Common Vocal Health Myths by Caroline Murrah

As a voice-specialized speech pathologist and former professional actor, I’ve encountered my fair share of vocal health myths. In today’s digital age, social media platforms are filled with vocal health information. While there is some fantastic content out there, it can be challenging to sift through misinformation and know what to trust. Shockingly, a recent study examining vocal health content on social media found that "less accurate videos are more likely to be viewed and shared on TikTok” (Alter et al., 2023).

In this blog post, I will debunk three common vocal health myths and replace them with evidence-based information to add to your vocal health toolbox. I will also discuss some of my personal experiences surrounding vocal health as a performer and what I wish I had known back then.

Tufts Medicine Voice Care

As a speech-language pathologist, I specialize in treating professional voice users, with expertise in singing voice rehabilitation. At Tufts Medicine Voice Care, I work closely with Dr. Ashley O’Connell Ferster, a fellowship-trained laryngologist who also specializes in the care of the professional voice. When designing our Voice Care Program, Dr. O’Connell and I made it a priority to evaluate all professional voice users as a team. Our goal is for our patients to leave their initial evaluation feeling supported and equipped with strategies to improve their vocal health from both a medical and therapeutic perspective.

My Vocal Health Experiences as a Performer

Rewinding about 8 years, I was fresh out of my undergraduate musical theatre conservatory program and embarking on the Broadway National Tour of the musical Fun Home. Equipped with my room-temperature-only water, Throat Coat tea, and Entertainer’s Secret throat spray, I was ready to take the industry by storm.

Like many performers, I would occasionally spiral into panic when I felt a tickle in my throat or felt throat discomfort after pushing myself vocally. If I could go back in time, I would tell myself that singers are vocal athletes who will inevitably experience vocal ups and downs. This is perfectly normal and nothing to be ashamed of. We are humans who sometimes get sick or tired or stressed or overscheduled—all of which can affect the voice. What is important is learning how to manage voice issues when they arise and prevent them when possible.

While I did my best to implement every piece of vocal health wisdom into my routine, certain recommendations were difficult to follow. Particularly when it came to my favorite food group. Despite reminders from teachers and colleagues that dairy products could negatively impact my voice, I simply could not imagine life without pizza and ice cream! I never found that dairy affected my voice, so I chose to ignore their well-meaning advice. This leads me to my first vocal health myth:

Myth 1: Dairy Coats the Vocal Folds

Nothing we eat or drink actually touches our vocal folds; otherwise, it would be going “down the wrong pipe.” Our throats have two tubes: one for breathing and one for swallowing. The vocal folds sit at the top of our airway, so nothing you swallow is intended to touch them. It’s also a myth that drinking milk increases mucus production in the throat. Researchers think the milk-mucus myth is related to the way milk molecules interact with our saliva. When milk and saliva mix, it creates a thicker residue that can be mistaken for mucus, temporarily coating the inside of our mouth and pharynx, which is not where the vocal folds are located. Drinking water
can help rinse away this residue! (Balfour-Lynn, 2018)

However, there are a few reasons you might consider avoiding dairy as a singer. If you experience laryngopharyngeal reflux (LPR), dairy products can be a trigger, and LPR can lead to vocal fold irritation or increased mucus production in the throat. Common LPR symptoms include the sensation of something stuck in the throat, mucus in the throat, and frequent throat clearing. If you are concerned about LPR, it's recommended to consult with your doctor or a laryngologist. Another valid reason to avoid dairy before singing is, simply, if it bothers you. However, if you love a cold glass of milk before singing and don’t find that it affects your voice, here’s your permission to enjoy it!

Myth 2: Drinking Cold Water Tightens Muscles of the Voice Box and Negatively Impacts Singing

Like dairy, the water we drink does not touch our vocal folds. It moves from our mouth into the esophagus, which sits behind the larynx (voice box). Therefore, cold water does not touch the laryngeal muscles involved in singing. As a singer, I got into the habit of drinking room temperature water or warm tea before singing, so I typically still prefer these options. Drinking warm tea with honey feels soothing to my throat, and I personally enjoy it. However, if cold water is the only option available, it’s reassuring to know that it won’t impact my voice!

Myth 3: Menthol Cough Drops Help Reduce Throat Irritation

While the cooling and numbing effects of menthol may feel soothing initially, once it wears off, it can leave the throat feeling more dry, hypersensitive, and irritated than before. This can lead to a vicious cycle of relying on menthol cough drops to soothe throat irritation exacerbated by the cough drops themselves!

When choosing cough drops to soothe throat irritation or dryness, it’s usually best avoid ingredients with numbing properties like menthol, benzocaine, dyclonine, or peppermint. Instead, opt for glycerin or pectin-based lozenges. My personal favorites include Grether’s Pastilles, Luden’s Wild Cherry Throat Drops, and Halls Throat Soothing lozenges (cool berry flavor). Many types of Halls cough drops do contain menthol, so it’s important to read the label.

Final Thoughts

Many singers have told me that developing an understanding of the science behind certain sensations (like a throat tickle) helps alleviate their fears and redirect their focus toward vocal problem-solving and implementation of science-based strategies and techniques. One of the most important lessons I have learned about vocal health is that many pieces of advice are not black and white. While eating dairy products doesn’t bother my throat, it’s possible that it could bother someone else, whether due to acid reflux or personal preference. Listen to your body, consult with a doctor, and figure out what works for you!

Dr. O’Connell and I are thrilled to connect with Boston Singers’ Resource and are happy to be a resource for you throughout your career. We are committed to getting singers in the door in a timely manner. If you would like to schedule an appointment, please call our office (617-636- 5511) and tell them you are with Boston Singers’ Resource. Whether you are experiencing a voice issue or are simply interested in establishing care and maintaining your vocal wellbeing, we look forward to supporting your vocal health!

References

Alter, I. L., Charney, S. A., Karle, W. E., Born, H., & Chern, A. (2024). An evaluation of quality,
         reliability, and accuracy of vocal health content on TikTok. Journal of Voice. https://doi.org/10.1016/j.jvoice.2023.12.022
Balfour-Lynn, I. M. (2018). Milk, mucus and myths. Archives of Disease in Childhood, 104(1), 91–93. https://doi.org/10.1136/archdischild-2018-314896