Symptoms A-Z

My Voice is Hoarse, Why? 10 Hoarse Throat Causes & Treatments

Understand your hoarse voice symptoms, including 9 causes & treatment options for your hoarse voice.

This symptom can also be referred to as: dry voice

An image depicting a person suffering from hoarse voice symptoms

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Contents

  1. Symptoms
  2. Causes
  3. 9 Possible Hoarse Voice Conditions
  4. Treatments and Relief
  5. FAQs
  6. Questions Your Doctor May Ask
  7. Statistics
  8. References

Hoarse Voice Symptoms

Most people have experienced being stuck in in bed, with a congested, runny nose, and dry, persistent cough. Often the symptoms only get worse to include a voice so hoarse it is barely recognizable. Sometimes a hoarse voice can be the result of a bad cold, or even a particularly raucous sports game.

Hoarse voice symptoms can also be accompanied by:

  • Sore, dry or scratchy throat [1]
  • Altered voice quality, pitch or volume [2]
  • Cough [4]
  • Runny nose

However, a hoarse voice can also be a sign of more serious, underlying problems. It is important to follow-up on hoarseness and other associated symptoms in order to get appropriate care.

Hoarse Voice Causes

Hoarseness is the result of inflammation or irritation to your voice box or larynx. Inflammation of the larynx is laryngitis [1, 5, 6, 7]. Inside the larynx are the vocal cords that normally open and close smoothly to help produce the sound of your voice. When you have laryngitis, your vocal cords become so swollen they cannot open and close properly, causing your voice to sound hoarse.

Laryngitis can be caused by a variety of conditions. Depending on the cause, laryngitis can be temporary (acute) or long-lasting (chronic)[7].

Inflammatory hoarse voice causes:

  • Infections: Viral upper respiratory infections can cause inflammation and irritation of the vocal cords and larynx that leads to hoarseness that usually improves once the infection subsides. Bacterial and fungal infections can also cause acute laryngitis [7].
  • Allergies: Those seasonal allergies that cause runny nose and itchy eyes can also result in hoarseness.

Environmental hoarse voice causes:

  • Irritants: Alcohol and smoking can directly irritate the vocal cords and larynx [2]. Overuse of these substances can lead to chronic laryngitis and sometimes cause cancers that further contribute to hoarseness. Acid reflux, also known as GERD, causes direct irritation to the larynx that can become chronic [16].
  • Overuse: Speaking too much, too loudly and even prolonged singing (watch out for those nights of karaoke) can all cause hoarseness [1, 2, 6, 7].
  • Iatrogenic (Medical related hoarse voice causes): Medications, such as inhaled corticosteroids for asthma, can cause either acute or chronic laryngitis due to its direct contact with the larynx [8]. Also, in situations requiring intubation (a tube placed in your larynx to assist with breathing) during surgery can cause injury and irritation of the larynx.

Neuromuscular hoarse voice causes:

  • Any medical condition that can cause paralysis or tension of the vocal cords can result in chronic laryngitis [8]. Some of these conditions include nerve injury or multiple sclerosis [1].

Malignant hoarse voice causes:

  • Some throat cancers can cause hoarseness. Alcohol and smoking increases the risk of throat cancer [9, 10].

9 Possible Hoarse Voice Conditions

The list below shows results from the use of our quiz by Buoy users who experienced hoarse voice. This list does not constitute medical advice and may not accurately represent what you have.

Acid reflux disease (gerd)

Acid reflux disease, also known as GERD, occurs when the acidic contents of the stomach come back up into the esophagus. The most common symptoms are heartburn and regurgitation.

Rarity: Common

Top Symptoms: nausea, sore throat, pain below the ribs, cough with dry or watery sputum, deep chest pain, behind the breast bone

Urgency: Primary care doctor

Viral infection of the larynx (voice box)

Laryngitis an inflammation of the larynx, or voice box. This causes the vocal cords to swell and leads to a hoarse, raspy voice.

A viral infection, such as the common cold or influenza, is nearly always the cause of laryngitis. These infections are spread through casual contact, as when someone sneezes and the droplets are inhaled from the air.

Most at risk are people whose immune systems are already weakened by illness, medication, or chemotherapy.

Symptoms include hoarseness; sore, irritated throat; difficulty speaking; coughing; and sometimes fever.

Forcing speech during laryngitis can cause permanent damage to the vocal cords. Hoarseness that never really clears up should be seen by a medical provider, as it can be a symptom of a more serious condition.

Diagnosis is made through throat swab and sometimes blood tests.

Treatment involves rest and drinking plenty of fluids until the virus has run its course, and resting the voice so the swelling can subside on its own. Antibiotics are not effective against a viral illness.

Rarity: Common

Top Symptoms: sore throat, runny nose, fever, dry cough, hoarse voice

Urgency: Self-treatment

Viral throat infection

A viral throat infection is an infection of the throat, or pharynx, that is caused by viruses. Viruses are different from bacteria such as Streptococcus pyogenes (which causes "strep throat"). Viral infections are the most common cause of sore throats in children and adults.

Symptoms include a sore throat, fever, fatigue, congestion, runny nose, cough, or others depending on the specific virus. Less common symptoms that sometimes present in children include fluid-filled bumps on the hands, feet, or mouth, or, in adults, painful mouth ulcers.

Treatment focuses on rest, hydration, and over-the-counter methods to alleviate symptoms. Some cases require antiviral medications.

Rarity: Common

Top Symptoms: sore throat, cough, congestion, fever, hoarse voice

Symptoms that always occur with viral throat infection: sore throat

Symptoms that never occur with viral throat infection: being severely ill

Urgency: Self-treatment

Lung cancer (non-small cell)

Lung cancer is one of the leading causes of cancer-related deaths in the U.S. and worldwide. In 2012, lung cancer was diagnosed in 1.8 million people and caused approximately 1.6 million deaths. When someone is diagnosed with lung cancer, one of the first steps is to stage the disease in order to determine both treatment and prognosis. Ninety-five percent of all lung cancers can be categorized as "small cell" or "non-small cell." About 10 to 15 percent of lung cancers are considered small cell lung cancers while 80 to 85 percent are non-small cell lung cancers. Cancer, in general, is a condition characterized by overgrowth of a certain cell type. Our bodies naturally have a variety of cell types to serve different functions. The distinction between small cell and non-small cell lung cancer can be determined by looking at a small sample of the lung tissue where the cancer is growing and determining what cell type is overgrowing. Based on the stage of the lung cancer, surgical resection may offer the best outcomes. There are a number of symptoms associated with lung cancer that will be discussed in this article, the most common of which being cough.

Rarity: Rare

Top Symptoms: cardinal symptoms of lung cancer like chest pain or changes in breathing, fatigue, cough, shortness of breath, chest pain

Urgency: Primary care doctor

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Common cold

The common cold is a viral infection of the upper respiratory tract, which includes the nose, mouth, sinuses, throat, and larynx. There are over 200 viruses that can cause upper respiratory infections, and usually the exact virus behind a cold is never known.

The common cold is, of course, very common. Americans catch over one billion colds per year, with adults averaging two to three per year, and children averaging as many as eight colds per year.

The common cold usually lasts about a week, and is self-limited (meaning it goes away on its own). Although there is no treatment for the common cold, there are many strategies for prevention and improvement of symptoms.

Rarity: Common

Top Symptoms: fatigue, headache, cough, sore throat, congestion

Symptoms that never occur with common cold: being severely ill, severe muscle aches, rash, severe headache, sinus pain

Urgency: Self-treatment

Vocal cord overuse

When yelling or speaking loudly, the vocal chords may become overused, causing one's voice to become hoarse. This is called mechanical laryngitis, in other words the inflammation of the voice box.

Rarity: Uncommon

Top Symptoms: sore throat, hoarse voice

Symptoms that never occur with vocal cord overuse: fever

Urgency: Self-treatment

Post-infectious cough

Post-infectious cough is a cough that begins with a cold or other upper respiratory infection, but does not clear up when the infection does. Instead, it lingers for three weeks or more and becomes chronic.

Most susceptible are smokers, because the irritation from the smoke provokes the cough. Other common causes are post-nasal drip, asthma, and some high blood pressure medications.

Symptoms include an irritating sensation in the throat that may provoke severe bouts of coughing. Some coughing is normal and is part of the body's mechanism to clear the air passages and expel any foreign material, but such a cough should only be brief and intermittent.

A post-infectious cough can interfere with quality of life. A medical provider should be seen for help with the condition, both to ease the symptoms and to rule out a more serious cause for the coughing.

Diagnosis is made through patient history, physical examination, and chest x-ray, with the goal of ruling out different conditions one by one until the actual cause is found and can be treated.

Rarity: Uncommon

Top Symptoms: cough, congestion, clear runny nose, mucous dripping in the back of the throat, hoarse voice

Symptoms that always occur with post-infectious cough: cough

Symptoms that never occur with post-infectious cough: fever

Urgency: Phone call or in-person visit

Hypothyroidism

Hypothyroidism, or "underactive thyroid," means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body's metabolism.

The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.

Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.

Diagnosis is made through a simple blood test.

Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It's important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.

Rarity: Rare

Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches

Urgency: Primary care doctor

Obstructive sleep apnea

Obstructive sleep apnea (OSA) is a relatively common condition, especially in obese adults. It refers to obstruction (blockage) of the airway during sleep. This obstruction is usually caused by the back of the tongue and the muscles of the palate relaxing and falling backward, which blocks the trachea (windpipe). A blocked airway can lead to decreased oxygenation of the blood. The body senses this, and you will wake up and resume breathing normally before falling back asleep again. This cycle can repeat itself many times throughout the night, resulting in poor quality sleep, which can result in excessive sleepiness during the daytime and other significant medical problems. The primary treatment for OSA is to keep the airway open through the night by using a continuous positive airway pressure (CPAP) device.

Rarity: Common

Top Symptoms: fatigue, irritability, daytime sleepiness, trouble sleeping, sore throat

Symptoms that always occur with obstructive sleep apnea: snoring or apneas

Urgency: Primary care doctor

Hoarse Voice Treatments and Relief

Most of the time, hoarseness and laryngitis resolve on their own and there are many things you can do at home to help alleviate your hoarse voice symptoms.

  • Rest your voice: Avoid talking and shouting. Try not to whisper or clear your throat, as this actually causes more swelling and strain to your vocal cords [2].
  • Drink fluids: Fluids moisten your throat and make it easier to clear things like food with less irritation [6].
  • Avoid caffeine, alcohol and smoking: All of these can dry and irritate your larynx. Moreover, caffeine, alcohol and other caffeinated beverages can dehydrate your body and exacerbate your hoarseness because it strips your throat of its mucous [11].
  • Avoid spicy foods: If you have GERD, spicy foods can exacerbate your reflux and cause irritation of your larynx and vocal cords.
  • Use a humidifier: This adds moisture to the air and can help open your airway and make breathing easier.
  • Eliminate allergens from your environment: Allergies can not only cause but also exacerbate your hoarseness.
  • Prevent upper respiratory infections: Wash your hands often, shoulder your sneezes and if possible avoid contact with others who have upper respiratory infections.

See your doctor if these home remedies do not improve the duration or severity of your hoarseness. Your doctor will be able to determine the cause and provide the proper treatment.

However, seek medical attention immediately for hoarse voice symptoms if you also have:

FAQs About Hoarse Voice

Here are some frequently asked questions about hoarse voice.

Can thyroid problems cause hoarseness?

Yes, hypothyroidism can cause a deepening of the voice [12]. This deepening is often noticed and more common in middle-aged women. A thyroid nodule [1] or thyroid cancer [13] can interrupt the nerve that supplies one of an individual's two vocal cords, causing paralysis and hoarseness. Finally, surgery on the neck can cause paralysis and hoarseness.

What does is sound like when your voice is hoarse?

Hoarseness refers to a change in the characteristics of an individual's voice [1, 2]. It can apply to a variety of changes in the voice, including weakness or inability to produce significant volume, fatigability or losing one's voice quickly, a shaky or altered pitch, a warbling or tremulous tone, or a strained voice quality.

Why is my voice hoarse but my throat doesn't hurt?

A hoarse voice without a sore throat can occur when a non-inflammatory condition has caused loss of vocal cord function [1, 7]. This can be caused by overuse like yelling or speaking in an abnormal tone for long periods of time. A vocal cord polyp or nodule which can develop from overuse (e.g. speakers, singers), and can also cause hoarseness. Additionally, surgery, cancer, or neurological disorders like Parkinson's disease can also cause hoarseness without pain albeit much less frequently than the above causes.

Can allergies cause my voice to be hoarse?

Yes. Allergies can cause voice hoarseness [7]. Over time, mucus from an allergic reaction to pollen and dust in the air can cause a buildup of mucus [14]. This mucus may cause a runny nose or post nasal drip in which it drips onto the back of the throat, causing irritation and inflammation. Over time, this can cause a sore throat and a hoarse voice.

Why is my voice constantly hoarse?

Chronic hoarse voice may be caused by chronic laryngitis - defined as a hoarse voice and sore throat that lasts longer than three weeks [7]. Chronic laryngitis can be caused by inhalation of chemical fumes (e.g. industrial fumes, cigarette smoke), gastroesophageal reflux or (GERD) causing some stomach acid to affect the vocal cords, chronic alcohol use, or post nasal drip from allergies [1, 14, 15].

Questions Your Doctor May Ask About Hoarse Voice

To diagnose this condition, your doctor would likely ask the following questions:

  • Do you currently smoke?
  • Do you have a sore throat?
  • Do you have a cough?
  • Any fever today or during the last week?

The above questions are also covered by our A.I. Health Assistant.

If you've answered yes to one or more of these questions

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Hoarse Voice Symptom Checker Statistics

People who have experienced hoarse voice have also experienced:

  • 11% Cough
  • 10% Sore Throat
  • 5% Dry Cough

People who have experienced hoarse voice were most often matched with:

  • 60% Acid Reflux Disease (Gerd)
  • 20% Viral Infection Of The Larynx (Voice Box)
  • 20% Viral Throat Infection

People who have experienced hoarse voice had symptoms persist for:

  • 36% Less than a week
  • 23% Less than a day
  • 19% Over a month

Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

Hoarse Voice Symptom Checker

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References

  1. Hoarseness. National Institute on Deafness and Other Communication Disorders (NIDCD). Updated March 6, 2017. NIDCD Link.
  2. Ho T. Hoarseness. U.S. National Library of Medicine: MedlinePlus. Published October 30, 2016. MedlinePlus Link.
  3. Tesini BL. Infections. Merck Manual Professional Version. Updated June 2018. Merck Manual Professional Version Link.
  4. Voice Disorders. U.S. National Library of Medicine: MedlinePlus. Updated May 17, 2018. MedlinePlus Link.
  5. Laryngitis. NCBI. NCBI Link.
  6. Vorvick LJ. Laryngitis. U.S. National Library of Medicine: MedlinePlus. Published December 10, 2016. MedlinePlus Link.
  7. Sasaki CT. Laryngitis. Merck Manual Consumer Version. Updated May 2018. Merck Manual Consumer Version.
  8. Reiter R, Hoffmann TK, Pickhard A, Brosch S. Hoarseness - Causes and Treatments. Deutsches Arzteblatt International. 2015;112(19):329-337. NCBI Link.
  9. Otolaryngology - Head and Neck Surgery. Johns Hopkins Medicine. Johns Hopkins Medicine.
  10. Schiff BA. Laryngeal Cancer. Merck Manual Professional Version. Published April 2018. Merck Manual Professional Version.
  11. Gastroesophageal Reflux Disease (GERD)/Heartburn. Johns Hopkins Medicine. Johns Hopkins Medicine.
  12. Wisse B. Hypothyroidism. U.S. National Library of Medicine: MedlinePlus. Published June 14, 2018. MedlinePlus Link.
  13. The American Cancer Society Medical and Editorial Content Team. What is Thyroid Cancer? American Cancer Society. Updated April 15, 2016. American Cancer Society.
  14. Shmerling RH. Treatments for Post-Nasal Drip. Harvard Medical School: Harvard Health Publishing. Published April 2018. Harvard Health Publishing.
  15. Post-Nasal Drip. healthdirect. Updated March 2018. healthdirect Link.