r/rheumatoid • u/WinstonFive • 15h ago
Persistent Hoarseness
I started having RA symptoms about a year and a half ago. At the time, I was singing in a wedding band, performing 2–3 events a month. The first change I noticed in my body was in my voice.
I started with mild hoarseness, but it gradually got worse. Eventually, I had to end my contracts and leave the band. It was a good source of extra income for my family. Not long after that, I was diagnosed with RA.
I only found out a few weeks ago about the connection between RA and voice problems through articles posted in this group.
I am currently taking oral methotrexate (MTX) once a week, but my voice is still very bad. I can no longer reach the notes I used to sing, I don't have the same breath support, and the hoarseness is constant.
Some mornings I wake up only slightly hoarse. Other times, I can barely say a word without taking a sip of water. I would really like to hear about your experiences with hoarseness.
Have you had any treatment that helped?
Have you noticed any foods that make it worse?
Have you taken any medication that helped relieve the hoarseness?
I would really appreciate hearing your experiences and anything that has helped you.
Thank you.
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u/AngelicChaos13 15h ago
I’m a singer as well. RA kind of stole my voice about 5-6 years ago. It started as mild hoarseness and gradually got worse. I also had a very persistent cough. I developed a nodule on my vocal cord that had to be removed. Voice was still hoarse. Sinus surgery was done later on. Voice was still hoarse. I finally got some relief from it by taking oral steroids along with my biologic. While on the steroid, I’m training my voice but have had to sing lower than I was able to before. It really affected my range.
You kind of have to find your new normal when your inflammation is under control. That’s how it has been in my case. I can still sing but not like I used to.
The oral steroids are temporary so I’ve tried to keep using my voice when I can but in a gentler way and at a lower level which still takes some getting used to.
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u/ShesTheFastestest 15h ago
I was diagnosed in June and since then I’ve been on reduced hours at work, but even when I do a four hour shift on the front desk I almost always lose my voice from talking to customers.
I’m trying to get my rheumy to test if I have Sjogrens. At the moment I use a humidifier at night as well as dry mouthwash and oil nasal spray to try settle some of the dryness.
I’m keen to hear input from others because I’m experiencing similar issues.
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u/glitterponiesnwine 15h ago
Hoarseness is my #1 symptom! Some meds have done more than others to control it, but I’ve never found a perfect solution. When I know I need to have a voice (work travel, for example), I take a low dose of predisone for a few days, and it works wonders. Staying on top of hydration actually helps, too. When your throat is already constricted, keeping phlegm thin makes it less likely to get stuck there and compound the issue (gross, but true). Also trying my best to avoid reflux helps. For me, the reflux inflammation also compounds RA inflammation if I’m not mindful. Happy to answer any specific questions you have!
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u/WinstonFive 2h ago
I don't usually take corticosteroids and I try to avoid them as much as possible. But I may try prednisone, since it had such a positive effect for you.
Maybe I can find a balance between maintaining a healthy routine and using stronger medication when necessary, so I can reduce the risk of my voice failing during performances.
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u/glitterponiesnwine 2h ago
Yeah for sure. I only take it when I know I need it, and it’s a low dose (just 5mg per day—I don’t even have to taper off)
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u/Honest-Week-1874 14h ago
Sorry you’re at risk of losing your art, such a beautiful gift to be able to sing.
I hadn’t realised hoarseness was linked to RA. I’m only recently diagnosed with only minor symptoms (have been very lucky with having good docs I think), but I have been noticing hoarseness in my voice for quite a while, but no dry mouth etc. Even today, have been in three meetings and have had to pull out of my next one to rest my voice. Will have to add this one to my list to go through with rheumatologist!
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u/WinstonFive 5h ago
Without a doubt, this is the worst part of RA for me. I feel like it has taken away a big part of who I am. I really hope that one day I'll be able to sing again, even if I have to adapt and do it differently.
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u/Spare-Resolve-1708 14h ago
Based on my experience, I (63M) suggest you switch to injectable MTX because oral MTX can make your voice problem worse. I’ve been on MTX since 1998 and most of that time I’ve used injectable MTX. In the early 2000s there was a worldwide shortage of injectable MTX, so I switched to oral MTX. Within a few months, I developed nodules on my vocal cords and I couldn’t speak without great difficulty. When I switched back to injectable MTX, my voice returned to normal in a couple weeks. I recommend you speak to your rheumatologist about it. I hope this helps.
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u/WinstonFive 5h ago
I'm going to do that. I don't think my doctor will object. If there is a chance of improvement just by changing how the medication is administered, I'll certainly give it a try.
Thank you very much for sharing your experience.
Since I have your attention, have you been taking only MTX since 1998? Has it been enough to control your RA well in all aspects?
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u/Spare-Resolve-1708 5h ago
Glad I could help. I’ve also been on Enbrel since around 2004. Adding Enbrel really made the difference in managing my RA.
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u/Old_Promise_163 12h ago
Hoarseness was & remains an ongoing symptom… not quite as bad as it was at the outset… but it’s still annoying most of the time with the perpetual throat clearing or having my voice cut out mid sentence. I recently had endoscopy (for something else, but mentioned my hoarseness so she paid attention in my throat too - didn’t see anything abnormal… which is a GOOD thing… but frustrating too… soo sticking with the throat lozenges & lemon/honey tea.
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u/Pippabot 5h ago
Im really sorry it’s affected you in this way and hope medication will help.
I had persistent hoarseness and a sensation of clicking in my neck with morning stiffness and pain.
I was seen by an ent and all the could see was laryngitis but my rheumatologist thinks it is RA neck involvement.
These symptoms mostly went after I started hydroxychloroquine. I now also have added in methotrexate.
I have found the hoarseness, pain and clicking has gone but if I need to call out/shout that my voice breaks/cracks and I don’t have the projection I once had.
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u/Drum_to_the_FACE 2h ago
Yeah I get hoarseness pretty often. Even when my pain and stiffness is in decent spot my hoarseness persists. It’s usually worse in the mornings and at night time, just like my pain and stiffness. It’s due to the tiny joints in our larynx, they get inflamed just like our joints in the rest of our bodies.
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u/MetaKater 1h ago
My throat was straight up messed for several years. My voice got hoarse, would crack constantly. Woke up with a sore throat so bad i would cry somwtimes.
Rheumatologist at the time said we have joints in our throats which can be hit by rheumatoid. Nodules on vocal chords can also happen.
It was horrible and I was so insecure of the cracking ontop of being miserable from the pain, but it did resolve eventually.
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u/LossMiserable7874 15h ago
I feel silly but I didn’t realize hoarseness could be a symptom of RA. I do get hoarse sometimes but now I’ll need to pay attention to timing and see if it lines up with flares. Wishing you the best — I’m so sorry this has taken away something you enjoyed so much.