Most of us are familiar with the occasional hoarse voice or “frog in the throat,” typically caused by a cold, seasonal allergies, or even aging. These voice alterations usually disappear on their own. However, persistent changes to the voice can sometimes signal something more serious, such as an underlying chronic condition. Medical professionals advise paying attention to these signs, which could warrant a visit to the doctor. Here, experts break down some of the potential causes of long-lasting voice changes and what they might mean.
1. Gastroesophageal Reflux Disease (GERD)
One common culprit for voice changes is Gastroesophageal Reflux Disease (GERD). This digestive condition occurs when stomach acid and bile flow back up into the esophagus, irritating the vocal cords.
“GERD can lead to hoarseness, especially early in the day,” explains Dr. Alexa Mieses Malchuk, a family physician in Cary, N.C. The constant throat irritation and frequent coughing or throat clearing associated with GERD can cause significant changes to the voice. “Anyone with a persistent cough, not linked to an infection, should be evaluated for GERD or post-nasal drip,” Malchuk advises.
While GERD is fairly common, untreated cases can lead to more severe health problems over time, so it’s important not to ignore these signs. Dr. Malchuk adds that while it’s easy to become anxious over small changes in your voice, seeking medical advice is a sensible step if these symptoms persist.
2. Parkinson’s Disease
Voice changes can also serve as an early indicator of Parkinson’s Disease (PD), a progressive neurological disorder. Recent studies suggest that voice dysfunction may be among the first signs of motor impairment in individuals with PD, with changes often appearing before more noticeable symptoms like tremors or stiffness.
“Speech requires coordination of multiple cognitive functions, and Parkinson’s can disrupt these networks,” says Dr. Ariane Park, a neurologist at Ohio State University’s Wexner Medical Center. The condition can result in softer speech, mumbling, or a hoarse tone, as well as a slower or faster speaking rate.
For individuals noticing voice changes along with other neurological symptoms, consulting a neurologist can help secure a diagnosis and access to treatments such as medications, speech therapy, or communication aids.
3. Alzheimer’s Disease
Alzheimer’s Disease also has a profound impact on speech. The degenerative brain disorder causes difficulties in memory, cognition, and communication, leading to noticeable changes in how a person speaks. Early signs often include difficulty finding words, especially the names of familiar people or objects, with increased pauses during speech.
According to a 2022 study, technology is being developed to detect Alzheimer’s in its early stages by analysing subtle speech changes. Early detection through this type of technology could be key to better managing the progression of the disease.
4. Amyotrophic Lateral Sclerosis (ALS)
Amyotrophic Lateral Sclerosis (ALS) is another neurodegenerative disease that affects speech. ALS damages the nerve cells responsible for controlling the muscles needed for speech, leading to slurred, slow, and breathy speech. Over time, respiratory muscle weakness can further exacerbate speech problems.
“About 50% of individuals with ALS experience a slow cognitive decline, and analysing speech can offer insight into how the disease is progressing,” says Emily Baxi, director at BD2. Advances in machine-assisted speech analysis are helping to better understand ALS and develop targeted treatments.
5. Bipolar Disorder and Other Mental Health Conditions
Bipolar Disorder, a condition characterised by extreme shifts in mood, can also manifest in voice changes. “During a manic episode, speech is often pressured, loud, and exaggerated,” says Dr. Victor Fornari, a psychiatrist at Northwell Health. On the flip side, during depressive episodes, speech can become soft, slow, and minimal.
Voice pattern changes are also seen in other mental health conditions like Obsessive-Compulsive Disorder (OCD), where repetitive phrases or words may become common. Dr. Serra Akyar, also of Northwell Health, explains that changes in neurotransmitter function drive these speech alterations.
Exciting advancements in speech analysis technology could soon assist in diagnosing a range of mental health conditions. “A short recording of natural speech could reveal the likelihood of conditions such as schizophrenia, anxiety, or depression,” says Baxi. Although not definitive, this tool could become an important part of the diagnostic process.
When to See a Doctor
Speech and voice are essential windows into our overall health. Voice changes, especially those that persist, should not be overlooked. As Dr. Fornari notes, “The voice is often a reflection of a person’s emotional state and health.” If you or someone you know experiences ongoing voice changes or shifts in speech patterns, it’s essential to seek medical advice to rule out any underlying conditions.
With increasing awareness and advancements in speech analysis, early detection of serious health issues could be just a conversation away.
