Effects of MG on My Singing and Speaking Voice

I have talked with a few people about how myasthenia gravis (MG) has affected their voice - their singing voice in particular. It has affected mine, too. MG impacts the voluntary muscles of the body, especially the eyes, mouth, throat, and limbs. It can cause difficulty or inability swallowing, talking, and even a change in the tone and quality of our voice.^1,2

MG voice and speech issues

At one time, I did some singing in public and even recorded a song. I used to be a pretty good singer, at least I had been told that by many people. However, now I can tell sometimes I’m "off-key." My voice will also "crack" or sometimes I can’t hold a note very long, or maybe the pitch is off. I can usually hear when I hit a sour note or when my voice us under par.

I can often tell ahead of time when my voice will sound "off" by how my throat feels. Sometimes I feel like I have mucous in my throat and like I have to constantly clear my throat. Other times, it just doesn’t feel right. I don’t really know how to describe the feeling - it’s just different. It just isn’t normal. I’ve also noticed my voice will trail off or will almost become a whisper as I start running out of breath. To compensate for that, I’ll sometimes take a breath at the wrong time.

For people with MG, issues with public speaking or singing may be a result of vocal fatigue. That means our voice wears out as we use it throughout the day due to muscle fatigue of the throat or lungs. It can also cause difficulty controlling the pitch. Our voice may be monotone, which is the inability to change the vocal pitch.²

These symptoms are frustrating

I’ve never had a wide vocal range, but now my range is even smaller! Now I usually sing in a lower key, but on a good day, I can still hit the higher notes. It’s frustrating my vocals aren’t as good as they used to be. Sometimes it bothers me so much that I just mouth the words.

I used to have a clarinet. But there were times I couldn’t play due to the amount of breath it took. I do still have a keyboard, so sometimes I play it when I’m having trouble with my voice. At least I do have it to fall back. Plus, I very much enjoy playing and arranging my music.

It's much the same when doing public speaking. Though I don’t do public speaking anymore, it is something many other people with MG still do. As with singing, speaking can also cause voice fatigue. It can lead to the same symptoms, such as slurred speech, issues with pitch, their voice trailing off, or a voice that becomes more nasal.

How to manage speech problems

For both singing and public speaking, resting the voice and getting plenty of rest for our body is key. For me, the voice issues are intermittent so I can still sing most times. But other times, I won’t sing around anyone (except maybe my husband) because of being off-key.

Besides resting my voice, I also try plain warm tea. That seems to help me as much as anything else. I just slowly sip it. For the voice, iced or cold drinks are a big no-no, even if you don’t have MG.

A speech or voice coach may also be able to help by teaching strengthening exercises or other strategies. I recommend doing voice exercises while your MG medication is at its peak and when you aren’t tired.

Seek medical attention if you are experiencing problems. Your doctor can run tests to make sure there aren’t other underlying causes of your voice changing. They may also prescribe medicine that can help MG symptoms. The biggest improvement or success may be just making sure our MG treatment is first and foremost a part of our continued treatment.