Hoarseness

I am a 21 year old female. I have a normal BMI of 20. I do not ever smoke or drink coffee, and rarely drink alcohol or soda. For the past few years, I have experienced very frequent hoarseness which is more more and impairing my ability to speak clearly and communicate with others. I also have difficulty swallowing and trouble catching my breath sometimes. I drink sufficient water every day to ensure that my mucus membranes are not dehydrated, but I still have persistent hoarseness that is affecting my quality of life.

Something I've noticed that might be significant -- Once in a while (once a month, tops, I do not have a caffeine addiction) I pop an OTC headache medicine containing caffeine to treat a headache, and for hours after I take it, I have a beautiful, normal voice. I know that caffeine helps blood vessels constrict, so does that mean that my throat is permanently swollen?

Any advice?

[Vivek V Gurudutt, MD]

Interesting question.  There is not much evidence to support caffeine improving vocal quality.  The efficiency of how we use our vocal cords plays an important role in the vocal quality of our voice.  Using proper technique to voice can be affected by our energy level, mood, etc.  However, there are many factors that can contribute to hoarseness.  Various processes including reflux, nasal/sinus drainage, persistent cough, vocal abuse, as well as vocal cord lesions and smoking can all cause speech disturbances.  Getting evaluated by a laryngologist (ent specializing in the voice box) could help you.  An evaluation with the physician visualizing your cords with a scope and possible analyzing the vibratory function of the cords with stroboscopy could help you find some answers.  Good luck.