Mya-Keto: Ketogenic diet as a complementary therapy for myasthenia gravis - a randomized controlled trial

Myasthenia Gravis (MG) is a rare disease in which the communication between nerves and muscles is disturbed. A major symptom is an exercise- and time-of-day-dependent muscle weakness, which can cause sufferers to feel tired and have difficulty performing simple tasks such as lifting objects or chewing food. It is caused in 75% of cases by the detection of so-called autoantibodies against the acetylcholine receptor, which is fundamentally important for communication between nerve and muscle. Treatment options include drug inhibition of acetylcholinesterase and systemic immunotherapy, although this is often associated with many side effects. Furthermore, there are still no predictive markers available that can predict the individual course of the disease. As a result, the majority of patients suffer from a significantly impaired quality of life despite the current very dynamic drug development.

Aspects of lifestyle change that could potentially have a positive effect on disease activity and progression have not yet been investigated in a scientific context for MG. However, there is increasing evidence that the gut microbiome can have a major influence on the development of the disease and further disease activity. A change in diet may therefore provide complementary therapeutic approaches, as it has often been shown that patients with MG have a disturbed and, above all, lower diversity of intestinal bacteria. This can be significantly influenced by diet. Furthermore, a positive influence on the course of the disease has already been demonstrated in other autoimmune diseases such as rheumatoid arthritis or multiple sclerosis.

The aim of the study is therefore to investigate whether a change in diet to a so-called ketogenic diet ("Paleo diet") has an influence on the disease activity of MG patients and whether this in turn can lead to an improvement in quality of life. A ketogenic diet is a diet that is low in carbohydrates and very high in protein and fat to cover daily energy requirements. By avoiding carbohydrates, the body has to obtain glucose (sugar) from other building blocks in order to supply organs such as the brain with the right amount of energy. This process is called ketosis and can only be maintained if the change in diet is followed strictly and continuously.


Study leader: Dr. med. Frauke Stascheit - Clinic for Neurology at the Charité Universitätsmedizin Berlin

Registration: to follow

Flyer: Link

Contact: Benjamin Makus ( & Frauke Stascheit (

Duration of the study: 12-week intervention with 3 visits (baseline, week 6, week 12) with physical examination, blood sampling and collection of MG-specific questionnaires on quality of life