Myasthenia gravis is an autoimmune disorder that results in the production of antibodies that either block or cause the destruction of the ach receptor. why do you think that tamara’s symptoms become worse as the day progresses? myasthenia gravis is an autoimmune disorder that results in the production of antibodies that either block or cause the destruction of the ach receptor. why do you think that tamara’s symptoms become worse as the day progresses? in the morning, the reserves of atp are larger, allowing for sufficient acetylcholine release to overcome the unresponsive receptors. however, as the day progresses and stores of atp become depleted, muscle function becomes progressively worse. as the muscle becomes fatigued over the course of the day’s activities, the receptors bind less acetylcholine, which results in smaller and smaller action potentials being generated. smaller action potentials mean weaker contractions, as seen by the increasing muscle weakness. in the morning, the neuronal reserves of acetylcholine are larger, allowing for sufficient neurotransmitter release and resulting in effective muscle signaling. as the day progresses and the stores of acetylcholine become depleted, muscle function becomes progressively worse. in myasthenia gravis the ach receptors have a hyperaffinity to acetylcholine. after muscle activity, fatigue and weakness occur as fewer unbound receptors are available to bind acetylcholine.