Hoarseness and The Thyroid Gland 

Teachers, public speakers, cheerleaders, and singers are all at risk for voice hoarseness because they overuse, misuse, and strain their vocal cords daily. With rest, the problem usually subsides. A cold or any other upper respiratory infection can also lead to temporary laryngitis. 

But when you have a hoarse voice that won’t go away, it’s time to find out why. 

Although your hoarse voice can stem from several different causes, at Palmetto Endocrinology, we often see patients with a hoarse voice related to thyroid nodules and dysfunction. Let’s go through exactly what that means and when it requires treatment. 

Common causes of a hoarse voice 

In addition to upper respiratory infections and overuse, your hoarse voice could be a symptom of: 

• Gastroesophageal reflux disease (GERD): when stomach acid travels up your esophagus and irritates your larynx 
• Vocal polyps, nodules, or cysts: bumps on your vocal folds 
• Vocal fold bleeding: ruptured blood vessels  
• Vocal fold paralysis: dysfunction typically caused by injury or infection 
• Neurological disorders: nerve miscommunication or neurological disease 

When you have a voice problem, the most obvious culprit seems to be the vocal cords and the soft tissue folds that generate sound. But sometimes, the problem lies elsewhere — like in your thyroid gland. 

How your thyroid gland affects your voice 

Your thyroid is a small gland situated just under your larynx (Adam’s apple) at the front of your throat. It has two lobes, which give it the shape of a butterfly. Although it’s small, your thyroid has a big job — it produces the hormones that regulate your digestion, body temperature, and heart. 

Sometimes, often for reasons unknown, small thyroid nodules develop on the surface of the gland. In many cases, these tiny bumps don’t cause any symptoms, so you may not even know you have thyroid nodules unless a doctor detects them during an exam. The types of thyroid nodules include: 

• Fluid-filled cysts 
• Colloid nodules, benign overgrowths 
• Inflammatory nodules caused by long-term swelling 
• Multinodular goiter, when several nodules enlarge the thyroid 
• Hyperfunctioning thyroid nodules that produce thyroid hormone indiscriminately  
• Cancerous thyroid nodules, rarely 

Typically, thyroid nodules are harmless. But if they multiply or become too large, they can cause some problems.  

A hoarse voice is one of the most common symptoms of large thyroid nodules because they protrude and press against your vocal cords. This not only changes your voice, but it also makes it difficult to swallow and breathe. 

If you have hyperfunctioning thyroid nodules, you may face some problems beyond a hoarse voice. This type of thyroid nodule has a mind of its own, and it pumps out thyroid hormone without waiting for a signal to do so. This can lead to hyperthyroidism and a flood of thyroxine in your bloodstream.  

Treatment for thyroid nodules 

To determine whether you have thyroid nodules — and if so, which type — we run a series of tests, including a thyroid hormone blood test, thyroid ultrasound, and possibly a thyroid scan using radioactive iodine. If we suspect cancer, we perform a fine-needle biopsy to take a sample of the cells in the thyroid.  

In most cases, thyroid nodules don’t need any treatment at all other than regular monitoring. If you have hyperfunctioning nodules, we may recommend radioactive iodine treatments to shrink them. Surgical removal is the best way to address cancerous thyroid nodules.  

If you have a hoarse voice that won’t go away, don’t ignore it because it may point to a serious health condition. Find out if your thyroid is the problem by scheduling an appointment with Palmetto Endocrinology. 

Author

Joseph Mathews, MD, FACP, FACE, ECNU, CCD Joseph W. Mathews M.D., a board certified Endocrinologist and Medical Director of Palmetto Endocrinology, was born and raised in South Carolina. He earned his Bachelor of Science in Biology from the College of Charleston, Cum Laude. He then achieved his M.D. at the Medical University of South Carolina where he also completed his residency in Internal Medicine and a Fellowship in Endocrinology, Diabetes, and Metabolism. Dr. Mathews is also a Fellow of both the American College of Endocrinology and the American College of Physicians, holds an Endocrine Certification in Neck Ultrasound (ECNU) and is a Certified Clinical Densitometrist (CCD). He has extensive experience performing ultrasound guided fine needle aspiration biopsies. His practice includes a range of specializations including prescribing and fitting patients with insulin pumps. Dr. Mathews' practice has drawn patients from out of state to benefit from his expertise in thyroid disorders, diabetes, cortisol problems and their Endocrine disorders.