What Should I Eat If I Have Myasthenia Gravis? Your Comprehensive Nutrition Guide

October 5, 2025 •

4 min read

Approximately two-thirds of individuals with myasthenia gravis (MG) experience difficulties with chewing and swallowing, making proper nutrition a critical aspect of symptom management. Understanding what should I eat if I have myasthenia gravis is key to supporting overall health and mitigating the challenges posed by this autoimmune condition.

Quick Summary

A practical nutrition guide for myasthenia gravis patients focuses on anti-inflammatory foods, modifying food textures to ease swallowing, and navigating dietary needs influenced by medication side effects. It emphasizes nutrient-rich, easy-to-manage foods while advising against high-fat, processed, or hard-to-chew items, all while prioritizing hydration and energy management.

Key Points

Manage Chewing and Swallowing: Opt for soft, moist, and easy-to-chew foods to conserve energy and reduce the risk of choking or aspiration.
Embrace Anti-Inflammatory Foods: Incorporate foods rich in omega-3 fatty acids, antioxidants, and fiber while limiting processed, high-fat, and sugary items.
Strategize Meal Timing and Frequency: Eat smaller, more frequent meals, and plan larger meals when your muscle strength is at its peak, often after taking medication.
Address Medication Side Effects Dietarily: Counteract corticosteroid side effects like fluid retention and bone loss with low-sodium, high-calcium, and high-potassium diets. Manage potential diarrhea from other medications with bland, low-fat foods.
Consult a Professional Before Supplementing: Be cautious with supplements, especially magnesium, zinc, and certain herbs, which can interact with MG medications or worsen symptoms. Always consult your doctor before starting any new supplement.
Prioritize Hydration: Maintain adequate fluid intake to support muscle function and prevent constipation, though liquid consistency may need to be managed for safe swallowing.

Navigating Dietary Challenges with Myasthenia Gravis

Living with myasthenia gravis (MG) presents unique nutritional challenges, primarily due to muscle weakness and fatigue. The voluntary muscles, including those for chewing (mastication) and swallowing (dysphagia), can become easily fatigued, impacting mealtime and potentially leading to malnutrition or weight loss. Additionally, medications used to treat MG can cause side effects that require specific dietary adjustments. A thoughtful and personalized nutrition plan, developed with a healthcare team, is essential for managing symptoms and improving quality of life.

The Role of an Anti-Inflammatory Diet

As an autoimmune disorder, myasthenia gravis involves chronic inflammation within the body. Adopting an anti-inflammatory dietary pattern can be a beneficial strategy for symptom management. This approach focuses on nutrient-dense foods while limiting those that may promote inflammation.

Focus on:

Omega-3 Fatty Acids: Found in fatty fish like salmon, sardines, and mackerel, as well as plant-based sources like walnuts and ground flaxseed. These have potent anti-inflammatory properties.
Colorful Fruits and Vegetables: Berries, leafy greens, and cruciferous vegetables like broccoli are rich in antioxidants and polyphenols that help combat oxidative stress.
Healthy Fats: Extra virgin olive oil and avocados provide monounsaturated fats that support overall health.
Probiotics and Gut Health: A healthy gut microbiome can influence immune responses. Consider probiotic-rich foods like yogurt with active cultures to support gut health.
Hydration: Staying well-hydrated is vital for muscle function and managing fatigue. Drinking plenty of water throughout the day is recommended.

Limit or Avoid:

High-Fat and Processed Foods: These can contribute to weight gain and increase fatigue, placing more strain on muscles.
Refined Grains and Sugary Items: Foods with excessive sugar and processed carbohydrates can lead to energy spikes and crashes, which are particularly detrimental for managing fatigue.
High-Salt Foods: Excessive sodium can lead to fluid retention, a common side effect of steroid medications like prednisone. Avoid salty snacks, processed meats, and canned soups.
Alcohol: Alcohol can interfere with muscle function and the effectiveness of MG medications.
Caffeine: For some, caffeine can worsen symptoms like diarrhea associated with certain MG medications.

Managing Chewing and Swallowing (Dysphagia)

For many with MG, modifying food textures is necessary to ensure adequate nutrition and prevent aspiration (food entering the lungs). A speech language pathologist can provide specialized guidance, but general strategies include:

Choose softer, moist foods: Moisten solid foods with sauces, gravy, yogurt, or butter. Tender meats like fish or ground chicken are better choices than tough cuts of beef.
Modify textures: Mash vegetables, puree fruits into smoothies, or opt for soft-cooked cereals like oatmeal. Cook whole grains to a soft, mashable consistency.
Eat smaller, more frequent meals: This strategy helps maintain energy levels and prevents fatigue from large, strenuous meals.
Time meals strategically: Eat your largest meal when your energy levels are at their peak, often earlier in the day.
Rest before and during meals: Conserve energy by resting for 30 minutes before eating and pacing yourself throughout the meal.
Maintain proper posture: Sit upright while eating to promote safer swallowing.
Beware of mixed consistencies: Be cautious with foods that have both liquids and solids, such as cereal with milk or chicken noodle soup, as they can be difficult to manage.

Dietary Support for Medication Side Effects

MG treatments often involve medications with side effects that can be managed through diet.

Corticosteroids (e.g., prednisone): These can cause fluid retention and weaken bones. Limit sodium intake to prevent fluid retention and ensure adequate calcium and vitamin D for bone health. Good sources of calcium include fortified juices and cereals, and cooked dark leafy greens.
Acetylcholinesterase inhibitors (e.g., Mestinon): These can sometimes lead to diarrhea and stomach upset. Avoid fatty, spicy, or high-fiber foods that can aggravate these symptoms. Focus on bland, easily digestible foods and replace lost potassium with fruits like bananas and avocados.

Comparison of Food Textures for MG Patients


Difficult to Chew	Easier to Consume
Tough meats (steak, jerky)	Minced or ground meats (meatloaf, shredded chicken)
Dry, crumbly foods (crackers, dry rice)	Moistened foods with gravy, sauce, or broth
Crusty breads (bagels, hard toast)	Soft breads, overnight oats
Raw, hard vegetables (carrots, celery)	Well-cooked, mashed, or pureed vegetables
Nuts and seeds (whole)	Nut butters (smooth), seed powders in smoothies
Chips, popcorn	Smoothies, yogurt, applesauce

Considerations for Supplements

Certain supplements should be used with caution for MG patients due to potential interactions with medications or symptom aggravation.

Magnesium: High-dose supplements can increase muscle weakness and interfere with medications. Consult your doctor before taking magnesium supplements.
Zinc: High doses may boost immune activity and interfere with immunosuppressants. Obtain zinc from food sources rather than supplements, unless directed by a doctor.
Creatine: While some studies show benefit for muscle strength in general, its effect on MG is not well-established and may worsen fatigue. Discuss with a healthcare provider before use.
Herbal Supplements: Immune-stimulating herbs like echinacea may worsen autoimmune activity. Always check with your doctor before trying herbal remedies.

Conclusion

There is no one-size-fits-all diet for myasthenia gravis, but a strategic approach to nutrition can significantly improve symptom management and quality of life. By focusing on anti-inflammatory principles, adapting to dysphagia with modified food textures, and making dietary adjustments for medication side effects, patients can address their unique nutritional needs. The best path forward involves close collaboration with a healthcare team, including a doctor and dietitian, to create a personalized plan. For further reading, the Myasthenia Gravis Foundation of America provides valuable resources for patients and caregivers.

Frequently Asked Questions

There is no single best diet for myasthenia gravis. A personalized approach, often centered on anti-inflammatory principles, is recommended. This includes eating whole foods, focusing on healthy fats and lean proteins, and tailoring food consistency and meal timing to manage individual symptoms like fatigue and swallowing difficulties.

People with myasthenia gravis should generally avoid or limit high-fat and processed foods, excessive salt, and sugar. Certain foods like tough meats, dry crackers, and alcohol can be difficult to chew or may interfere with medication. Some high-dose supplements like magnesium and zinc should also be avoided unless a doctor approves.

To manage chewing difficulties, focus on soft, moist, and easy-to-chew foods such as ground meat, fish, mashed vegetables, and smoothies. Add sauces or gravy to dry foods and cut food into small, manageable pieces. Resting before and during meals can also help conserve energy.

If you experience dysphagia, sit upright while eating, take small bites, and rest between mouthfuls. Foods can be puréed or thickened to a safer consistency as recommended by a speech pathologist. Avoid talking while eating to minimize the risk of aspiration.

Yes, medications for MG often have dietary implications. Steroids can cause fluid retention, requiring reduced sodium intake. Anticholinesterase drugs may cause diarrhea, which can be managed by avoiding spicy, fatty, or high-fiber foods and eating bland, easy-to-digest options.

Yes, high-dose magnesium supplements can worsen muscle weakness and interfere with MG medication. High doses of zinc and immune-boosting supplements like echinacea may also be problematic. Always consult a healthcare provider before taking any new supplement.

Eating smaller, more frequent meals is generally recommended for myasthenia gravis patients. This strategy helps to manage fatigue and maintain energy levels throughout the day. It also reduces the chewing and swallowing effort required at one time, making mealtimes easier and safer.