What Your Voice May Be Telling You About Your Health Everyday Health MenuNewslettersSearch Healthy Living What Your Voice May Be Telling You About Your Health By Anne HardingReviewed: April 29, 2015Fact-Checked Is That Change in Your Voice a Disease Symptom ThinkstockUsually when your voice gets a little raspy, you can blame an upper respiratory tract infection — a cold or a throat infection, for example — and count on having your regular voice back in a few days. Rarely, however, a hoarse, shaky, or weak voice can be a sign of a more serious illness. “When we get concerned is if the hoarseness goes on for more than three weeks,” says Milan Amin, MD, director of the New York University Voice Center in New York City. For the following conditions, a change in your voice such as raspiness, tremor, or breathiness may be one of the first symptoms. Autoimmune Illness Hoarseness Lester Lefkowitz/Getty ImagesCertain diseases in which the immune system launches an abnormal attack on the body can lead to inflammation of the vocal cords, causing hoarseness. The problem may be particularly severe with Sjogren's syndrome, which causes damage to glands that produce tears and saliva, causing dry mouth and throat. Other autoimmune conditions that have been linked to hoarseness include polymyositis, rheumatoid arthritis, scleroderma, and lupus. The National Institute of Arthritis and Musculoskeletal and Skin Diseases offers tips on how people with Sjogren's and similar conditions can protect their voices: “Try not to clear your throat before speaking. Instead, take a sip of water, chew sugar-free gum, or suck on sugar-free candy. Or else make an ‘h’ sound, hum, or laugh to gently bring the vocal cords together so you can get sound out.” Nerve Injuries Breathiness Getty ImagesDamage to the nerves that control the vocal cords can make the voice weak and breathy. Operations on nearby areas — such as surgery on the thyroid gland, spine, or heart — can accidentally nick these nerves. “It becomes a huge quality-of-life issue for a lot of these folks,” Dr. Amin says. Rather than waiting to see if nerve damage heals on its own, which can take months, an ear, nose, and throat specialist will usually intervene to “plump up” the vocal cords by injecting them with fillers — the same materials dermatologists and plastic surgeons use to temporarily erase wrinkles. “We're able to do that without taking patients to the operating room,” says Amin. “You can just literally numb them up, inject them, and send them on their way, and they're fixed.” Viral Infections Vocal Weakness ThinkstockInfections affecting the larynx — whether they're viral, bacterial, or fungal — can cause hoarseness, which will typically get better on its own. But severe viral infections can damage the nerves responsible for vocal function. “Instead of a raspiness of their voice, they have a weakness,” Amin says. “They have to push really hard to be heard, or their voice gets tired at the end of the day.” Injectable fillers are also used to treat people with vocal issues due to infection. Larynx Lung or Thyroid Cancer Voice Changes and Weakness Peter Dazeley/GettyChanges in the voice can, in rare cases, be due to pre-cancerous or cancerous growths on the larynx. Smokers are at the greatest risk of laryngeal cancer, and excessive alcohol consumption has also been implicated in the disease. Symptoms include changes in the voice, ear pain, sore throat, the sense of having a lump in the throat, difficulty breathing or swallowing, and lumps in the neck. Cancers that affect nearby structures, such as the lungs or thyroid gland, can also push on the vocal nerves and weaken the voice. If you have any of these symptoms, especially if you are a smoker, see your doctor. Parkinson' s Disease Soft Gruff or Shaky Voice AlamyPeople with Parkinson's often find their voice becomes very soft and difficult for other people to hear. Their voice may also sound gruff or hoarse or shaky. The National Parkinson Foundation offers these and other tips to help you maintain a stronger voice:Express your ideas in short, concise sentences.Speak louder than you think is necessary, but don’t try to shout over noise.Ask your doctor to refer you to a speech-language pathologist for an evaluation. Vocal Cord Atrophy Weakness and Hoarseness Zephyr/GettyTypically, beginning in a person's sixties, the voice can get weaker and more hoarse. That's because the vocal cords begin to atrophy. “Many of their friends or relatives or spouses have hearing loss, so it becomes a real problem,” Amin says. “Many [older people] become somewhat socially isolated, they don't feel comfortable going out to restaurants or clubs or something like that because they can't communicate all that well.” And social isolation can also lead to depression, he adds. Aging-related vocal weakness can sometimes be treated by injecting the vocal cords with filler, which allows the cords to touch better and helps make the voice louder, he says. GERD Hoarseness AlamyHoarseness as a symptom of GERD, or gastroesophageal reflux disease, started getting a lot of attention from doctors a few years ago — too much, in fact, Amin says. “We're seeing lots of people who are being overtreated for reflux for their hoarseness.” Many primary care doctors prescribe a course of reflux medication for patients with hoarse voices, without examining them further, he explains. This can be a big problem if a person's hoarseness is actually due to cancer or another serious illness. People with long-standing hoarseness need to undergo laryngoscopy, in which a lighted tube is inserted into the throat so the larynx and vocal cords can be examined, he adds. Then, if no malignancy is found, reflux treatment may be warranted. Overusing Your Voice Hoarseness David Jakle/GettyPeople in jobs that require them to project their voice — think of middle-school teachers in a raucous classroom, traders on the stock exchange floor, or exercise instructors calling out moves over loud music — can develop benign growths on their vocal cords that cause hoarseness. It's a little bit like the way football players expect some aches and pains during the course of a season, Amin says. “If you're using your voice that much, at some point … you're going to have an injury that puts you out for a while.” When a person who uses their voice a lot feels some hoarseness coming on, Amin adds, it's good idea for them to rest their voice for a day or so if possible. Fortunately, teachers and others who rely on their voices to make a living can learn strategies for speaking more efficiently and causing less strain on their vocal cords from a speech pathologist. Voice Symptoms That Could Be Health Warnings Zave Smith/GettyIf you notice changes in your voice that aren't related to a cold or sore throat, or if hoarseness lasts for more than three weeks after you recover from an upper respiratory tract infection, check with your doctor. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), these vocal changes can signal underlying health problems:Your voice is hoarse or raspy for a prolonged period.You lose the ability to hit high notes while singing.Your voice sudden gets deeper.You frequently have a raw, achy, or strained throat.It takes more effort for you to simply talk.You need to clear your throat repeatedly. How to Protect Your Voice ThinkstockThe American Academy of Otolaryngology-Head and Neck Surgery, NIDCD, and others suggest these ways to protect your voice:Stay hydrated — drink six to eight glasses of water a day.Limit alcohol and caffeine. Both can dry out and irritate your throat.Use a humidifier in winter, or if you live in a dry climate.Avoid medications that dry out your throat, for example some cold and allergy medications.Don't smoke; avoid second-hand smoke.Stay away from spicy foods, which can trigger throat-irritating reflux.Don't use mouthwash that contains alcohol or other substances that can irritate the throat.Breathe deeply to support your voice, which is less tiring than talking from the throat.Don't cradle the phone between your head and shoulder, which can make neck muscles tense.Don't speak too loudly, or too softly. Both yelling and whispering can strain your voice. 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