What virus causes you to lose your voice

Many athletes think it’s perfectly fine to push through injury, even if it hurts. Of course that’s not usually a smart decision. Vocal athletes are on the same playing field – if you push your voice when you have a cold, the flu, or allergy symptoms, you’re risking permanent damage to your vocal cords.

Vocal athletes are people who use their voices for more than just casual conversation. These people are teachers, call center employees, ministers, public speaking professionals, singers, and more. When you depend on your voice to make a living, it’s important to protect it from damage.

The effects of allergies, colds, and flu

So many of my patients come to me saying they were sick, but they pushed through whatever they had to do vocally. That’s when they run into trouble and end up hoarse or losing their voices entirely.

When you push your voice through a cold, your vocal cords can swell, which can lead to a condition called laryngitis. When you develop laryngitis, pushing your voice is a very bad idea. Even if you’ve committed to singing in a recital or giving a three-hour lecture, it’s best to postpone or find a substitute, or you may end up in trouble. Treatment for laryngitis includes resting your voice – using it too much can lead to long-term damage that may require surgery.

If your allergy, cold, or flu symptoms are causing you to cough and clear your throat a lot, or if you’re concerned that you’ve developed laryngitis, check with a laryngologist (a type of otolaryngologist, or ear, nose, and throat doctor who specializes in the vocal cords and care of the voice). Throat clearing and coughing are traumatic events for your vocal cords that can cause damage if the symptoms are not resolved quickly. Your laryngologist can help to optimize your treatment and help protect your voice to avoid long-term damage.

Treating and avoiding long-term voice damage

Most of us don’t really think about our voice as a tangible thing that requires care – until we can’t use it because of illness. When you get sick and lose your voice, you may think it’s just a normal part of being sick.

Hydration is huge for voice care because water helps thin the mucus that then lubricates the vocal cords as they vibrate. The vocal cords dry out quickly. And it takes a long time to rehydrate them. The best way to keep your hydration at an optimal level is by drinking plenty of water. Not tea, not coffee, not soda – water. Drinks that contain caffeine may seem like they’re hydrating you, but they’re really drying you out more. Unfortunately, your decongestant cold medicine may contribute to dehydration of the vocal cords. Of course, we always stress the importance of nicotine cessation. Not only because of the cancers associated, but also the heat is damaging to the vocal cord tissues.

Over time, your vocal cords can develop abnormal growths, which are often considered a wear and tear injury from constant use and abuse of the voice. These lesions can continue to enlarge and make the voice worse and worse until surgical removal may be required.

Our team tries to keep people out of the operating room. But sometimes vocal cord surgery is necessary because of irreversible damage.

Before we operate, we almost always start our patients in a voice therapy program to see if the lesion will shrink and possibly even go away. Reversibility is common with vocal cord growths, but they don’t go away on their own – it requires patience and diligence by both the patient and the voice team. Sometimes we can cancel surgery, which is wonderful for everyone!

There are several ways to treat vocal cord damage. But, like all medical conditions, prevention is key. If you’re sick, don’t try to push your voice. It’s disappointing to miss a performance or have to skip a speaking event at work, but it sure beats having to go through surgery to save your voice. To schedule with a laryngologist, call 214-645-8898.

Voice loss is often due to acute laryngitis. Laryngitis occurs when your larynx (voice box) becomes irritated and inflamed. Most cases of laryngitis are caused by viral infections, like the common cold.

You can also irritate your voice box when you overuse your voice — like when yelling at a sports game or concert — or from exposure to environmental irritants like pollution and smoke.

Inflammation of the voice box

Your voice box contains your vocal cords. When you talk, your vocal cords open and close smoothly. As air passes through them, they vibrate to make sounds.

When your vocal cords are swollen or inflamed, your voice becomes distorted and may sound hoarse, raspy, or become too quiet to hear.

Laryngitis typically heals on its own and lasts less than 3 or 4 weeks. However, it can sometimes become chronic (long-lasting).

Treating laryngitis and getting your voice back involves treating the inflammation and irritation in your voice box.

Here are some methods to try.

Resting your voice is the single most important factor in healing laryngitis. Irritation and inflammation need time to resolve, and avoiding using your voice at all gives your vocal cords the chance to recover.

Try not to talk at all for a day or so, and if you must talk, do so quietly.

2. Don’t whisper

You might be surprised to learn that whispering can make laryngitis worse, and you should avoid doing it when your voice is hoarse.

When you whisper, your vocal cords are pulled tight and are unable to vibrate, which puts extra strain on them. Instead of whispering, use a “confidential voice,” or a natural voice at a low volume.

3. Talk with a doctor about medication

Corticosteroids are prescription medications that help reduce inflammation. If you’re someone whose work depends on your ability to talk or sing, your doctor may consider giving you a short course of steroids to speed up healing.

However, corticosteroids have risks and should not be routinely prescribed. They may not be suitable for everyone,

4. Drink warm liquids

Drinking plenty of fluids is always recommended when you’re healing from laryngitis. Laryngitis is most often caused by a viral infection, so resting and drinking plenty of fluids will help you heal as quickly as possible.

Warm liquids like tea, broth, or soup may help soothe your irritated throat, keep your airways moisturized, and thin out mucus. Try drinking around 60 ounces per day.

Avoid caffeinated drinks like coffee and black tea, as they can lead to dehydration. If skipping your morning coffee is out of the question, be sure to replenish your fluids with water or herbal tea.

5. Gargle salt water

Gargling warm salt water may help treat laryngitis by keeping your throat moist. It can also kill any bacteria.

Add 1 teaspoon of salt to a glass of warm water and try gargling two or three times per day until your voice returns.

6. Suck on a lozenge

Sucking on a throat lozenge increases your saliva production, which can help keep your throat moist.

Try a lozenge containing honey, which has natural antibacterial and anti-inflammatory properties.

7. Take a hot shower

The steam from a hot shower can help moisten your vocal cords and soothe your throat.

Inhaling warm steam by taking a hot shower or bath several times a day may help reduce hoarseness and clear the vocal cords of sticky secretions that cause laryngitis symptoms.

8. Get a humidifier

Inhaling humidified steam can keep your upper airways moisturized and remove secretions around your vocal cords that cause you to lose your voice.

Try using a humidifier throughout the day and while you sleep when experiencing laryngitis symptoms.

9. Avoid smoking

If you’re a regular smoker or vaper, try taking a few days off. Smoking is commonly linked to throat inflammation, so anyone healing from laryngitis should avoid smoking and stay out of smoky environments.

If you’re unable to quit nicotine right away, consider using a nicotine patch or other smoking cessation aid.

10. Avoid alcohol

Alcohol is an irritant that can dry out your throat, which could exacerbate laryngitis symptoms.

Drinking alcohol may delay healing, so avoiding it is recommended when you’re trying to get your voice back.

Laryngitis doesn’t typically require treatment. It’s often caused by a viral infection, so antibiotics won’t help. Symptoms typically clear up on their own within 3 to 7 days.

If you’re someone whose job depends on your voice, however, your doctor may be willing to prescribe corticosteroids to decrease inflammation.

If your laryngitis symptoms last longer than 2 weeks, or if your symptoms are very painful and you have trouble swallowing, you should see a doctor. You may have chronic laryngitis or laryngitis caused by acid reflux.

Your doctor can perform a physical exam and recommend a specialist if necessary.

It may come as a surprise to you the variety of medical conditions that can lead to voice problems. The most common causes of hoarseness and vocal difficulties are outlined below. If you become hoarse frequently or notice voice change for an extended period of time, please see your Otolaryngologist (Ear, Nose, and Throat doctor) for an evaluation.

Acute Laryngitis

Acute laryngitis is the most common cause of hoarseness and voice loss that starts suddenly. Most cases of acute laryngitis are caused by a viral infection that leads to swelling of the vocal cords. When the vocal cords swell, they vibrate differently, leading to hoarseness. The best treatment for this condition is to stay well hydrated and to rest or reduce your voice use. Serious injury to the vocal cords can result from strenuous voice use during an episode of acute laryngitis. Since most acute laryngitis is caused by a virus, antibiotics are not effective. Bacterial infections of the larynx are much rarer and often are associated with difficulty breathing. Any problems breathing during an illness warrants emergency evaluation.

Chronic Laryngitis

Chronic laryngitis is a non-specific term and an underlying cause should be identified. Chronic laryngitis can be caused by acid reflux disease, by exposure to irritating substances such as smoke, and by low grade infections such as yeast infections of the vocal cords in people using inhalers for asthma. Chemotherapy patients or others whose immune system is not working well can get these infections too.

Laryngopharyngeal Reflux Disease (LPRD)

Reflux of stomach juice into the throat can cause a variety of symptoms in the esophagus (swallowing tube) as well as in the throat. Hoarseness (chronic or intermittent), swallowing problems, a lump in the throat sensation, or throat pain are common symptoms of stomach acid irritation of the throat. Please be aware that LPRD can occur without any symptoms of frank heartburn and regurgitation that traditionally accompany gastro esophageal reflux disease (GERD).

Voice Misuse and Overuse

Speaking is a physical task that requires coordination of breathing with the use of several muscle groups. It should come as no surprise that, just like in any other physical task, there are efficient and inefficient ways of using your voice. Excessively loud, prolonged, and/or inefficient voice use can lead to vocal difficulties, just like improper lifting can lead to back injuries. Excessive tension in the neck and laryngeal muscles, along with poor breathing technique during speech leads to vocal fatigue, increased vocal effort, and hoarseness. Voice misuse and overuse puts you at risk for developing benign vocal cord lesions (see below) or a vocal cord hemorrhage.

Common situations that are associated with voice misuse:

• Speaking in noisy situations
• Excessive cellular phone use
• Telephone use with the handset cradled to the shoulder
• Using inappropriate pitch (too high or too low) when speaking
• Not using amplification when publicly speaking

Benign Vocal Cord Lesions

Benign non-cancerous growths on the vocal cords are most often caused by voice misuse or overuse, which causes trauma to the vocal cords. These lesions (or bumps) on the vocal cord(s) alter vocal cord vibration and lead to hoarseness. The most common vocal cord lesions are nodules, polyps, and cysts. Vocal nodules (also known as nodes or singer’s nodes) are similar to “calluses” of the vocal cords. They occur on both vocal cords opposite each other at the point of maximal wear and tear, and are usually treated with voice therapy to eliminate the vocal trauma that is causing them. Contrary to common myth, vocal nodules are highly treatable and intervention leads to improvement in most cases. Vocal cord polyps and cysts are the other common benign lesions. These are sometimes related to voice misuse or overuse, but can also occur in people who don’t use their voice improperly. These types of problems typically require microsurgical treatment for cure, with voice therapy employed in a combined treatment approach in some cases.

Vocal Cord Hemorrhage

If you experience sudden loss of voice following yelling, shouting, or other strenuous vocal tasks, you may have developed a vocal cord hemorrhage. Vocal cord hemorrhage results when one of the blood vessels on the surface of the vocal cord ruptures and the soft tissues of the vocal cord fill with blood. It is considered a vocal emergency and is treated with absolute voice rest until the hemorrhage resolves. If you lose your voice after strenuous voice use, see your Otolaryngologist as soon as possible.

Vocal Cord Paralysis and Paresis

Hoarseness and other problems can occur related to problems between the nerves and muscles within the voice box or larynx. The most common neurological condition that affects the larynx is a paralysis or weakness of one or both vocal cords. Involvement of both vocal cords is rare and is usually manifested by noisy breathing or difficulty getting enough air while breathing or talking. When one vocal cord is paralyzed or weak, voice is usually the problem rather than breathing. One vocal cord can become paralyzed or weakened (paresis) from a viral infection of the throat, after surgery in the neck or chest, from a tumor or growth along the laryngeal nerves, or for unknown reasons. Vocal cord paralysis typically presents with a soft and breathy voice. Many cases of vocal cord paralysis will recover within several months. In some cases, however, the paralysis will be permanent, and may require active treatment to improve the voice. Treatment choice depends on the nature of the vocal cord paralysis, the degree of vocal impairment, and the patient’s vocal needs. While we are not able to make paralyzed vocal cords move again, there are good treatment options for improving the voice. One option includes surgery for unilateral vocal cord paralysis that repositions the vocal cord to improve contact and vibration of the paralyzed vocal cord with the non-paralyzed vocal cord. There are a variety of surgical techniques used to accomplish this. Voice therapy may be used before or after surgical treatment of the paralyzed vocal cords, or it can also be used as the sole treatment.

Laryngeal Cancer

Throat cancer is a very serious condition requiring immediate medical attention. Chronic hoarseness warrants evaluation by an otolaryngologist to rule out laryngeal cancer. It is important to remember that prompt attention to changes in the voice facilitate early diagnosis. Remember to listen to your voice because it might be telling you something. Laryngeal cancer is highly curable if diagnosed in its early stages.