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How Hypothyroidism Can Affect Your Voice

Learn how hypothyroidism can affect your voice.
How Hypothyroidism Can Affect Your Voice
Last updated:
8/18/2023
Medically Reviewed by:

In this article

In the United States, over 17 million adults suffer from vocal cord problems such as hoarseness or sudden voice deepening. While various factors contribute to voice changes, untreated thyroid disorders can affect vocal cord function.

Specifically, studies have shown that hypothyroidism – when your thyroid doesn’t produce enough thyroid hormone –can affect your vocal cord function and voice. 

So, whether you’re a singer, teacher, or simply someone who enjoys talking, you’ll want to understand how hypothyroidism impacts your vocal cords. 

Importance of your vocal cords

Your vocal cords, also known as vocal folds, are two tiny bands of muscle located at the top of your larynx. The larynx, also called your voice box, sits on top of your trachea (windpipe), where air enters and exits your lungs.

When you’re not talking, the vocal cords are open, and air moves freely through your larynx. But, when you are speaking, your vocal cords close. As exhaled air moves out of your lungs over the closed vocal cords, they start to vibrate. These vibrations produce sound waves.

The size and shape of your vocal cords -- and the resonating cavities the sound waves travel through -- determine your voice’s pitch, volume, and tone. Resonating cavities like the throat, nose, and mouth help adjust the sound of your voice.

 

Symptoms of vocal cord dysfunction

A change in your voice could signal a problem. Changes include:

  • New onset of hoarseness or raspiness
  • Sudden voice deepening
  • An achy, raw, or strained throat
  • Persistent clearing of your throat
  • Difficulty talking

While this article focuses on how a lack of thyroid hormone affects your voice, you should know there are many potential causes for voice problems. Other conditions that may result in voice changes include:

  • Upper respiratory infections
  • Gastroesophageal reflux disease (GERD)
  • Overuse of your voice
  • A growth on the vocal cords
  • Certain cancers
  • Emotional trauma

Vocal symptoms associated with hypothyroidism

According to research, up to 98% of people with hypothyroidism will develop some voice-related symptoms. 

Voice changes progress slowly, making it hard to notice them immediately.

A hoarse voice with a rough, raspy sound is the most common voice problem in those with hypothyroidism, but individuals could also experience:

  • Inability to speak or sing at both high and low pitches
  • Deepening of the voice (especially in women)
  • Vocal fatigue or the feeling of straining or tiredness after talking for a long time
  • Lower voice volume results in a weaker or softer-sounding voice

People with subclinical hypothyroidism, a mild form of hypothyroidism, may also notice mild changes in their voice.

 

Causes of voice problems in those with hypothyroidism

The exact ways that hypothyroidism affects your voice are unknown. But experts believe voice changes related to hypothyroidism may be caused by the following:

  • Fluid build-up on or near your vocal cords
  • Weakness of the vocal cords due to thyroid gland enlargement (goiter)
  • Inflammation of the vagus nerve, the main nerve that controls involuntary functions such as heart rate and breathing
  • Enlargement of the cricothyroid muscle in your neck

These changes to or around your vocal cords may reduce their vibration sensations, resulting in changes in your voice.

Although rare, damage to your vagus nerve or the recurrent laryngeal nerve can result in vocal cord paralysis. A surgical procedure called a thyroidectomy, where all or part of the thyroid gland is removed, can sometimes result in temporary or permanent vocal cord paralysis. 

Treatment of thyroid-related vocal problems

Fortunately, most problems with vocal function are reversible if the underlying cause is addressed correctly.

An older study from 1971 looked at several patient cases where correcting hypothyroidism with thyroid hormone therapy improved their voices. Since then, many studies have shared similar results.

Thyroid hormone replacement medications supplement your natural supply of thyroid hormone. Medication helps achieve euthyroidism, meaning your thyroid hormone levels are within the normal range.

However, achieving euthyroidism takes time, even with medication management. It can take up to 8 weeks for thyroid hormone replacement medications to reach their full effect. And you should expect dose changes along the way, which can extend the time it takes to achieve euthyroidism.

Once you are on a stable dose, you should start to see improvement in your voice within 3 to 6 months.

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Tips for protecting your voice

There are steps you can take to protect your voice, including:

  1. Stay hydrated for better vocal cord function
  2. Avoid excessive throat-clearing or yelling
  3. Practice good breathing techniques when speaking or singing by taking deep breaths from your chest
  4. Rest your voice throughout the day
  5. Limit the use of medications that can dry out your vocal cords, such as OTC cold and allergy medications
  6. Quit smoking and avoid second-hand smoke, as smoke irritates your vocal cords

A note from Paloma Health

If you notice changes in your voice, such as hoarseness or a scratchy voice, it might be time to check your thyroid function.

You have two options for checking your thyroid. The first is to visit your local lab and have your blood drawn. While this is usually a quick visit, the hours and wait time at the lab can make it an inconvenience. Your second option is to do an at-home thyroid test.

Paloma’s at-home testing kit tests your thyroid function from the fingerpick blood sample. And one of the best parts - you do it from the comfort of your home at your convenience. Your results will appear in Paloma’s easy-to-use patient portal within a week of mailing your blood sample. Our results come with a personalized explanation of each thyroid biomarker. Purchase a kit today and start your health improvement journey. 

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References:

NIDCD. Taking Care of Your Voice. NIDCD. Published August 18, 2015. Accessed August 9, 2023. https://www.nidcd.nih.gov/health/taking-care-your-voice

National Cancer Institute. Larynx & Trachea | SEER Training. Cancer.gov. Published 2019. Accessed August 9, 2023. https://training.seer.cancer.gov/anatomy/respiratory/passages/larynx.html

Junuzović-Žunić L, Ibrahimagić A, Altumbabić S. Voice Characteristics in Patients with Thyroid Disorders. Eurasian J Med. 2019 Jun;51(2):101-105. doi:https://doi.org/10.5152/eurasianjmed.2018.18331

Knudsen R, Gaunsbaek MQ, Schultz JH, Nilsson AC, Madsen JS, Asgari N. Vocal cord paralysis as primary and secondary results of malignancy. A prospective descriptive study. Laryngoscope Investig Otolaryngol. 2019 Jan 29;4(2):241-245. doi:https://doi.org/10.1002/lio2.251

Brodnitz FS. Hormones and the human voice. Bull N Y Acad Med. 1971;47(2):183-91.

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Emilie White, PharmD

Clinical Pharmacist and Medical Blogger

Emilie White, PharmD is a clinical pharmacist with over a decade of providing direct patient care to those hospitalized. She received her Doctor of Pharmacy degree from Massachusetts College of Pharmacy and Health Sciences. After graduation, Emilie completed a postgraduate pharmacy residency at Bon Secours Memorial Regional Medical Center in Virginia. Her background includes caring for critical care, internal medicine, and surgical patients.

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