Hi! I've had trouble swallowing for years, and my voice gets hoarse as soon as I feel a bit tired or nervous. Knowing that my cervical vertebras (and spine in general) are unstable and in general bad shape, I have found a possibility. Osteoarthritis and other vertebrae degeneration diseases result in osteophytes, which are bony outgrowths. These can interfere with movements, in this case, swallowing -- either by narrowing the pharynx or by reducing its ability to move up and down. Another possibility is more obvious; a floppy, loose or collapsible pharynx will have effects on speech and swallowing, especially when you're tired and can't compensate.
A simple X-ray will rule in or out the presence of osteophytes.
For the other hypothesis, I have no idea how it could be investigated, since it's related to functional limitations.
ps: MS and other neurodegenerative diseases such as CMT (Charcot-Marie-Tooth, dozens of variations) can produce hyperlaxity-like symptoms, reduced functionality in sphincters, paresthesia (tingling/burning feelings), and numbness, as well as POTS-like dysregulation. However they can be EASILY ruled out by measuring nerve impulse speed, looking for nerve/brain lesions or, in the case of MS, by looking for specific antibodies (found in 85% of cases). Under the microscope, skin and membranes will look normal in MS and CMT; however, nerves will show demyelination. Diagnosis of MS and CMT has greatly improved over the last few years, with a better understanding of the causes and course of the disease, and less false positives (wrong diagnosis).
ps: Some copper deficiency diseases are known to result in hypermobility, skin laxity, dysautonomia and seizures. Symptoms are variable in nature and severity, and overlap with Ehlers-Danlos, MS, CMT, etc., so this can be confusing for the medical personnel. OHS (Occipital Horn Syndrome) was formerly classified as Ehlers-Danlos type IX, but is now considered a separate disease related to the (more severe) Menkes Syndrome. In the case of OHS, swallowing and speech symptoms might be caused by nerve damage, and not by the hyprmobility itself.
- High arched foot (pes cavus) and hyperlaxity of the foot (March 2012)
- Hypermobile ankle (March 2012)
- Transitional vertebra L5
- Raynaud’s (treated with Adalat) (Septembre 2012)
- Mitral Valve Prolapse (MVP) (December 2012)
- Beighton score 4+/9