Module 2 Lesson 14: Singing from the Inside Out: How the Gastrointestinal, Endocrine, & Musculoskeletal Systems Affect Your Singing

Transcription

Gastrointestinal System

Stomach acid is important for digestion but can wreak havoc on your vocal cords. Heartburn, indigestion, chronic gastrointestinal reflux disease (GERD,) or a stomach virus all create excess stomach acid, which is highly irritating to the vocal folds. My students with GERD have come to their voice lesson complaining of a rough voice and excess mucus. Many have never heard that stomach issues can also affect their voice.

If you have frequent bouts of reflux, consider elevating the head of your bed with bricks or wood blocks by 6-8 inches. There are also special inserts made for this. Pillows don’t work because of the folded position they put your torso in. It just puts more pressure on your stomach, which pushes the acid up into the esophagus.

If you are struggling with excess stomach acid, experts suggest that you cut back on or eliminate chocolate, coffee, alcohol, carbonated beverages, citrus, tomatoes, mint, and black pepper, and fatty foods from your diet.

Chronic GERD has sidelined many a singer. If symptoms persist, work with your doctor to reduce stomach acid through diet and medication.


Endocrine System

The endocrine system is made up of glands that produce, store, and release hormones into your bloodstream. From the break in an adolescent male voice to the vocal fatigue and loss of higher harmonics in women when they menstruate, hormones affect the voice throughout a lifetime.

In men, they show up during puberty. Higher levels of testosterone increase the bulk of the vocal ligaments and muscles, which leads to a drop in the higher pitches of the voice. When that drop occurs, the male voice ends up cracking. As men age, their voices stabilize, and the cracking goes away.

In women, hormones affect the voice throughout a lifetime. For some, higher estrogen levels before menstruation cause swelling in the vocal folds and larynx, resulting in vocal fatigue. Not all women experience premenstrual vocal syndrome, but if you are one of those who do, it’s helpful to track the phases of your cycle. Notice what changes occur in your voice and see if there’s a pattern. A good voice teacher can give you strategies for decreasing the demands on the voice during those phases when your voice is under more strain. If the changes are debilitating, it would be wise to consult with an endocrinologist.

During menopause, reduced estrogen, progesterone, and androgens can lead to vocal cord thickening and reduced elasticity. Many women sing well into their older years, but it’s not always easy. Commitment to vocalizing regularly is essential, and when you start losing the elasticity needed for those higher notes in a song, it doesn’t hurt to change the key you’re singing in.

Thyroid Health

Your thyroid is a butterfly-shaped gland that sits behind your Adam’s apple, low on the front of your neck in front of the trachea. It secretes hormones that are important for metabolism, body temperature, and growth and development. It also has nerves that run through it that are important for vocal quality.

The primary hormone your thyroid secretes is thyroxine — or T4. Too little, and you’re hypothyroid. Too much, and you're hyperthyroid.

So, how does this affect the voice?

Both hypo and hyperthyroidism can cause hoarseness, reduced intensity, fatigue, and loss of range in your voice. Hyperthyroidism can also cause involuntary spasms in the muscles of the larynx, a condition known as dysphonia.

In my own experience as a singer and teacher, I’ve found hypothyroidism to be more common. When I was in my 40s, I experienced many of the symptoms of hypothyroid — fatigue, feeling cold when others were warm, low blood pressure and heart rate, and dry skin. When I had blood tests to measure my thyroid-stimulating hormone (TSH) and T4 levels, they were always in the normal range. But my T4 levels were on the low side. I finally found a naturopathic doctor who prescribed a low dose of thyroid medication. It made all the difference.

I heard similar stories from many of my female students.

If you’re experiencing any of the above symptoms regularly and can’t figure out the cause, definitely see your doctor for a diagnosis. A simple blood test will give you more information.


Musculoskeletal System

[Illustration of Phrenic Nerve and Spine]

Here’s a look at an illustration of your spine from the side.

In Gray’s Anatomy, we’re told that “The nervous system controls and coordinates all organs and structure of the human body.” Gray’s Anatomy, 29th Ed; page 4. When you’re spine is injured, or out of alignment, it can affect the function of the nervous system, which can affect the corresponding functions of the body shown here.

When your body has insufficient nerve energy going through the spine, the nerves that stimulate the vocal folds don’t work efficiently. You can have a 60% reduction in nerve energy before you feel pain, so you might not even sense when this is happening.

The muscles that work to close the vocal cords are innervated by a nerve running through C5 here in your neck. If you have unresolved whiplash or other injuries to the neck, it can sometimes make it difficult for the voice to sing a clean sound because the nerves aren’t able to stimulate the vocal cords so that they can close tightly enough.

In my own experience, just having super tight neck muscles can affect the voice. During one of my voice lessons, I was having difficulty singing a clean sound. I’d been complaining of neck pain, so Tom massaged the back of my neck with a small hand-held massager for 5 minutes. We tried the exercises again, and the difference was astonishing. I could use the same amount of effort with a much better result.

The other part of your voice that’s affected by your spine being out of alignment is your diaphragm. Here, you can see that if T3 is out of alignment, it can affect your breathing. When the nerve energy isn’t working efficiently, your diaphragm will have difficulty expanding quickly. There have been times when my back has been out of alignment, and I didn’t even realize I was struggling to breathe when I sang. After an adjustment in this area, it was much easier to take a breath.

Prevention: What You Can Do

As my chiropractor has said, It’s not about the bones. It’s really about the muscles. The bones are just along for the ride.

Anything you can do to keep your muscles strong and flexible will help you keep your spine in alignment. Gentle stretching five to seven times a week and weights two to three times a week are what many health experts recommend. I take a travel yoga mat with me in my suitcase so that I can stretch after a long day of sitting on planes and in cars.

Speaking of sitting, one of the most important things you can do to keep your spine aligned is to sit and stand in a way that’s ergonomically sound. Computer and smartphone use has created an alarming increase in chronic neck and back pain. Proper support for the muscles in your neck and back when using your electronic devices will help your posture, and your singing. [https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/office-ergonomics/art-20046169]

Having a chiropractor and massage therapist on your wellness team is helpful. If you can find practitioners that work with singers regularly, even better.