That Pose Chewing and Swallowing Challenges

Weakness in the jaw and throat muscles is a common symptom of MG, making the texture of food a critical consideration. Certain foods require more effort to chew and manipulate in the mouth, increasing the risk of fatigue, choking, or aspiration.

Tough and Dry Foods: Dry, crumbly foods like crackers, toast, rice, and cookies can be difficult to manage and increase the risk of aspiration. Tougher meats like steak or raw vegetables that require prolonged chewing can also be very tiring.

Mixed-Consistency Foods: Items that contain both solids and liquids, such as cereal with milk or chicken noodle soup, can be tricky to swallow safely. The different consistencies require more complex coordination of the swallowing muscles.

Comparison Table: Foods to Avoid vs. Alternatives


Food to Avoid (and why)	Symptom Impact	Recommended Alternative	Benefit of Alternative
Tough Meats (steak, jerky)	Chewing fatigue, swallowing difficulty	Minced or Ground Meat (e.g., in stew)	Easier to chew, less jaw strain
Salty Snacks (chips, pretzels)	Fluid retention (from prednisone)	Unsalted snacks, fresh fruit slices	Reduces swelling and blood pressure issues
Soda & Sugary Drinks	Energy spikes and crashes, fatigue	Water, herbal tea, sugar-free smoothies	Promotes stable energy levels and hydration
Dry, Crumbly Foods (crackers, toast)	Aspiration risk, difficult swallowing	Moistened foods with gravy or sauce, oatmeal	Softer texture, safer to swallow
Fried & Processed Foods	Fatigue, weight gain, increased inflammation	Lean protein (fish, poultry), whole grains	Provides sustained energy, anti-inflammatory
Alcoholic Beverages	Interferes with medication, worsens weakness	Water, diluted juices, mocktails	Supports hydration and medication effectiveness
Dairy (during diarrhea)	Can worsen digestive upset	Yogurt with active cultures	Contains probiotics that can soothe the gut

Nutritional Strategies and Lifestyle Adjustments

Beyond avoiding specific foods, adopting certain eating habits can significantly improve symptom management with MG.

Adapt Food Consistency

Moisten solids: Add sauces, gravies, or broth to dry foods to make them easier to swallow.
Choose soft foods: Opt for soft-cooked vegetables, mashed potatoes, scrambled eggs, and yogurt.
Modify textures: Puree or blend vegetables and fruits into smoothies or soups to minimize chewing effort.

Manage Meal Timing and Portion Size

Eat smaller, more frequent meals: Instead of three large meals, consume several small meals throughout the day. This helps maintain consistent energy levels and reduces fatigue from chewing.
Time meals with medication: Some patients find it helpful to eat about an hour after taking anticholinesterase medication, when their muscle strength is at its peak.
Eat when energy is highest: Plan larger meals or more demanding eating tasks for times when your strength is typically best, often earlier in the day.

Stay Hydrated and Eat Mindfully

Prioritize water: Adequate hydration is crucial for muscle function and fighting fatigue.
Sit upright: Maintain an upright posture while eating to reduce the risk of choking.
Rest between bites: Pause for a few seconds between mouthfuls to allow jaw muscles to rest and recover.
Focus on the swallow: Be mindful of the swallowing process, and if coughing occurs, lean forward to help clear the throat.

Conclusion: Personalized Nutrition for Myasthenia Gravis

While there is no one-size-fits-all diet for myasthenia gravis, avoiding high-fat, processed, sugary, and excessively salty foods is a key first step in managing symptoms. Being mindful of food textures and consistency can also significantly improve safety and comfort during mealtimes, especially for those with dysphagia. By combining thoughtful food choices, strategic meal planning, and communication with a healthcare team, including a registered dietitian, individuals can create a personalized nutrition plan that supports their overall health and quality of life with MG. It is important to monitor how your body reacts to different foods and make adjustments as needed to best manage your symptoms. For additional support, consider joining online communities or organizations like the Muscular Dystrophy Association (MDA) to connect with others and find more resources.

Frequently Asked Questions

Yes, avoiding certain foods can help manage myasthenia gravis symptoms, though it's not a cure. While no specific food causes MG, some foods can exacerbate issues like fatigue and difficulty chewing or swallowing. Adopting mindful eating habits that consider food texture and nutritional content can significantly improve quality of life.

Tough meats and dry, crumbly foods should be avoided because they require more strenuous chewing, which can cause jaw muscle fatigue in individuals with MG. Dry textures also increase the risk of choking or aspirating food into the lungs, a serious concern for those with swallowing difficulties.

Yes, high-sugar foods and drinks can worsen myasthenia gravis fatigue. The rapid energy spikes and subsequent crashes caused by sugar consumption can be particularly detrimental when managing a condition already characterized by low energy levels.

No specific diet has been identified to cure or directly change the severity of myasthenia gravis, as it is an autoimmune disorder. However, following an anti-inflammatory diet and avoiding trigger foods that worsen fatigue or impact medication effectiveness can help manage symptoms and improve overall well-being.

Instead of tough meats, opt for softer protein sources that are easier to chew. Good alternatives include minced or ground meat, fish, well-cooked poultry, eggs, and legumes like beans and lentils.

Alcohol is generally not recommended for people with myasthenia gravis because it can interfere with muscle function and reduce the effectiveness of MG medications. This can exacerbate muscle weakness and other symptoms.

To make meals easier, modify food textures by choosing soft or pureed foods, moistening dry solids with sauces or gravy, and thickening liquids if recommended by a speech pathologist. Eating smaller, more frequent meals can also help conserve energy.

Yes, you should be cautious with magnesium supplements. While an essential mineral, magnesium can interfere with certain MG medications and, in some rare cases, has been linked to triggering a myasthenic crisis. Always consult with your doctor before starting any new supplement.

Managing weight can be a concern with myasthenia gravis. Some MG medications, like corticosteroids, can cause weight gain. Also, reduced physical activity due to muscle weakness can contribute to weight increase. Maintaining a healthy weight is important as extra weight puts more strain on your muscles and can worsen fatigue.