By Karen Kier
Pharmacist on behalf of the ONU HealthWise team

The power of having a voice is important so one can be active and have a participatory role in making or influencing a decision.  At times we can think of this as it relates to politics and our role in making our voice heard.  The John F. Kennedy Presidential Library and Museum offers a course for 3rd to 6th graders titled Making Your Voice Heard.  The course teaches about civic engagement and making a difference by writing letters.  The goal is to use the written word to effect change in communities and government.  

Besides the written word, we can use verbal communication to inspire, create, and innovate.  We can use our voice to create movies, television shows, art, theater, music, and poetry.  When I hear the voice in conversation, I often think of the television show The Voice. An interesting concept of judges blindly listening to someone’s voice without any other visual clues.  

The music competition first aired on April 26, 2011.  The show completed season 22 on December 13, 2022.  For those who watch, country music’s Blake Shelton is the only original coach on The Voice and he plans to finish out season 23 and walk away from coaching.  

How does one’s voice correlate to one’s health?

Several diseases as well as medications can alter one’s voice.  Changes in the voice can include pitch, strength, and quality.  Voice changes could be caused by the brain or nervous system with diseases such as Parkinson’s disease, multiple sclerosis, or amyotrophic lateral sclerosis (Lou Gehrig’s disease).  The ability to speak or changes in the quality of speech can be impacted by strokes or other brain injuries.  Growths, swelling, or inflammation of the vocal cords can result in changes.  

Laryngitis is the technical term for swelling of the vocal cords resulting in a loss of voice or developing a hoarse or raspy voice.  Laryngitis is usually short-term especially with upper respiratory infections including viruses.  Chronic laryngitis can be the result of a long-term cough, acid reflux (heartburn), or asthma.  

Medications can cause changes in voice quality, pitch, and strength.  Some of the more obvious ones would be female and male hormones.  This is not a surprise as we can hear a voice change in young children as they become teenagers.  Many may not realize other drugs can cause significant changes.  Medications used to control blood pressure or hypertension can alter one’s voice. ACE-inhibitors can cause a chronic cough and result in hoarseness.  As a pharmacist, I have encountered this side effect more frequently in altering one’s voice more than any other blood pressure medication. 

Besides blood pressure medication, other categories of medications noted for voice changes include antidepressants, muscle relaxants, antihistamines, and decongestants.  Since we use antihistamines and decongestants to treat colds, flu, and allergies, it may be hard to distinguish the effect of the drug on the voice versus the effect of the virus on the vocal cords.  

The medical literature has been studying the impact of viruses on the vocal cords.  In a study published in the journal of Signal, Image and Video Processing, researchers found a significant change in voiced (vibrating vocal cords) and unvoiced speech segments as a result of the common cold.  The authors found acoustic properties of one’s voice with a cold differed from those of normal speech for the same person.  By evaluating the segmented speech, researchers without knowing a person’s diagnosis were able to detect changes in voice quality indicating a cold.  

Some of this research has been prompted by what has been referred to as the ‘COVID-19 voice” caused by the SARS-CoV-2.  The change most often associated with the COVID-19 voice is the development of hoarseness as the virus takes its course.  Initially, scientists thought this was related to the inflammation of the vocal cords and the sticky nature of the mucus or phlegm resulting from the virus as well as the impact of lung changes with a significant cough.  However, scientists have evaluated the impact of the virus on the vagal nerve, which helps to control the upper airway.  Any viral changes of the vagal nerve can change the ability of the vocal cords to produce a normal sound.  

A study published in the Journal of Voice described dry throat and the buildup of phlegm as the two most common symptoms with an active COVID-19 infection. The study reported 73.3% suffered a tired voice from COVID-19.  For patients who suffered from long-term voice changes, the researchers found these individuals were more likely to have required oxygen therapy to manage COVID-19.  

The best advice for managing vocal changes due to viruses is to stay well hydrated, use cough drops, and rest your voice.  It is recommended to see a specialist if your voice does not improve after a viral infection such as the common cold, the flu, RSV, or COVID-19.  

Have a voice! Talk to your pharmacist or health care professional about the impact of viruses and medications on your voice!

ONU HealthWise is offering COVID-19 vaccines as well as flu shots Monday through Friday from 10:00 a.m.-5 p.m. The bivalent COVID-19 vaccines are available.  Clinics are Monday through Friday from 4:00-6:00 p.m. Please call the pharmacy for more information.  

ONU HealthWise Pharmacy
419-772-3784