Sometimes changes to the way you sound can be an indication of wider health issues, discovers What’s your voice REALLY telling you?

From an allergy or a cold to tiredness and stress, many things can change the tone or sound of our voice. However, if you start to notice a more persistent change in the way you sound, then it could be a sign of a more serious health problem. So what are the signs and symptoms to look out for?

Croaky It could be: acid reflux

“Acid reflux is one of the most common causes of a croaky or hoarse voice,” says Dr Adam Staten, GP and clinical director of onedaytests.com.

“Sometimes the presence of acid reflux is quite obvious because it is associated with symptoms of heartburn or indigestion but often people experience ‘silent reflux’ which may only cause symptoms such as a change in your voice, a persistent sore throat or the feeling of a lump in the throat.

“When acid reflux is the cause of a croaky voice, you’ll tend to find that your voice isn’t consistently croaky but instead changes from day to day, and often throughout the day too.”

Nasal It could be: sinusitis

We all recognise that nasal-sounding voice that comes with having a cold, but this can be particularly noticeable if you’re suffering from sinusitis. “The sinuses are air-filled spaces in the bones of the face and skull. One of their functions is to provide resonance to the voice, like the sound box of a guitar,” says Dr Staten.

“In sinusitis the sinuses fill with mucus, pushing out the air so that the voice becomes thin and nasal. You can get similar alterations to the sound of the voice in other conditions such as nasal polyps, or enlarged adenoids.”

Hoarse or deeper It could be: autoimmune disease

“A number of autoimmune diseases might affect the voice but it is probably most closely associated with an underactive thyroid,” says Dr Staten.

“An underactive thyroid can result in a hoarse, deepened voice because it may cause swelling of the vocal cords.

“Usually, there will be other symptoms such as weight gain, feeling cold all the time, or persistently feeling tired. “Other, rare autoimmune diseases may also affect the voice, such as Sjogren’s syndrome in which the salivary glands stop producing saliva. This, in turn, causes an extremely dry mouth which may alter the sound when you speak.

“Diseases like rheumatoid arthritis and lupus may also cause changes due to chronic inflammation, but this isn’t common.”

Quiet, monotone, shaky It could be: Parkinson’s

Parkinson’s disease not only affects movement and mobility but it can also cause considerable changes to a sufferer’s voice.

“Parkinson’s can affect the fine movements of the muscles and larynx that are involved in speech,” explains Dr Staten. “This often results in a very quiet, emotionless voice.

“Often speech therapy can help improve the quality of the voice or help slow the deterioration.”

General changes It could be: laryngeal cancer

“Although there are many reasons why your voice might change, laryngeal cancer is the

‘‘ Our sinuses provide resonance to the voice like a guitar soundbox

one we never want to miss,” says Dr Staten. “It is more common in people who smoke or drink too much.

“As the change in the voice is due to a physical change in the structure of the larynx caused by the cancer, the vocal change is usually permanent and does not tend to fluctuate from day to day but will also worsen over time.”

Breathless voice It could be: nerve damage

If you suddenly sound breathless when you speak then see your GP for further tests.

“A change in the voice, which may be associated with difficulty breathing or noisy breathing can be caused by damage to the laryngeal nerve which controls the movement of the vocal cords.

“It’s not common and is most often caused by injury to the nerve during surgery to the neck,” says Dr Staten.

“However, it can sometimes be caused by tumours in the neck or chest and so, if there is no other obvious cause for the nerve to be damaged, it needs to be investigated.”

Weak voice It could be: vocal cord atrophy

“Our voices often change as we get older because the vocal cords, larynx and muscles involved in speech are all affected by age in the same ways as the rest of our body,” explains Dr Staten.

“The larynx may lose flexibility and the muscles controlling the vocal cords may weaken. The vocal cords themselves can become thinner and weaker, which is known as vocal cord atrophy.

“All of these changes can cause our voices to become weaker, quieter, and change in quality as we get older.”

Constant frog in your throat It could be: cancer

Rest assured that in most cases having the feeling of a frog or lump in your throat is not due to anything serious.

“Doctors call this sensation ‘globus’. It’s very common and in the majority of cases it is unpleasant but absolutely nothing to worry about,” says Dr Staten.

“There are many causes including acid reflux, mucous, stress and anxiety, smoking or overusing your voice.

“Very rarely, however, this can be a sign of cancer, especially if the frog feeling is permanent, worsening or on one side. If you notice other symptoms such as food getting stuck in the gullet or weight loss, then see your GP.”

‘‘ Our vocal cords can weaken as we age giving us a quiet voice