A 70-year-old client fills in an online intake form, saying she has myasthenia gravis, hypertension, and hypothyroidism. She only takes Synthroid, and says her hypothyroidism and hypertension are well controlled. She has low back pain and muscle soreness. At first glance, this seems fairly simple. MG does not appear to be a major factor for her, because she is not controlling it with medication. But a closer look reveals some possible tangles between MG, hypothyroidism, and some cautions about hypertension drugs. Join me as I completely overthink this situation, it will be fun! Resources: Barnes, S. (2023) Massage is not just a luxury for those of us with myasthenia gravis | Myasthenia Gravis News. Available at: https://myastheniagravisnews.com/columns/massage-is-not-just-luxury-those-us-with-myasthenia-gravis/ (Accessed: 16 April 2025). Myasthenia Gravis (no date a) Physiopedia. Available at: https://www.physio-pedia.com/Myasthenia_Gravis (Accessed: 16 April 2025). Myasthenia Gravis (no date b). National Library of Medicine. Available at: https://medlineplus.gov/myastheniagravis.html (Accessed: 16 April 2025). Myasthenia Gravis | National Institute of Neurological Disorders and Stroke (no date). Available at: https://www.ninds.nih.gov/health-information/disorders/myasthenia-gravis (Accessed: 16 April 2025). Myasthenia gravis - causes, symptoms, treatment, pathology (2016). Available at: https://www.youtube.com/watch?v=bYGxGdu9MsQ (Accessed: 16 April 2025). ‘Myasthenia Gravis: Practice Essentials, Background, Anatomy’ (2024). Available at: https://emedicine.medscape.com/article/1171206-overview (Accessed: 16 April 2025). Myasthenia Gravis: What Is It? (no date) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/17252-myasthenia-gravis-mg (Accessed: 16 April 2025). Sheikh, S. et al. (2021) ‘Drugs That Induce or Cause Deterioration of Myasthenia Gravis: An Update’, Journal of Clinical Medicine, 10(7), p. 1537. Available at: https://doi.org/10.3390/jcm10071537. Host Bio: Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist’s Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP’s partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner’s books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com. 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