Medical Marijuana for Myasthenia gravis: States & FAQ

Quick answer

Yes, in many places. 1 state program name myasthenia gravis on the official list, and 14 more let the certifying provider decide. Either way, a provider licensed in your state has to evaluate you and agree that cannabis is appropriate.

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14provider's discretion

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Understanding myasthenia gravis

Myasthenia gravis is an autoimmune condition in which the immune system blocks signals between nerves and muscles, causing weakness that worsens with use and improves with rest. It is uncommon, affecting roughly 14 to 40 of every 100,000 people in the US.

Weakness often affects the eyes, face and throat, causing drooping eyelids, double vision and trouble chewing, swallowing or speaking, and it can also affect the arms, legs and breathing. Treatment includes medicines such as pyridostigmine, steroids and other immune treatments, newer targeted therapies and sometimes removal of the thymus gland.

Symptoms patients hope to ease

Muscle aches and soreness from strain
Fatigue that builds through the day
Trouble sleeping
Anxiety about sudden weakness
Stomach cramping from treatment side effects

Does myasthenia gravis qualify in your state?

What the research says

Not enough research. There is little good research on cannabis for this condition specifically. Patients usually use it for related symptoms such as pain, muscle spasms, nausea or poor sleep, where some evidence exists.

There is very little research on cannabis for myasthenia gravis, and no clinical trials have tested it in this condition.
People who use cannabis with myasthenia gravis typically do so for related symptoms such as pain, sleep or anxiety.
Evidence that cannabis can modestly ease chronic pain comes from studies in other conditions, summarized in the 2017 National Academies review.
There is no evidence that cannabis improves muscle strength or changes the immune process behind myasthenia gravis.

Sources: National Academies of Sciences, Engineering, and Medicine, The Health Effects of Cannabis and Cannabinoids (2017); FDA approvals; published trials. General information, not medical advice.

How doctors approach myasthenia gravis

Doctors are usually very cautious with cannabis in myasthenia gravis because of the risk of added weakness and sedation.
If cannabis is considered, CBD-dominant products are often discussed first because they cause less sedation than THC.
Non-inhaled forms such as tinctures are generally preferred to avoid irritating the airways.
Starting very low and going slow, with your neurologist informed, is essential.

Risks and precautions

Sedating effects could worsen breathing or swallowing weakness, so seek urgent care for any trouble breathing or swallowing.
Cannabis can add to the sedation from sleep aids, anxiety medicines and pain medicines, some of which are already used with caution in myasthenia gravis.
CBD can change how the liver processes some immune-suppressing medicines, which may affect their levels.
Smoking or vaping can irritate the airways and is best avoided.
Tell your neurologist before starting, since many drugs can worsen myasthenia gravis and they track every change.
Not recommended during pregnancy or breastfeeding, and never drive while impaired.

What to bring to your evaluation

A neurologist's diagnosis letter or clinic notes confirming myasthenia gravis.
Antibody test results and nerve or muscle studies if available.
A full medicine list, including pyridostigmine, steroids and immune treatments.
A symptom diary of weakness, fatigue, pain and sleep.
A government photo ID and proof that you live in your state.

Don't have records handy? Many patients are evaluated on their history alone.

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How to get certified for myasthenia gravis

Answer a few questions
Pick your state, tell us your symptoms and what you've already tried. Review your answers and contact you to schedule your video visit.
Meet your doctor by video
Join from your phone or laptop. Have a photo ID ready. The doctor reviews your history and decides whether cannabis is right for you.
Get certified and registered
Pay the evaluation fee, then submit your state registry form. The doctor files your certification. We walk you through the state form line by line.

Myasthenia gravis: 9 common questions

Does myasthenia gravis qualify for a medical marijuana card?

Yes, in many places. 1 state program name myasthenia gravis on the official list, and 14 more let the certifying provider decide. Either way, a provider licensed in your state has to evaluate you and agree that cannabis is appropriate.

Which states list myasthenia gravis as a qualifying condition?

As of our latest check of each state's official list: Illinois. Providers can also certify it in Alaska, California, Colorado, Delaware, Florida, Hawaii, Louisiana, Maine and 6 more, which don't use a fixed list. Lists change, so confirm on your state's page before you apply.

Can I get certified for myasthenia gravis online?

Yes, in 12 of those states — including Illinois, California, Delaware, Hawaii, Louisiana and 7 more — your first evaluation can happen by video with a provider licensed there. In 3 others, such as Alaska, Colorado and Florida, the first visit must be in person, and renewals can usually be done online.

Can cannabis help myasthenia gravis?

There is little research on cannabis for myasthenia gravis, and no evidence that it improves strength or the immune process. Some people use it for related problems like pain, poor sleep or anxiety. Talk with your neurologist before trying it.

Can cannabis make muscle weakness worse?

Cannabis, especially THC, can cause drowsiness, heaviness and slowed reactions, which may feel like or add to weakness. This is a particular concern if your throat or breathing muscles are affected. Start very low and seek urgent care if breathing or swallowing gets harder.

Can I use cannabis with my myasthenia gravis medicines?

CBD can affect how the liver processes some immune-suppressing medicines, which may change their levels. Cannabis can also add to sedation from sleep and anxiety medicines. Review every product with your neurologist before combining.

Is CBD or THC safer for myasthenia gravis?

CBD is often considered first because it causes less sedation, but it is not risk-free and can interact with medicines. THC is more likely to cause drowsiness and dizziness. Neither has been studied in myasthenia gravis.

Can cannabis help with steroid side effects like poor sleep?

Some people taking steroids report trouble sleeping and turn to cannabis for help. There is no research on this in myasthenia gravis. Ask your doctor first, since sedation at night may matter if your breathing muscles are weak.

What form of cannabis is safest for myasthenia gravis?

Non-inhaled forms such as tinctures or capsules avoid irritating the airways. If swallowing is weak, a tincture may be easier than a capsule. Choose low-THC options, start with a very small amount and keep your care team informed.

Medical marijuana for myasthenia gravis