Voice

Autoimmune Disease and the Voice: Is There a Connection?

Research shows that people with autoimmune disease have an increased likelihood of voice, airway, and respiratory symptoms, such as dryness in the mouth and throat, hoarseness, and difficulty speaking.

What’s the connection? Many autoimmune diseases impact the body in areas such as sleep, hydration, the joints, and the nervous system. All of these functions are critical for a healthy voice. Your voice is an essential part of who you are. If you’re experiencing problems with it, voice therapy with a licensed, certified speech pathologist can help. 

What is an autoimmune disease? 

Your immune system is an army of cells that defend your body from invaders such as toxins, bacteria, yeast, parasites, viruses, heavy metals, infections, and stress. When the perceived “danger” to the body is gone, the immune system’s inflammatory response is supposed to turn off. However, sometimes it doesn’t. This leads to chronic inflammation and long-term chronic illness, which can affect every cell and organ system in the body.

With more than 80 autoimmune diseases in existence, some will sound familiar to you, such as type 1 diabetes, multiple sclerosis, and rheumatoid arthritis. Others are more rare. According to the National Institutes of Health, autoimmune disease affects more than 24 million people in the United States. Another 8 million people have auto-antibodies, which indicate a person’s chance of developing an autoimmune disease. 

What causes autoimmune disease? 

The exact cause of autoimmune disease is unknown. Possible causes of autoimmune disease include diet, genetics, and less exposure to diverse microbiota (meaning: we over-sanitize everything!). Some doctors believe autoimmune disease may be linked to our gut. Did you know that approximately 80% of our immune system is located in the gut? 

Autoimmune diseases are mostly treated medically with prescription drugs. However, integrative and holistic approaches are available as well. 

Autoimmune diseases can cause a variety of symptoms, and they’re not always easy to diagnose. But early detection of autoimmune conditions is critical. If you have an autoimmune disease or an undiagnosed chronic illness, speak with your doctor, registered dietician, nutritionist, and/or health coach. It’s important to explore the root cause and learn about lifestyle changes you can make to reduce your symptoms and live a fulfilling life. You should have a strong support system and a team of medical professionals that you trust and who listen to you. 

What symptoms of autoimmune disease affect the voice? 

The whole body is connected. An autoimmune condition can impact every organ in our body. That includes our laryngeal function:

  • Respiration (breathing)

  • Deglutition (swallowing)

  • Phonation (voice)

  • Coughing

Depending on the autoimmune condition, it may cause voice symptoms such as:

  • Dryness in the mouth and throat

  • Inflammation in the vocal folds

  • Joint disorders, which can lead to limited mobility of the vocal folds

  • Difficulty producing voice

  • Airway stenosis (narrowing of the airway, which leads to difficulty breathing)

How different autoimmune conditions affect the voice

Here are just a few examples of autoimmune conditions that can impact the voice and upper airway. 

Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory condition impacting many joints. In RA, the immune system attacks its own tissue, including the joints. This condition can affect the cricoarytenoid joint (or CA joint), which controls the opening and closing of the vocal cords. RA can lead to severe vocal tension, pain in the throat, painful swallowing, a chronic cough, difficulty breathing, and changes in vocal quality. 

Sjogren’s syndrome 

Sjogren’s syndrome is a disorder of the immune system that often accompanies other autoimmune diseases. It is often identified by its two most common symptoms: dry eyes and a dry mouth. Sjogren’s syndrome can cause symptoms such as joint pain, swelling and stiffness, swollen salivary glands, skin rashes or dry skin, chronic fatigue, and a persistent dry cough. Because of chronic dry mouth and dry throat, Sjogren’s syndrome often causes difficulty swallowing and changes in the voice. 

Lupus

Systemic lupus erythematosus (SLE) is a chronic disease in which noxious antibodies gradually damage multiple organ systems. Lupus can cause hoarseness, throat pain, and difficulty breathing. Some people with lupus have reported total aphonia, or inability to speak, that can last for several days before or after an autoimmune flare-up.

The connection between lupus and voice problems appears to be related to the cricoarytenoid joint, which has a fibrous joint capsule around it filled with synovial fluid. Lupus causes inflammation of the synovial lining, which places pressure on the vocal folds.  

How can a speech therapist help with autoimmune voice problems? 

If you’re experiencing changes in your voice, reach out to a speech-language pathologist who specializes in the voice and voice disorders. Also known as a speech therapist, they are trained to work with the upper airway, disorders of the voice, and swallowing. While a speech therapist cannot make an autoimmune condition go away, they can teach you techniques to reduce the symptoms affecting your voice.

A speech therapist can teach you techniques to reduce the symptoms affecting your voice.

Voice treatment may also help prevent further inflammation in the laryngeal area. Therapy sessions are individualized and specific to each client’s needs. 

Another benefit to therapy? Your speech therapist will be there to help you advocate for your health every step of the way, helping you find your voice in both a literal and figurative way. 

For more information on autoimmune disease, check out these resources: 

Global Autoimmune Institute Support Group 

Global Autoimmune Institute–Autoimmune Organizations 

The Autoimmune Association–About Autoimmunity 

The Immune System Recovery Plan by Susan Blum, MD 

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