Hoarseness Related to Corticosteroid Use?

Hi all,  I have been on several corticosteroids (Pulmicort, QVar, Dulera).  They each caused pretty intense hoarseness to the point where my voice is cracking and I can only talk in a low tone for 20 minutes, at best.  Now my doctor is trying Symbicort to see if this works out better.  But in the meantime, while I am waiting for the hoarseness to disappear, are there any comfort measures that work?  I am using cough drops, drinking herbal tea, and trying not to talk much (very hard to accomplish) .  I do rinse and gargle carefully right after using the meds.  



Comments 24

  • K8sMom2002

    I do hope the Symbicort works better for you! Do you have a job where you have to talk a bunch? That would make this even rougher!

    Several of our members have experienced hoarseness like you describe. And I used to have at least two weeks each year when the seasons changed where I would completely lose my voice. 

    I like your approaches — warm soothing drinks and honey and lemon seemed to help mine, but I would follow your doc's suggestions on what would work best for you.

  • Kathy P

    I had used Advair for years with no issues, but when my doc switched me to Dulera, I would up with really bad vocal cord issues. And it took back but to figure out what was causing it. I wound up with an ulceration.

    Between the allergist and the ENT he sent me to, this was what I needed to do:

    • Rest my vocal cords – this was hard! I had to cancel meetings so I wasn't talking for long periods of time.
    • Avoid irritating foods – acidic, caffeine, any reflux triggers. I also took a reflux med for a while.
    • Cough meds and cough drops – I had to keep from coughing!
  • Nancy Knight

    Thanks for your reply!  I am retired, and I am cancelling any of my activities where I have to use my voice alot.  I, too, am avoiding the reflux/acidic foods, and hoping I can remedy this on my own.  Really don't want to take the reflux meds, as my body seems to be rebelling against so many drugs!  More harm than good in some instances.  

  • Kathy P

    Sounds like a good plan! Hope it works quickly. Hopefully the Symbicort doesn't cause any issues!

  • Megan Roberts

    How are things going for you now @Nancy Knight? Has your hoarseness improved with the above steps at all yet?

  • Nancy Knight

    It's improving slightly.  I am avoiding talking and that helps.  Going to buy some eucalyptus oil; planning to add it to water and steam my throat gently.  Hoping to get this resolved without taking any serious medications such as the reflux drugs!

  • K8sMom2002

    Hugs, Nancy — glad you're seeing some improvement. Will your doctor be following along so you two can decide if reflux meds would be the right option? 

    As my doc has explained so many times, sometimes the right medication for the right amount of time can save me from a far worse scenario which might mean I'd have to take far more serious medications! It's all a question about balancing risks and benefits.

    A friend shared this with me, and it has really helped me talk to doctors about medication. BRAND

    • B – benefits: What are the benefits of me taking this medication?
    • R – risks: What are the risks? Can you help me visualize those risks as far as how many people in a hundred are actually affected?
    • A – alternatives: What are some alternatives that I can try first?
    • N – Nothing: What happens if I do nothing? Can I do nothing for a while without any harm?
    • D – decision: This is the final step — the decision that you and your doc come to after going through all this.

    It would be great if your hoarseness got better with the strategies that you're trying without the expense and the bother of another medication — fingers, toes and eyelashes crossed that your strategy works! 

  • Nancy Knight

    I like that acronym – Brand- It's a good way to organize my questions and decisions.  I am seeing my doctor in a week and will bring this up if the hoarseness is not resolved.  Thanks for the input!  

  • K8sMom2002

    That's why I like it, too — it has really helped me discuss meds with my doc. Sometimes we go a different way because my doc can see that a med really makes me uncomfortable, but sometimes the doc can show me that my fears were misplaced. 

    I hope that the hoarseness is all gone by the time you see your doc, but it might not be a bad idea to go ahead and mention it. You seem to be doing SO many things that sound helpful for a hoarse voice! Sending good …

  • Donna Stecker

    Hi Nancy, I too had hoarseness for about 8 plus years. Was DX by ENT doctor with silent acid reflux and prescribed anti-reflux med, which I really didn't want to take because it interferes with absorption of Vit D 3, but did take for couple of months. I believe it helped the hoarseness somewhat. Saw another ENT doctor and she said besides rinsing mouth after using your inhaler, to gargle also. When seen by this doctor, dx of inflammation of vocal cords was made. Then about six months ago, I started drinking Bragg's Apple Cider Vinegar, a capful or a little more ( equals about 1 tsp) in cup of water, taste not so good, but I just chug it down. Wow, what an improvement, hoarseness is gone. I drink this once a day now. When I started I drank this morning and night.

  • Nancy Knight

    Donna, thanks so much for sharing your story.  I have also been diagnosed with silent acid reflux for about 3 years.  My main symptom was hoarseness!  I did take reflux meds a few times and they worked well. But I know they have major side effects, and I am not getting any younger!   I finally figured out my trigger foods and gave them up and have had no reflux in a year.  So now my hoarseness is back, and my asthma specialist blames the corticosteroids, not reflux! 

    In any case, I will definitely try the apple cider vinegar.  I also like the idea about gargling and rinsing the mouth when using the inhaler.  Seems like these improvements will have a cumulative effect.  

  • Kathy P

    Reflux can be an asthma trigger too.  My doc just asked me about bit it when I was there yesterday because I can't seem to get my asthma back under control. 

    I have certain trigger foods I know to stay away from. I eat a lot of fermented foods which seems to keep my tummy happier overall.

  • K8sMom2002

    Because I used to wind up with laryngitis at least twice a year at the change of the seasons due to allergies, my doctors have recommended a lot of different home comfort remedies to me. Most of them (vinegar in water, lemon in water, hot tea, tomato juice, Vitamin C drops) seem to be at least slightly acidic in nature — good for my issues, which was caused by the actual post nasal drip.

    One doctor explained it this way — your mucus is alkaline, and the acid in these home remedies neutralizes and balances out the ph level, which soothes your throat. Try as I might, I haven't found that same information in any reputable medical website or study, but that is what he told me.

    I know that when my throat burns and is inflamed from too much or too thick mucus, what soothes it is acidic things. No ice cream for me — give me some tomato soup!

    That would NOT work if you were managing reflux caused by too much acid in the tummy. So it's important to talk with your doctor about what the source of your troubles are and how you can manage it.

    Also, I understand about being a woman and getting older and worrying about osteoporosis. I was diagnosed with osteoporosis and osteopenia when I was in my 20s. That leaves lots of treatment options off the table.

    But doctors have reassured me that if I needed to take these medications for a short while, we could figure out ways to balance out the side effects that cause problems for folks like me. They urge me to remember the big picture. 

  • Pljohns

    I too have vapor reflux-usually doesn't give me issues unless I'm using a lot of albuterol or have a lot of drainage.  I do take OTC reflux meds and they help but here lately with all of the albuterol and junk, been using tums like night time candy!  I have found that prednisone also causes the reflux to flare up.

  • Megan Roberts

    How is your voice doing @Nancy Knight? Are you still struggling with hoarseness? I have been trying to change my diet to reduce acid (mostly because it triggers asthma symptoms) and was thinking I would give the cider vinegar a try. Wanted to check in and see if it helped you out, or if something else was helpful in finding relief.

  • Nancy Knight

    I finally took a two week course of Zantac 150 mg 1 x day and that cleared it up.  I think I have identified the meds that caused the hoarseness so next year I can avoid them and hopefully it will not recur.


    The cider vinegar seems like a good remedy to try, but I didn't get around to it this year.  Good luck.  Keep us posted on  whether it works for you.


    I kept a food diary for about 6 months and was able to eliminate the foods that caused my reflux, and that part is under great control.  Sadly, I have given up chocolate completely, and the occasional glass of wine.  But it's worth it to me, as I am already on alot of meds and don't want to take any extras!


  • LK

    Nancy,  That's great that you have figured out what was causing a lot of your reflux!

    I need to start keeping a diary for the same purpose. 

  • K8sMom2002

    Hugs on the chocolate! Is there another treat that can give you the same feeling of reward without the pain? I've heard of folks who can't have chocolate being able to use as a pretty close stand-in, but your mileage may vary.

    What other foods do you avoid?

    I can totally get why you are willing to do without rather than add any more meds on. 

  • Nancy Knight

    I also avoid red tomatoes, but have found that yellow tomatoes are low in acid and I can frequently find them in the grocery store.  I need to try making spaghetti sauce with yellow tomatoes and that would be a good substitute.  Generally the food diary helped me figure out which foods cause immediate problems (wine, chocolate, heavy red tomato based foods like lasagna, some citrus but not all) and which ones I can have if I take some Tums with them.

    I forgot about carob and that is worth a try.  But now that I have given up some foods completely, I don't crave them anymore, so that is great! Also, if I have been really careful for at least a week, I can often allow small portions of some trigger foods.  The hardest part is being invited to dinner at friend's houses, and having to prepare them for my trigger foods or being very careful what I eat.  Restaurants are no problem however.  

    I think most people's triggers are different, and it's trial and error until you figure it out.



  • K8sMom2002

    Yay! I'm so glad you've made an adjustment!

    Oooh, yellow tomatoes can be so sweet! Back before I found a go-to jarred sauce that was safe for my DD's food allergy, I tried this (can you tell I'm a fan? ) You bake the tomatoes in the oven.

    It does call for white wine, but since I am a tee-totalin' Baptist, I skipped the wine, and it turned out just fine. 

    I'm wondering now if a person could skip the oven and use a slow cooker instead. One thing that you definitely need with this is a food mill, unless you scald the tomatoes first and peel them that way. (The seeds don't really bother me, but it may you.) I was lucky, and my sister and my step mom found me a food mill at an estate sale.

  • K8sMom2002

    Nancy, wondering if you were ever able to find treats with carob so that the giving up of chocolate didn't hurt so badly? 

    Donna, how is your hoarseness? Still banished by home care methods? I thought about you when another member mentioned voice troubles on a new thread called 

  • Nancy Knight

    Hi, I saw your post today and it reminded me to try carob!  I am going to Whole Foods today to try out some recipes.  Just yesterday I was at my book club meeting and everyone was eating chocolate something but me!  It brightened my day to think about an alternative!  I will let you know how it works out.