Joint pain, skin rashes, hair loss — these are all lupus symptoms that you’re likely familiar with. But one feeling you may not expect with lupus involves a tight throat that makes you feel like you’re choking. This sensation can be scary and unnerving, and many MyLupusTeam members wonder whether it’s related to the condition.

“For the last few weeks, I have felt like someone has been choking me,” one member wrote. “It feels like I ate too much and the food is pressing at the back of my throat, and at the same time like someone has their hand around my neck, pressing their thumbs into my esophagus. This is a new symptom for me, and I’m not sure what it's related to. Anyone else experienced this?”

Another member replied, “Yes, it happens to me also. I had a swallow test done, but everything was normal.”

If you’ve ever felt throat tightness and wondered if it was a symptom of lupus, read on to find out what might be causing it and how to manage it.

What Causes a Tight Throat With Lupus?

Several factors may affect your throat when you’re living with lupus. Possible culprits include thyroid problems, anxiety, swollen lymph nodes, and reflux.

Thyroid Problems

Thyroid disease is more common among people with lupus than it is in the general population, and because the thyroid gland is located in your neck, issues with this organ could cause throat tightness.

The authors of one 2020 study reported that about 25 percent of people with systemic lupus erythematosus (SLE) had thyroid nodules (growths on the thyroid gland). However, these nodules were found in just 13 percent of people without lupus.

Thyroid nodules may not always produce symptoms, but when they do, a common one involves tightness in the throat that can cause swallowing or breathing difficulties.

“I get kind of a choking sensation, and my doctor sent me for an ultrasound of my thyroid,” one MyLupusTeam member wrote. “Turns out that I have two nodules growing on my thyroid. I can’t even wear a necklace or scarves.”

Another member said, “Your lupus may affect your thyroid, making it large so it feels like you are choking.”

Anxiety and Stress

The stress of living with a chronic autoimmune disease can lead to anxiety, which is experienced by about 37 percent of people with lupus. One potential symptom of anxiety is the feeling of a lump in your throat, which can make it difficult to breathe.

“I feel like I’m choking sometimes,” a MyLupusTeam member wrote. “My doctor diagnosed anxiety. I take a low-dose anxiety medication, and it’s helping. Talk to your doctor about anxiety — it’s a real thing.”

Swollen Lymph Nodes

People with lupus are prone to developing swollen lymph nodes, particularly during flares. Lymph nodes are located all over your body, including in your neck. If your lymph nodes swell — a condition known as lymphadenopathy (swollen glands) — the pressure on your throat can make it feel like you can’t breathe.

“Does anyone else struggle with lymph swelling everywhere, even in the throat?” one MyLupusTeam member asked.

“Lymphadenopathy has been a constant companion of mine,” another member replied. “The nodes never decrease in size but get slightly larger when I am having a flare. I have several in my neck and belly.”

Reflux and Other Issues

Medical conditions like acid reflux (heartburn), gastrointestinal reflux disease (GERD), and sores called throat ulcers can also cause tightness in your throat. Many people try to treat heartburn symptoms with over-the-counter drugs, but talk to your doctor before starting any new medications, even those that don’t require a prescription.

Occasionally, a feeling of tightness in the throat may be accompanied by difficulty swallowing. If that happens, contact your rheumatologist for further assessment. Your symptoms could indicate either GERD or esophageal dysmotility (foods and liquids don’t move easily down the tube that goes from your mouth to your stomach).

Talk to Your Doctor

Work with your rheumatologist or other health care professional to pinpoint the source of your throat tightness or difficulty swallowing. Because lupus affects so many areas of the body, the specific symptom will guide your doctor’s medical advice. For instance, if you have anxiety, your rheumatology team might refer you to a counselor for therapy, whereas thyroid nodules might require a referral to an endocrinologist.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Are you living with a throat tightness and lupus? What seems to trigger this sensation for you? Share your experience in the comments below, or start a conversation by posting on your Activities page.