How To Make It Through The Cold & Flu Season When You’re A Singer
photo by alexandra gorn
Imagine this.
It's morning, and your alarm clock has just yanked you out of a deep sleep. You hit the snooze button, and think, Oh my god, just a few more minutes. I've got that show coming up, and I'm so frickin' tired. And then you notice a tickle in the back of your throat. You try and ignore it, hoping it will go away once you've downed your first cup of coffee. It doesn't. The tickle turns to scratchiness, the floodgates open behind your nose, and the coughing begins.
You've worked for months on this upcoming performance. You've rehearsed, created marketing materials, sent out a press release, newsletter, and posted on social media. All of this on top of a jam-packed schedule. You don't want to cancel, but you also don't want to show up and not sing your best — or worse, harm your voice.
It's not easy when your body is your instrument. Other musicians get sick too, but their instruments don't wheeze or get clogged up with mucus when attacked by an infection.
In this blog post, you'll learn how to stay healthy during the cold and flu season, what to do when you're sick, and how to decide when it's time to cancel a performance.
First, let's take a look at what happens to your voice when you catch a cold or flu.
Your Vocal Cords, Lungs, and Sinuses
The vocal cords are made up of five different layers that need to stretch, contract, and vibrate when you sing. When you're sick, and they're dried out, covered with thick mucus, or irritated by postnasal drip, they thicken up and lose the elasticity they need to function well.
Your lungs are another vital part of your instrument. Sufficient air supply is essential for creating and maintaining tone, volume, and intensity. When irritated or filled with mucus, inhalation is a struggle. Exhalation leads to coughing. And when you cough, the vocal cords literally slam together, creating even more irritation and swelling.
And then there are your sinuses. When they're swollen and irritated, it negatively impacts your sound.
Medications & Their Effect on Your Voice
If you have a performance, the first thing you need to do is decrease the inflammation and irritation levels in your body. But before you take an over-the-counter medication or herb, do some research. Many will actually make your voice worse.
Antihistamines and decongestants dry out your vocal cords. Those cold meds in your medicine cabinet might make your symptoms easier to tolerate, but they’ll diminish the elasticity in your vocal cords. They’ll end up feeling like rubber bands left on the dashboard of a car in the Sahara Desert.
Before you use a bronchial inhaler, over-the-counter meds, vitamins, and herbs, or a nasal spray, find out how they’ll affect your voice.
The National Center For Voice And Speech lists common medications and their effects on the voice on their website. It’s my go-to resource when I need information.
But what if your coughing or post-nasal drip is so bad that you’re losing sleep or you feel like you’re drowning in snot? What if your doctor has prescribed a medication that will cause dryness?
Sometimes you have to weigh the positive vs. the harmful effects of taking a medication. If a remedy helps you get back on your feet but dries out your voice, you’ll need to re-hydrate your vocal cords as quickly as possible. Drink massive amounts of water (64 ounces a day at least) and take Guaifenesin — an over-the-counter medication that I use and have recommended to singers for over 30 years.
Guaifenesin
Guaifenesin is obtained from a tree bark extract called guaiacum. It's the active ingredient in Robitussin, Mucinex, and other over the counter expectorants that helps to liquefy mucus. Guaifenesin makes the cell walls in your body permeable to all the water you're drinking, so the vocal cords rehydrate, vibrate, and stretch more easily.
Guaifenesin is also one of the safer drugs to take regularly. According to the Physicians Desk Reference, you can take it with most medications, and it has very few (if any) possible side effects.
I take 200 mg of guaifenesin a day because I'm on a medication that causes dryness, and I'm post-menopausal (which makes me drier than I used to be.) To find out what dosage is right for you, make sure and read the directions carefully. If you’re lightweight or female, start with half the suggested amount. Every-body is different, though, so experiment until you find the dosage that works for you.
VERY IMPORTANT! When buying Mucinex or Robitussin over the counter, make sure Guaifenesin is the ONLY active ingredient. Some Mucinex and Robitussin cold and flu remedies have decongestants and antihistamines in them — which, as you now know, are extremely drying. Also, make sure and drink a full glass of water when you take the medication. Guaifenesin, without enough water, will also make you drier.
Disclaimer: In over 20 years of recommending this medication to students, I've only had one person complain of side effects. However, I am not a doctor. If you're concerned about the safety of this or any other medication, first consult your health practitioner.
Menthol
Menthol is another cold remedy to keep out of your medicine cabinet. Sucking on menthol lozenges may be soothing, but it’s also extremely drying. Try a lozenge without menthol, take a steamy shower, and use a humidifier to help soothe irritated lungs or nasal passages.
Anti-inflammatory Medications
Singers should stay away from any meds that contain aspirin or ibuprofen. Both thin the blood in your vocal cords. This can lead to vocal hemorrhaging when your already swollen vocal cords are stressed by back to back gigs or incorrect vocal technique. Use Tylenol instead
Prevention And Your Immune System
Getting enough sleep, washing your hands, and staying hydrated are important for wellness at any time of the year. But during the cold and flu season, they are essential. Many of the things that will help you regain your health once you’re sick will also give your body a boost, so you have a better chance of not catching a bug in the first place.
Here are some vitamins and herbs that I think you’ll find helpful for getting and staying well, plus some information about their effects on your voice.
Vitamins:
Let’s talk about vitamins first.
Vitamin D:
According to University Health News, “Vitamin D is the superstar nutrient you don’t want to be without.” Yet, it’s one of the most common vitamin deficiencies seen in adults. One Mayo Clinic study found that “as many as 57 percent of adults are deficient in this “sunshine” nutrient.”
A lack of Vitamin D is linked to cancer, autoimmune disorders, cardiovascular disease, depression, fatigue, muscle cramping, and you guessed it — low immunity. [2]
Performers are especially vulnerable to a lack of Vitamin D. We spend a lot of time in recording studios and performance venues. If you live in the northern hemisphere like I do, it’s hard to get enough sunlight, especially in winter.
The good news is, there are inexpensive, natural remedies that can reverse low Vitamin D3 levels.
Sunlight
The first one’s kind of obvious. If there’s sun out there — get out in it! 10 to 30 minutes a day can help you get enough vitamin D3.
A Lightbox
No sun? A 10,000 lux full-spectrum lightbox used every morning for 30 minutes can help increase your levels of Vitamin D. This is an excellent option for singers, shift workers, or those who live in areas where the sun doesn’t shine.
Supplements
Supplements are probably the easiest, most economical, and effective way of getting the Vitamin D you need. Between 1,000 IU to 5,000 IU is the daily dosage for adults. Before you start supplementation, be sure to get tested to see what your current levels are.
Vitamin C & Zinc
There’s been a lot of debate about whether Vitamin C and Zinc can help you fight off or shorten the duration of a cold. A large number of randomized trials have finally settled the debate. Adequate amounts of Vitamin C (up to 1 gram) and Zinc (up to 30 mg) can diminish your symptoms and shorten the length of time you’re sick.
But you have to be careful that you don’t take too much vitamin C when you’re a singer. I’ve had students come to their lesson, sounding dehydrated. Turns out they’d taken too much vitamin C. 2,000 milligrams and above can act as a diuretic, depriving your vocal cords of the moisture they need.
Essential B Vitamins
Vitamin B12 and B6 are both critical for immune support. A deficiency can inhibit the growth of white blood cells and their response. These vitamins also help to protect your gut from pathogens.
Herbs & Probiotics
In addition to vitamins, herbs and antioxidants are especially useful for fighting off infection, shortening the duration of your illness, and making the symptoms more tolerable.
Echinacea
You’ve probably heard about Echinacea and know that its antimicrobial properties help your body resist infection. But what I didn’t realize until recently, is that it also has anti-inflammatory properties, and it enhances the effects of probiotics.
Probiotics
Speaking of probiotics, did you know that they have far-reaching positive effects on more than your GI tract? Their immune-boosting properties reinforce the barrier of your intestinal lining, making it more difficult for bacteria to get into your bloodstream. I’ve been taking a product called HMF powder that was recommended by my naturopathic oncologist when I was undergoing chemotherapy treatments for breast cancer. Even though I have a clean bill of health, I continue to take it because it’s been so beneficial.
There are a lot of probiotics out there, but not all are created equal. Look for one that needs refrigeration and contains these four strains that have been proven by research studies to positively impact the immune system.
Lactobacillus rhamnosus GG
Bifidobacterium animalis
Lactobacillus paracasei
Lactobacillus acidophilus
N-acetyl-cysteine (NAC)
NAC replenishes glutathione, an antioxidant that helps your immune system function and can even help protect you against the flu. It also helps to clear mucus in the respiratory tract.
I was introduced to the benefits of NAC through my naturopathic doctor, who recommended I take it when I had a stubborn bronchial infection. I’ve been using it ever since when I need additional immune support.
Black Elderberry
The elderberry plant is a great source of protein, amino acids, minerals, vitamins, fiber, and antioxidants. It’s antioxidant properties in particular have been shown to have beneficial effects on the immune system.
Astragalus Root
Astragalus Root’s antioxidant properties are also a powerful immune booster and works to mitigate the effects of fatigue and stress on the body. It supports the health of all the organs in your body and has anti-aging properties as well.
My go-to remedies
Here are my go-to products when I’ve been around sick people or feel like fighting off an infection.
XLear is a nasal spray that’s excellent for irrigating your sinuses. Its non-habit-forming ingredients will open up and then coat the inside of your nasal passages with Xylitol — a natural ingredient that forms a barrier against bacteria. It’s also effective against pollution and airborne allergens. I use it every day.
Wellness Formula Herbal Resistance Liquid
Source Naturals makes a product that combines echinacea, elderberry, ginger, and a Chinese herb used for colds called Yin Chiao. While I don’t know of any scientific studies that prove the efficacy of this combination of herbs, my family, students, friends, and our naturopath have all experienced positive results from using it, so I thought I’d mention it here.
You and Your Physician
Now, I’m not a doctor, so please make sure and talk with yours before taking any herbs or supplements mentioned here. Some vitamins and herbs have contraindications when taken with other medications.
You’ll also want to get your blood checked to find out what your vitamin B and D levels are before taking them. High levels of these essential vitamins can also cause problems.
When To Cancel
So, now the hard part — when to cancel a performance.
It typically takes two weeks for a virus to run its course. If you aren’t feeling better after week two, it’s definitely time to see your physician. Having someone on your medical team who works with singers regularly is essential. They’ll understand how important your voice is to you, and will be up on the medications that are safe for you to take. Try to establish a relationship with an otolaryngologist before the shit hits the fan so that you can call and get in to see your doctor on short notice.
An otolaryngologist can also look at your vocal cords and advise you when they’re too swollen or inflamed for you to sing safely. On the rare occasion when you absolutely can’t cancel a performance, a short course of prednisone or corticosteroid injection may be prescribed. Proceed with caution. These drugs have many side effects and should only be taken as a last resort. If there are underlying issues that need to be addressed, like vocal fold nodules or lesions, they are not a long-term fix.
Your body is a wondrous thing.
I think every singer would agree that when your instrument is working well — in concert with your mind, emotions, and your audience, there’s no better feeling in the world. Knowing how to take care of your body is essential when you love singing as much as you do.
Some people think that singers are hypochondriacs. I think we’re just sensitive to the way our bodies feel — and that’s how it should be.
Learn to listen to your body. It’s your most precious resource. Give it the love and support it deserves. Get professional help and advice if you need it. Then, when you walk on stage, you’ll be able to trust that it will be there for you, giving voice to all that you are.
Do you have any remedies that you swear by when you’re trying to fight your way back to wellness? Please share them below!
Links to go deeper:
University Health News: How To Boost Your Immune System
Medical News Today: Tips For A Healthy Immune System
Providence Health: 5 Steps to a Strong Immune System This Cold and Flu Season
Here's a simple exercise you can use to regain vocal cord flexibility after you’ve been sick or trashed your voice from overuse or talking. It’s simple and safe to use no matter what kind of shape your voice is in.
