Thyroid and Vocal Chord Inflammation

Subject: Thyroid and Vocal Chord Inflammation
From: JHW
Date: 05 Jul 09 - 03:39 PM

Can anyone reassure me that my vocal chords will get better? At Christmas 2008 I had a seasonal cough but when that went I found still that singing made me cough. I couldn't sing, not a line.
Alongside this my Thyroid was found to be underactive so I'm now on permanent Levothyroxine; But even when my thyroxine was pronounced corrected I still coughed. Cancel your singing for six months was my GP's advice and my singing teacher went along with that and ceased my lessons.
It's a bit better a few months on but even trying to sing one song to myself I know it's nothing like right.
When the ENT specialist looked at the vocal chords with a periscope he confirmed them inflamed though he reckoned once my thyroxine level was right then I should be.   He gave me anti heartburn pills.    Thankfully there were no nodes.
Other Levothyroxine takers disagree and say (on other symptoms) they were up to a couple of years getting right.
Thanks, John
I've looked at past threads but has anyone specifically had vocal chords damaged by low thyroid and how long did it take to come back to normal?

Subject: RE: Thyroid and Vocal Chord Inflammation
From: Rabbi-Sol
Date: 05 Jul 09 - 10:41 PM

The anti-heartburn pills, depending on which ones are prescribed, can damage your vocal chords even further.

Acid reflux disease or GERD as we commonly call it could have been what did the original damage. Coughing is a major symptom of this along with the heartburn.

I am on Pepcid (Famatodine) 20 mg. twice a day and Prevacid 30 mg once a day for the rest of my life. My voice is now only good enough to sing raspy sea chanties.

Subject: RE: Thyroid and Vocal Chord Inflammation
From: Alice
Date: 05 Jul 09 - 10:57 PM

JHW, I know a professional singer who takes thyroid medicine and it doesn't seem to harm her voice.

Once the inflamed cords are well, you should be able to resume. Your voice teacher and ENT know best.

Have you tried the practical things to help with the reflux like putting bricks or phone books under the legs of the head of your bed so your body is at a slant while sleeping? Also avoid eating before bedtime and avoid things that could aggravate the reflux like mints.

Good luck.

Alice

Subject: RE: Thyroid and Vocal Chord Inflammation
From: Kent Davis
Date: 06 Jul 09 - 12:23 AM

JHW and Rabbi-Sol,

Although my practice is now limited to mental health, I am a D.O., board-certified in family practice, and I worked in a family practice until last year. I can't practice medicine over the internet, but I will make some general observations, which I hope may be helpful:

1. The combination of persistant hoarseness with inflamed vocal cords while on medication suggests an inadequate dose of medication or a lifestyle issue (See #4 below.)

2. It is unlikely that anti-reflux medication is damaging one's vocal cords even further. Anything is possible, of course, but it is FAR more likley that the the dose of medication is too LOW or that there is a lifestyle issue involved.

3. In my experience, it is more likely that the under-treated problem is the reflux rather than the hypothyroidism.

4. Alice's suggestions are excellent. Other common triggers include chocolate, coffee, orange juice, certain medications (naproxen and ibuprofen are two common ones), cigarettes, alcohol, and being overweight. People vary a lot in their sensitivities to these triggers.

5. Some people with this problem (my father, for instance) need greater acid suppression than once-daily prevacid will provide. He needed Nexium, 40 mg., TWICE daily. This can be expensive. If that's a problem, ask if there is a company-sponsered patient assistance program. (There used to be, and also the company was excellent about giving extra "samples" when I had a patient who couldn't afford the added cost of taking Nexium twice daily.) Twice a day Prevacid might work, but I had the most success with Nexium.

6. A related issue is snoring due to obstructive sleep apnea. Excessive snoring can sometimes cause hoarseness. Ask your spouse if you snore excessively and if you hold your breath while sleeping. (However, reflux is a more likely cause than this.)

7. Although levothyroxine theoretically should work well, more than a few of my patients had symptoms when on levothyroxine which vanished when I switched them to Armour thyroid. Ask your physician about it. I predict you will be told "But levothyroxine is the same thing". Say, "So I've been told, but would there be anything wrong with trying Armour?" Armour is not synthetic. It is a slaughterhouse product and so vegetarians and those who follow the food laws of the Torah or the Koran must consider their options carefully. Your pharmacy may be able to obtain a kosher or halal product, but it inherently non-vegetarian. (I have NOT seen in difference between the two products in regard to hoarseness, but I have seen a difference in some patients in regard to fatigue.)

Kent

Subject: RE: Thyroid and Vocal Chord Inflammation
From: VirginiaTam
Date: 06 Jul 09 - 03:02 AM

hmmm! this thread is making me think.

I have been having neck pain like crazy. I have hypo (low) thryroid. While is is mostly the back of my neck and down shoulders causing arm weakness.

The xrays, MRI and ultrsound confirm some osteo-arthritis in my cervical spine, I wonder if thryroid is compounding the problem. Throat often hurts, especially after singing. A muscular kind of hurt not sore throat feeling. Also wake several times a night, experiencing palpitations but not in chest. I hear them in my head and can see them like strobing (even see the veins in my eyes when the strobing happens). And an uncomfortable full feeling from my neck up through face and head. I think it has to do with pressure on front of my neck when I sleep.

My GP gave me meds for reflux. I don't have reflux. I told him. I had it in my 30s and I know what it feels like. But he was convinced the antacid would help, but it only gave me headache.

While my voice has gone lower and huskier with the thyroid I am not fussed. I like it. And yesterday, I was singing along with Loreena McKennitt, to see if I still could reach the upper range. Got through 3 CDs before neck started paining me muscularly. And was able to sing in Odetta range immediately after no problem.

So I would say, keep chin up (literally and figuratively). Rest when you need too. Check out your sleeping position and possibility of post nasal drip and stuff. Also keep your body hydrated. Are you getting enough fluids?

Subject: RE: Thyroid and Vocal Chord Inflammation
From: Rumncoke
Date: 06 Jul 09 - 08:59 AM

I have to take 200 micrograms of laevothyroxine every day, and I have sleep apnea so use a CPAP machine which blows air into my nose to keep my airway open at night.

I am very sensitive to carbohydrates, so I do Atkins - lots of water loads of fresh veges and salads, natural sources of protein, alcohol very rarely, no artificial flavours colours or preservatives.

I sing fairly well - at least, people ask me to sing more than once.

I'll never sing soprano, but then, I never did.

Despite having very low levels of thyroid hormone in my blood before it was confirmed, despite suspicions and regular testing over several years, I never had acid reflux, that I know of.

Perhaps the two problems are simply concurrent, not connected?

The slower healing process which low thyroid causes should return to normal-ish soon after you are fully topped up with the tablets.

Although your thyroid medication might require slight tweeking before it is stabilised, perhaps there is some other reason for the reflux and that needs some work now?

Anne Croucher

Subject: RE: Thyroid and Vocal Chord Inflammation
From: GUEST
Date: 06 Jul 09 - 01:47 PM

try stretching your muscles against the pain and holding

Subject: RE: Thyroid and Vocal Chord Inflammation
From: JHW
Date: 12 Jul 09 - 01:39 PM

Thanks very much to all. I didn't reckon I had a reflux problem but the ENT periscope guy asked if I ever had heartburn which I do now and then. MSG certainly gives me heartburn as does a week on pasties and beer at Sidmouth. Never thought it a condition - just took Sainsbury's Rennies if needed. A veggie for 25 years I do lots of veg and liquid. Not much beer of late as I've stopped going to Folk Clubs with not singing.
I have ordinarily no pain - just if I try to sing it stirs up the sore chords towards coughing so I don't do it.
VirginiaTam - Long before this episode I had pain in my neck. From chin down the front to collar bone. The Fates are determined to stop me singing and I was seeing (different)ENT about sudden (mid song!) deafness and asked about the pain in the neck.
Immediate response was that it was caused by poor singing technique. I protested that I'd sung since a toddler but the reply was that many get away with it so long then it catches up. The ENT dept. had ready a list of singing teachers so that's how I started with a teacher who confirmed how many had come to her with serious neck pains even contorted neck to minimise pain. That neck pain has long gone but I have kept up the lessons.
Kent Davis - my acid treatment was Omeprazole 20mg daily for 6 weeks then further periscope inspection in another 6 weeks, now due in a month. For the record my Levothyroxine is 75mcg a day.
I find lots of folks I know (all women) are on Levothyrixine and their experience is up to two years to be right. (I did not of course ask their symptoms)
Thanks again all, John

Subject: RE: Thyroid and Vocal Chord Inflammation
From: Rumncoke
Date: 12 Jul 09 - 02:18 PM

That is a fairly low dose of Thyroxine, though I had to start at 50 micrograms for fear of palpitations and other side effects. I can't recall how long it took to get up to the 200 a day I take now - I have been taking it for a very long time.

I think that women are genetically predisposed to thyroid failure, as there are others in my family all linked through the maternal line who are taking Thyroxine.

It could be that the dose will increase over time - be sure to have the blood tests done when they are due, or if you feel that you need to be checked. Apparently thyroids tend to fail in a very irregular way, sometimes rallying and sometimes shutting down so diagnosis is difficult - at least that is what I was told.

I was going to claim a good digestive record - as I don't suffer from indigestion, tend to eat and forget agout it - but I never inflicted beer and pasties on the system.....

Anne Croucher

Subject: RE: Thyroid and Vocal Chord Inflammation
From: JHW
Date: 21 Aug 09 - 03:45 PM

After more than six months enforced not singing, few pasties and not that much beer the guy with the periscope tells me me vocal chords are now 'pristine'. So anyone's guess what the cause was but time (or Omeprazole) has at last cured.
Now to try proper singing again!!
Fingers crossed, John

Subject: RE: Thyroid and Vocal Chord Inflammation
From: GUEST
Date: 31 May 10 - 09:56 AM

HELP, I HAD A THYROID SURGERY A YEAR AND A HALF AGO, FOR THE PAST TWO
WEEKS I HAVE LARYNGITIS AND HOARSENESS IN MY VOICE AS WELL AS BRINGING UP COLD ALL DAY. I AM THE CHOIR DIRECTOR AT MY CHURCH AS WELL AS BEING OVER A WOMEN SINGING ENSEMBLE. WILL I GET MY VOICE BACK AND WHAT CAN I DO?

Subject: RE: Thyroid and Vocal Chord Inflammation
From: VirginiaTam
Date: 31 May 10 - 10:16 AM

First off, request referral from your GP to see an Ear Nose and Throat specialist.

Also ask about the possibility of having a low level sinus infection causing that catarrh. Antibiotics should clear that up, though it may take several courses of different types. That kind of infection tends to be resistant to treatment.

See a voice coach about how to care for and get your voice back into shape.

Subject: RE: Thyroid and Vocal Chord Inflammation
From: VirginiaTam
Date: 31 May 10 - 10:17 AM

oops...

Meant to ask John how his voice is recovering.

Subject: RE: Thyroid and Vocal Chord Inflammation
From: Stringsinger
Date: 31 May 10 - 04:44 PM

John, in an offer to help, I will offer a radical idea. Change your diet. Stop eating dairy products. And get a modicum of aerobic exercise. Medicines may help as a stop-gap but not a cure. Stay clear of booze and tobacco smoke. Get enough sleep at night.

Singing requires training like an athlete.

Subject: RE: Thyroid and Vocal Chord Inflammation
From: GUEST,jvsingin1
Date: 08 Aug 11 - 05:58 PM

I have been singing since childhood and have a degree in Music/Voice. I found myself hoarse for over 6 weeks so I went to the doctor. Had blood panel done and initial thyroid test came back normal. Saw ENT. He said I have red inflamed vocal chords but otherwise healthy. Prescribed a 2 times/day pill to fight acid reflux. I don't believe I have acid reflux. I have lost 90 pounds in the last year and am (at age 41) in the top shape of my life. My voice seemed to be feeling better and after one weekend of singing at three church services, my voice is gone again. I have a "tired" feeling in my neck. Although my singing is not my full-time job, it is my passion and without it, I would be lost. I have been reading this strain and am convinced (because I eat very healthy and don't "feel" any symptoms of acid reflux, that my ENT was wrong. I use great singing/vocal technique as I have been doing this professionally for years. My heart is breaking because my singing voice is everything to me. Anyone have any suggestions of what to do next?

Subject: RE: Thyroid and Vocal Chord Inflammation
From: JHW
Date: 09 Aug 11 - 06:23 AM

Haven't seen this thread for a while but its just popped up again.
My voice is fine now, better than ever according to my singing teacher and returning after the year of no singing left it now balanced across my range (she says)
I never found out what was wrong or how it got better. Back at the ENT with the thing down the throat the guy said all was fine and I found it was. (After his prescribed anti reflux pills every day then a long rest after) I'm on thyroxine for good and I haven't given up dairy though I know someone who has with benefit. I'd rather not bother cows and I've tried all the soya milks and stuff. Found a new one, coconut, at Gnashers veggie shop at Sidmouth which I will use again.
Others advised Manuka honey which I tried though it costs a fortune.

Responding to Guest jvsinginl it was pain in my neck which first took me to the singing teacher several years ago, on the advice of the ENT. I had a pain from my chin down to the top rib. Singing teacher said it was common for untrained singers though I had sung ever since primary school.

The biggest surprise I found after being laid off singing for a year was that I could after all manage without it. I don't go to anything like the folk clubs I used to before. Two days at Sidmouth I spent walking and didn't get back to the afternoons at the Woodlands.

Subject: RE: Thyroid and Vocal Chord Inflammation
From: GUEST
Date: 15 Mar 12 - 11:40 PM

I had severely inflammed vocal cords last year (ears hurt too). Ent doc gave me augmentin (amoxicillin with clavulanic acid). Cleared it right up. Don't let them convince you that you have GERD when you know it's not...

Subject: RE: Thyroid and Vocal Chord Inflammation
From: GUEST,Susan
Date: 09 Jun 12 - 11:07 AM

I am a hyperthyroid patient. Does singing has an adverse effect on me?