Glucocorticoids can suppress the immune system through multiple pathways, but the exact mechanism of their efficacy in the treatment of MG is unknown. Studies have found that prednisone reduces AChR antibody levels and is associated with clinical improvement. A study at the University of Virginia showed significant improvement in 52% of patients, partial improvement in 15%, no improvement in 5%, and pharmacologic remission in 28%. The mean maximum duration of onset of action was 5.5 months, and eventually 14% of patients were able to discontinue the drug completely. The vast majority of patients responded well to alternate day therapy, but some felt poorly on the day of non-dosing, while daily therapy responded well. However, there are still some patients who do not respond to hormones. Daily equal dose therapy is recommended for diabetic patients to avoid excessive fluctuations in blood glucose levels. When hormones are used at moderate to high doses, MG symptoms usually show improvement within 2-3 weeks. Approximately 50% of patients may experience a transient exacerbation of symptoms early in the course of hormone application (within 7-10 days), usually lasting about 1 week, with approximately 10% of these patients requiring mechanical ventilation for unknown reasons, possibly related to hormone-induced hypofunction of the neuromuscular junction. Both the physician and the patient need to be fully estimated and prepared to avoid the occurrence of critical symptoms. Commonly used hormone drugs are: 1. Prednisone: For a reasonable prednisone treatment dose has not reached a unified understanding, prednisone can be given 10-20mg/day in a single dose to start, and increase 10mg after 1-2 weeks, after reaching the target dose of 0.75-1mg/kg for 8-12 weeks, and then gradually reduce the dose, which can be reduced to alternate day therapy. For patients with milder symptoms, especially those with simple ocular muscle type, the initial dose can be given 30-50mg/day, which can be increased to 0.75-1mg/kg according to the situation, and then changed to alternate day therapy when the condition improves. 2, high-dose methylprednisolone 500mg/day intravenous injection x 5 days, reduced to 240mg x 5 days, then reduced to 120mg x 5 days, later changed to prednisone 0.75-1mg/kg. this method is suitable for patients who are critically ill and have assisted breathing arrangements. There is no established guideline for prednisone dose reduction, and the dose is generally reduced gradually after 8-12 weeks of effectiveness, and it takes 1-2 weeks to reflect the recurrence of symptoms after dose reduction. Premature and rapid dose reduction often causes fluctuations in the disease. If the disease worsens during the dose reduction, the previous dosage can be restored. The total course of treatment takes 2-4 years with a gradient reduction method. The side effects of glucocorticoids are related to the daily dose of the drug, the frequency of administration and the duration of treatment. For different individuals, short-acting glucocorticoids with the lowest effective dose, the largest dosing gap and the shortest duration of administration should be given. Although there is no high-level evidence-based medical data to support the effectiveness of hormone therapy for MG, experience has shown that it is effective. Hormones have many side effects and special attention should be paid to their application, such as weight gain, Coxin’s face, infection, diabetes, hypertension, osteoporosis, and psychosis. Although unavoidable, some measures can be taken to reduce their extent. Patients on a low-calorie, low-carbohydrate, low-sodium diet can reduce weight gain, and taking calcium and vitamin D can reduce bone mineral loss. If the patient develops osteoporosis, treatment with a bisphosphonate compound such as alendronate is indicated. H2 receptor antagonists or proton pump inhibitors are not routinely used unless the patient develops gastric distress. Electrolytes, blood glucose, and blood pressure are checked regularly.