Remedies for Dysphonia - Loss of Voice

Dysphonia means compromised voice. This alteration can be qualitative or quantitative and consists in the difficulty in making sounds .

Dysphonia is a disease that affects the larynx, vocal cords, tongue and / or mouth.

The causes of dysphonia (in addition to aging) are to be found in anatomical and functional alterations, in infectious pathologies and in inflammations of the upper airways.

The various forms are not all the same and there is a precise diagnostic differentiation.

What to do

Aware of the causes of your own unhappiness, it can be very useful to adopt some preventive measures (see under Prevention).
Recognizing dysphonia: some vocal symptoms are typical of the disorder:

Hoarseness: associated with inflammatory diseases or more rarely with cancer.
Afonia: no voice. Associated with physical and mental exhaustion, bilateral paralysis of the phonatory muscles, laryngeal diphtheria or accidental inhalation of foreign bodies.
Fonastenia: weak voice. Generally associated with states of tiredness of the vocal organ.
Trembling or unstable: tone and quality altered. It is associated with neurological damage or muscle discomfort (it is not specific).
Aspirated or whispered: usually caused by muscular impairment of the vocal cords or neurological.
The most serious manifestations, in the presence of which it would be better to contact the doctor, are:

Complete loss of the voice for at least two days.
Hoarse voice, shrill or suddenly deeper.
Throat often dry and / or painful.
Difficulty talking and need to clear your throat frequently.
Persistent earache.
Loss of appetite and weight.
Cough with blood.
Enlarged lymph nodes.

The presence of one or the other symptom can indicate the level of severity and the cause. The diagnosis of the most serious disorders is of exclusively professional interest; therefore, it is advisable to consult a general practitioner or otolaryngologist who:

Objectively they will evaluate:

Duration and severity of the inconvenience.
Specific and associated symptomatology.
Clinical history.
Habits and lifestyle (profession, hobby, sport, abuse tendency and vices).

They will carry out one or more diagnostic investigations:

Throat inspection.
Laryngoscopy.
Laryngeal electromyography.
Deep and specific otorhinolaryngology inspection.

On the other hand, sometimes the dysphonia is clearly caused by non-serious causes. The remedies to be chosen and / or practiced independently are:

Allergies: practice the vaccine or take antihistamine drugs.
Smoking and alcohol abuse: quit smoking and drinking.
Dry throat: humidify the environment.
Gastroesophageal reflux disease (GERD): lose weight in case of overweight and carry out a specific diet.
Colds and upper respiratory tract infections (such as laryngitis): rest and drug therapy (if antibiotic, prescribed by a doctor).
Psychological stress: it is sufficient to eliminate the harmful source (permanently or on a fixed-term basis) or perform activities that promote relaxation.
Excessive or incorrect use of the voice (surmenage or malmenage): speech therapy and silence therapy are particularly useful.

There are also serious (less frequent) pathological causes and highly specific medical solutions:

Neurological disorders of the voice (spasmodic dysphonia): one of the solutions is the local injection of botulinum toxin.
Tumors, precancerous and non-cancerous lesions (polyps, nodules or cysts on the vocal cords): surgery.
Recurrent respiratory papillomatosis (caused by HPV virus): surgery.
Paralysis, weakness and vascular lesions of the vocal cords: surgery.
Leukoplakia: if severe with increased dysplastic risk, surgery is required.
Neck trauma or disabling surgery: it is not always possible to remedy.
Thyroid dysfunction: drug therapy (specific and anti-inflammatory) and surgery (goiter reduction).

What NOT to do

Speak out loud or for long periods.
Expose yourself to allergens.
To smoke.
Abuse alcohol.
Dehydrate.
Constantly ventilate with open mouth.
Ventilate with an open mouth during sport.
Attend environments with a very dry atmosphere (dehumidified, heated with a wood-burning stove or fireplace).
Follow a diet predisposing to gastroesophageal reflux disease.

Obesity (the GERD is predisposing).

If necessary, perform a speech therapy rehabilitation.

What to eat

The only useful nutritional recommendations are those for the dysphonia caused by gastroesophageal reflux disease.

In case of overweight (especially with android distribution), lose weight by practicing a low-calorie diet with an energy intake of 70% compared to normal.
Consume reduced meals, with moderate portions. The fractionation of calories could respect a similar criterion: breakfast at 15% of energy, two snacks (snacks) at 10% (or four at 5%), lunch at 35% and dinner at 30%.
Eat away from rest.
Season a little and only with extra virgin olive oil. 4 teaspoons a day are sufficient between lunch and dinner.
Of the animal ones, prefer foods that are lean and / or with little connective tissue:

Among the meats: avian without skin (chicken, turkey, etc.), rabbit, defatted pork or beef, etc.
Among the fishery products: cod, anchovies, sea bream, sea bass, corvina, ombrina, tuna fillet, prawns etc.
Among the cheeses: lean ricotta, light spreadable cheese, flakes of milk.
No more than one whole egg per serving.

It is possible to consume oilseeds but only away from the main meals, therefore near the snacks.
Among the proteic ones, prefer medium cooked foods. The recommended techniques are:

Boiling in water.
Vacuum packed.
Vasocottura.
Steam powered.
In a pressure cooker.
In a hot flame pan.
Baked.
Grilled.
Baked.

Among the cereals, legumes and derivatives, choose those with medium or low fiber content. Excess causes excessive gastric permanence.
Fruits and vegetables are tolerated cooked and raw, but the portions should not exceed 150g.
Insipid foods.
Fresh foods to be consumed "natural"; the only recommended long-term preservation method is freezing.
Consume products that do not contain molecules directly involved in the worsening of gastroesophageal reflux (they reduce the tone of the Lower Esophageal Sphincter - SEI), such as chocolate, mint and foods rich in fat (especially if cooked at high temperatures or prolonged).
If possible, eat foods with an average pH.
Take the food at medium temperature.

What NOT to Eat

Eliminate alcohol.

Other useful nutritional recommendations are those for dysphonia caused by gastroesophageal reflux disease.

High-calorie foods that can promote overweight.
Meals and large portions.
Quantitatively excessive dinners; they must NEVER be the richest meal of the day.
Meals close to rest.
Very seasoned foods.
Fatty foods, especially of animal origin, or rich in connective tissue:

Among the meats: offal, fatty cuts of pork, pork rind, ossobuco, sausages, salami, sausages, hamburgers etc.
Among the fishery products: salmon, eel, tuna belly, octopus, cuttlefish, mussels, clams, snails etc.
Among the cheeses: gorgonzola, pecorino, mascarpone, fontina, brie etc.
More than one egg yolk at a time.

Raw or overcooked protein foods:

Carpaccio, tartare, sushi etc.
Stew.
Ragù and the like.
Soups.
Braised.
Boiled meat.

The techniques not recommended are:

Stewing.
Frying in a pan.
Long cooking in the oven or on the grill or in boiling water.
Brazing.

Cereals, legumes and derivatives with a high fiber content (integral).
Excessive portions of fruit and vegetables.
Savoury foods.
Preserved foods:

Sottolio.
In brine.
Under salt.
Smoked and dried.

Spices and aromas, especially those that stimulate acid secretion:

Chili pepper.
Pepper.
Horseradish.
Ginger.
Onion, garlic, shallot.

Products that reduce the tone of SEI:

Chocolate and cocoa.
Mint.

Acidic foods and beverages:

Vinegar.
Beverages (for example cola).
Citrus fruits and juice.
Tomato and its juice.

Hot or iced foods.
Milk.
Coffee and tea.
Alcohol.
Broth.
Carbonated drinks (orange, cola, etc.).
Snacks and other junk foods.

Natural Cures and Remedies

In the case of dysphonia caused by GERD, phytotherapy may be helpful, in particular the intake of alkaloids with anticholinergic action (which reduce gastric secretion) or mucilaginous drugs (which protect the mucous membrane of the stomach):

Atropine and scopolamine (alkaloids): contained in the leaves of Atropa belladonna.
WARNING! Use is no longer recommended due to potential side effects; moreover, the berries of the same plant are strongly poisonous.
Mucilages: marshmallow, alginic acid, mallow, island lichen and aloe gel.

Activities that promote relaxation: useful in the treatment of stress dysphonia. Some are:

Phytotherapy: based on the intake of plants such as: valerian, hawthorn, lemon balm and above all passion flower.
Oligotherapy: based on the administration of minerals, in particular manganese-cobalt. This should be taken once a day for 3 weeks; after this it is reduced to 2-3 hires per week. Can be supplemented with magnesium.
Gemmotherapy: based on the administration of gems, in particular: Ficus carica (fig) and Tilia tormentosa (lime).
Aromatherapy: based on the inhalation (or cutaneous absorption) of neurosedative volatile essential oils, in particular: lavender, lemon balm, chamomile and bitter orange.

For dysphonia from excessive vocal commitment or more generally from irritation, it is possible to take a teaspoon of honey (even diluted in a little warm milk). It gives relief and seems to exert an emollient effect.

Pharmacological care

Depending on the cause, the following drugs can be used against dysphonia:

For the dysphonia caused by allergies: antihistamines and anti-inflammatories (see below).
For dysphonia caused by inflammation / infection of the upper airway:

Light topical anti-inflammatory drugs based on NSAIDs, in the form of sprays and sweets:

Flurbiprofen (eg Borocillina, Benactiv Gola, Tantum Verde Gola etc).

Topical antibiotics (for bacterial tonsillitis):

Fusafungina (eg Locabiotal).

Powerful topical disinfectants (can facilitate plaque elimination):

Rinse with diluted or pure oxygenated water.
Application of iodine tincture.

Antibiotics (for bacterial tonsillitis):

Clarithromycin (eg Biaxin, Macladin).
Amoxicillin (eg Augmentin).
Telithromycin (eg Ketek).

Antifungals for mycotic tonsillitis.
Antiviral drugs for viral tonsillitis (generally, used only when associated with more serious pathological conditions).
Systemic anti-inflammatories to be taken orally:

Paracetamol (eg Tachipirina and Efferalgan).
Ibuprofen (eg brufen and moment).

Corticosteroids. They are indicated for mononucleosis-dependent tonsillitis:

Cortisone (for example Cortone acetate).
Prednisone (eg Deltacortene and Lodotra).

Zinc tablets: particularly useful in case of tonsillitis associated with colds.

For dysphonia from gastroesophageal reflux disease:

Proton pump inhibitors (PPIs) and H2 receptor antagonists: reduce the acidity of gastric secretions and prevent the gastric contents from corroding the esophageal moss.

PPI:

Lansoprazole (eg. Pergastid, Lomevel, Lansox).
Omeprazole (eg Antra, Nansen).
Rabeprazole (eg. Pariet).

H2-receptor antagonists:

Nizatidina (eg. Nizax, Cronizat, Zanizal).
Ranitidine (eg Zantac, Ranibloc).

Esophageal mucosa protectors: protect the wall of the esophagus from acid attack:

Alginates (eg Gaviscon advance).

Prokinetic drugs: speed up the emptying of the stomach avoiding that the slowed-down evacuation favors the onset of the disorder:

Metoclopramide (eg Plasil, Isaprandil).
Domperidone (eg. Motilium, Peridon).

Bench antacids:

Sodium bicarbonate (NaHCO3).
Calcium carbonate (CaCO3).

Prevention

Avoid exposure to allergenic factors and, if available, use the antiallergic vaccine.
Preventing infectious diseases of the upper airways.
Stop smoking.
Stop drinking alcohol.
Treat a possible GERD and obesity.
Take silent breaks, especially when talking long and loud.
Reduce stress.
Hydrate yourself properly.
Maintain sufficient humidity in the air.
Eventually, follow a drug therapy: it varies according to the causative agent.
Eventually, take advantage of the surgery: also different depending on the cause.
Eventually, resort to speech therapy.

Medical Treatments

Surgery: there are many types of surgery to treat dysphonia. The techniques are:

Microlaringoscopy and endoscopic resection: useful for the removal of polyps, nodules, cysts, precancerous lesions, tumors and papillomas on the vocal cords.
Injection of a suspension of teflon to increase the volume of the paralyzed vocal cord: it brings the strings closer, improves the voice and prevents the inhalation of food (it cannot be performed if the paralysis is bilateral).
Tracheotomy: permanent or only in the course of respiratory failure.
Arytenoidectomy with lateralization of the vocal cord: it opens the glottis and optimizes the breathing space (it can change the quality of the voice).
Laryngoplasty: external cutting of the thyroid cartilage and insertion of material to move the vocal cord medially.
Partial or total thyroidectomy: necessary for the reduction of thyroid goiter.

Speech therapy: is a medical specialization that covers pathologies and disorders of voice, language, communication, swallowing and cognitive processes. Improves the use of the voice and prevents its abuse (excessive tone).
Local injection of botulinum toxin: reduces muscle spasms or abnormal movements, resolving neurological movement disorders that affect the vocal muscles of the larynx.