May Lupus Awareness Month

May Lupus Awareness Month is an annual observance to call attention to lupus and its impact on the lives of millions of individuals and families. Lupus symptoms can show up all throughout the body, from head to toe. Recent research suggests another potential lupus sign: voice loss.  Let’s start by exploring how the speaking voice is produced. There are 3 main functions necessary to create the voice (as described by the American Academy of Otolaryngology- Head and Neck Surgery):

  1. The Power Source — The Lungs
    • Vocal power comes from exhaled air. When exhaling, there is an airstream created in the windpipe (trachea) which powers vocal cord vibration.


  1. The Vibrator — The Voice Box
    • The voice box (larynx) is found at the top of the windpipe and contains the vocal cords. Vocal cords are folds that open and close when breathing, eating, etc.
    • When speaking, the folds come together and vibrate as the air passes through them.
    • They vibrate between 100 and 1,000 times per second — this speed variation adjusts the pitch that is created, and is controlled by muscles in the larynx.


  1. The Resonator — The Throat, Nose, Mouth, & Sinuses
    • The resonator elements of the vocal production system turn the buzzing created by the vocal folds vibrations into the sounds that we recognize as language.

What is voice loss?

When speaking about voice loss, we are typically talking about a hoarse, breathy voice which is known by the name ‘dysphonia.’ By itself, dysphonia is not simply a symptom of lupus. It can be caused by laryngitis, a cold, allergies, or even speaking or singing too loudly without resting (like cheering or screaming). The voice may also change in other ways. It could be raspy, strained, or simply softer and lower in pitch.


Lupus & voice loss:

Although voice loss isn’t a well-recognized sign of lupus, there are people discussing the symptom in online communities. For many people, it seems to be most prevalent during flares and the severity of the voice loss varies from person to person.

Lupus and the cricoarytenoid joint:

The connection between voice issues and lupus appears to be related to the only joint in the throat: the cricoarytenoid joint. The cricoarytenoid joints, located in between the cricoid and paired arytenoid cartilage in the larynx, are diarthrodial joints that tighten the vocal cords during speech and breathing and help them to open and close.

As a diarthrodial joint, the cricoarytenoid joint has a fibrous joint capsule around it that consists of synovial fluid that lubricates the outside portion of the bones. Lupus causes inflammation that affects the synovial lining, which in return, places pressure on the vocal cords. The swelling is what is thought to cause the voice issues with lupus.


Battling voice loss:

If you are experiencing consistent voice loss that can’t be linked to some external factor, you may wish to consult with your lupus treatment team. In addition to adhering to any medications prescribed by your treatment team, you should try to get an adequate amount of sleep and consume a well-balanced diet. Additionally, it’s important to avoid stress in limit inflammation.

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