Staying Warm and Safe This Fall: How Cold Weather Can Affect Myasthenia Gravis

As autumn settles in and the air turns crisp, many people with Myasthenia Gravis (MG) notice subtle changes in how their muscles feel. While heat sensitivity is often a big topic in the MG community, cold weather can bring its own set of challenges. Cooler temperatures can affect how our muscles and nerves work, sometimes making daily activities feel a bit tougher. Let’s take a closer look at why that happens and what you can do to stay warm, comfortable, and safe this season.

How Cold Temperature Can Impact Muscles & Neuromuscular Function

Lowered muscle strength and speed

When muscles get cold, they contract more slowly and with less force. In those without neuromuscular weakness, studies have shown that muscles cooled to around 68°F tire out faster and lose strength more quickly than when they’re at the ideal body temperature 98.6°F (CSEP | SCPE, PubMed Central). For those with MG, whose muscles already tire easily, that extra loss of efficiency can make everyday tasks more challenging.

Reduced nerve conduction and neuromuscular efficiency

Cold temperatures can also slow the nerves that send signals to your muscles. One study found that even simple muscle actions take more effort when the body is cold (1.PubMed Central, 2.PubMed Central). Because MG affects how nerves and muscles communicate, this slowdown can add to fatigue or weakness.

Higher risk of fatigue, stiffness, and injury

When it’s cold, muscles and tendons tend to stiffen. That stiffness, combined with slower metabolism in cool temperatures, can make movement more tiring and increase the risk of strain or small injuries (1.PubMed Central 2.PubMed Central  International Journal of Circumpolar Health). That’s why it’s so important to warm up and dress in layers before heading outdoors or doing physical activity.

Shivering itself can be exhausting

When your body tries to stay warm, it naturally shivers to create heat. But shivering takes energy and can quickly drain muscles. For someone with MG, whose muscles already work overtime, this can increase weakness or discomfort (American Physiological Society).

Practical Tips to Stay Warm, Safe & Maintain Function

Given these physiological factors, here are strategies to help navigate cold weather months with more comfort and less strain.

Dress Smart: Layering & Warmth

• Layer up — use base, insulating, and outer layers so you can add/remove depending on temperature or activity.

• Insulate extremities — warm socks, gloves, hats, and thermal liners help preserve body heat and reduce peripheral cooling.

• Use warm, flexible fabrics — avoid stiff or tight clothing that restricts movement; soft, stretchy fabrics help maintain circulation.

Home Preparations & Environment

• Warm your space gradually — bring rooms to comfortable temperatures before beginning tasks.

• Warm-up before activity indoors — do light movement or stretching to get blood flowing before venturing into cold or doing demanding tasks.

• Minimize drafts & cold surfaces — close windows, seal cracks, use rugs or carpeting to avoid cold floors.

• Use heated aids — heating pads, warm packs, or electric blankets (used safely) can help warm extremities before activity.

Movement & Activity Strategies

• Warm-up gently — dynamic movements (e.g. gentle stretches) help “wake up” muscles before heavier tasks. Harvard Health recommends dynamic stretching in cold seasons to improve mobility and reduce injury risk.

• Pace yourself — break tasks into smaller parts, alternate “heavier” tasks with lighter ones, and rest before fatigue kicks in.

• Avoid high-intensity exertion in cold — when muscle temperature is low, peak performance drops and fatigue accelerates.

• Be cautious if tasks require gripping, twisting, or fine motor movement, since cold may reduce hand dexterity and strength.

  
  

Safety Measures & Monitoring

• Know your limits — some days your muscles may tolerate less; listen to your body and adjust expectations.

• Avoid sudden exposure to extreme cold — gradual transitions help muscles adjust; going from warm indoors to freezing outdoors (or vice versa) can stress muscles.

• Stay hydrated and nourished — even in cold, hydration and nutrition support muscle energy metabolism.

• Consult your care team — let your neurologist, physical therapist, or occupational therapist know if changes in cold sensitivity or function occur. They can suggest assistive devices or changes in plan.

Special Considerations for Individuals with MG & Evidence Notes

• While most MG literature focuses on heat sensitivity (since heat often worsens symptoms) e.g. heat-induced weakness is well documented in MG with exposure to hot drinks, baths, or high ambient temperature. The cold can unmask issues by lowering neuromuscular efficiency and muscle contractility.

• One classic MG test, the ice test for drooping eyelids (ptosis), relies on cooling to temporarily improve muscle strength in the eyelid by slowing ACh breakdown, suggesting that cold may in some cases have short-term benefit in specific muscles. But that is not a general recommendation (nor is it a substitute for medical care). PubMed Central

• Individual responses vary widely. Some individuals with MG may notice minimal difference in the cold; others may be more sensitive.

Bottom Line

Cold weather presents real, physiological challenges to those living with MG. Cooler temperatures have the potential to slow muscles, reduce nerve conduction efficiency, increase stiffness, and make energy use less efficient. But with good layering, strategic movement, pacing, and environmental adjustments, many of these effects can be mitigated.

As always, before making any changes to your daily regimen, consult your healthcare providers, they know your medical history best and can help tailor strategies. Stay warm, listen to your body, and may your fall be comfortable, connected, and well supported.