Myasthenia gravis dietary taboos

Foods/drinks that are neurotoxic and affect medicinal efficacy that must be avoided, foods/drinks that are high-load and affect nerve conduction that need to be eaten with caution based on personal condition and body constitution, and foods that are academically controversial and do not require a one-size-fits-all ban. All taboos must be adjusted based on one's own tolerance. There is no universal prohibition list.

I recently received a 29-year-old patient with eye muscle type. After the summer, he felt too hot and ate iced watermelon every day. At most, he ate less than half a ten-pound melon a day. That night, he couldn't lift his eyelids and saw double images. The emergency department gave him a regular dose of pyridostigmine bromide, which lasted for two hours. Regarding the taboos of cold and cold foods, the opinions of traditional Chinese and Western medicine are actually consistent: according to traditional Chinese medicine, the vast majority of MG patients suffer from spleen and stomach qi deficiency. Excessive eating of cold and cold foods will damage the spleen yang and aggravate muscle dystrophy. ； Western medicine does not have the concept of "cold", but ingesting a large amount of low-temperature food in a short period of time will stimulate abnormal acceleration of gastrointestinal peristalsis, which directly affects the absorption efficiency of conventional oral drugs such as cholinesterase inhibitors. The efficacy of the drugs will be reduced, and the symptoms will naturally aggravate.

In addition to ice drinks and iced fruits that are easy to step on if you are greedy for coolness, there are also some things that you absolutely cannot touch, such as improperly handled puffer fish, moldy sugar cane, and undercooked green beans. The neurotoxins contained in these items will directly block the signal transmission at the neuromuscular junction. Healthy people may be poisoned and paralyzed if they eat them. If MG patients touch them, it will directly induce a crisis. If they are not sent to the hospital in time, their lives will be in danger. Alcohol is also a consensus-level taboo. Whether it is beer, liquor or fruit wine, as long as it contains alcohol, it will affect the release of acetylcholine. I have seen too many patients who are so weak that they can't stand up after drinking half a glass of beer. Don't risk your body.

There are also some foods that may cause trouble after just one bite, but patients who have eaten too much or are seriously ill need to pay special attention. For example, people often talk about high-magnesium foods, such as seaweed, nuts, and mushrooms. Magnesium ions inhibit the release of acetylcholine in nerve endings. It is okay for ordinary people to eat in large quantities. However, patients with systemic MG, especially those who have experienced crises in the past or currently have high blood magnesium, may aggravate their fatigue if they eat in large amounts. Last month, there was a 56-year-old aunt who heard from a community health class that seaweed supplements potassium and prevents blood clots. She cooked a large bowl of seaweed soup every day for a week. Later, her grip strength dropped to the point where she could not even hold chopsticks. When she came to check her electrolyte and blood magnesium, it was 0.3mmol/L higher than the normal value. After stopping seaweed, she recovered in less than a week. In addition, you should take your time with indigestible high-fat and high-viscosity foods such as glutinous rice, fried crispy pork, and sauced elbows. MG patients not only have weak muscles in their limbs, but also have weaker gastrointestinal smooth muscles than ordinary people. If they eat too much of these foods, the gastrointestinal tract will have to spend more effort to digest them, which will occupy all the energy in the body. Many patients told me that they would be paralyzed for most of the day after eating a hot pot meal. This is the reason.

As for the widely circulated statement on the Internet that "MG patients cannot eat seafood and soy products," this fact has always been controversial. There is a school of thought in traditional Chinese medicine that seafood, beef, mutton, and soy products are "fat substances" that will aggravate Qi deficiency and induce recurrence of the disease. Many doctors of the older generation will also advise patients in this way. ； However, there is no concept of "fat" in the Western medicine system. Instead, it is believed that seafood and soy products are sources of high-quality protein. As long as you are not allergic to these foods and do not have rashes, itching, or difficulty breathing after eating them, you can eat them normally. I have a 27-year-old patient with systemic syndrome. When he was first diagnosed, he was told by his family members that he should not eat shrimp. He had not touched any meat for a whole year. His albumin was as low as 32g/L and he would start to gasp after taking two steps. Later, I told him that he could eat it as long as he was not allergic. He ate boiled shrimp two or three times a week. After three months, his albumin rose to 40g/L and he could walk much more steadily. Of course, if you are allergic and really feel uncomfortable after eating seafood, you must avoid it. There is no need to follow the trend.

Another pitfall that everyone easily overlooks is the indiscriminate supplementation of health products. Many patients feel that they need to "enhance their immunity" when they are sick, so they buy a bunch of health products such as Ganoderma spore powder, royal jelly, and thymosin peptides and eat them randomly. Not to mention whether these products are useful, many unqualified health products may contain unknown doses of hormones or immune modulators, which will disrupt your own medication plan and even worsen the condition. There was a patient who believed in folk remedies, saying that eating raw toads can "detoxify and cure myasthenia". After eating it once, he was poisoned and was admitted to the ICU. It cost him hundreds of thousands to save him. It was really not worth the gain.

In fact, after having been in contact with MG patients for so many years, my biggest feeling is that dietary taboos really do not need to be so strict. Most of the dozens of fasting lists listed on the Internet have no basis. The core principle is: if it is clear that it is poisonous and will definitely make you feel uncomfortable after eating it, don’t touch it. If you are not sure, take a small bite first and try it. If there is no reaction after eating it, eat it normally. If you are really confused, ask your doctor. It is much more reliable than searching for unknown health posts on the Internet. After all, eating well and keeping up with nutrition are the foundation for a stable condition.