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I’m not convinced that thymectomy should be quite such an automatic response to the onset of MG. This article emphasizes the safety of the procedure, but an important question is whether it is justified for the individual. I was diagnosed at 67 (10 years ago) and once of the first responses to the diagnosis was a scan of my thymus gland. My doctors said that because of my age my thymus was very atrophied, not likely to be tumorous given its size, and almost certainly no longer active. I’ve been on prednisone (now down to 5mg) mestinon, cellcept and IVIG/Soliris since my diagnosis, and I have almost no symptoms. Thymectomy is not such a minor surgery, and the risks and inconvenience should be carefully balanced against the likelihood of real benefit for each individual. It seems plausible that patients over 50 may be less benefitted by the surgery, safe or not.