Following are suggestions for care and maintenance of healthy voices. Many of these remedies have not been scientifically tested, but I offer them as naturopathic alternatives that may be helpful with minimal risk of harm. These methods can help promote hydration, reduce irritation or inflammation, and reduce acid reflux symptoms. However, if you are experiencing voice changes or think you sustained a voice injury, please seek out care with a multidisciplinary voice treatment team. These are not suggested as alternative care for voice injury or voice disorders but can supplement the program you develop with your voice team.
Remember, you are a vocal athlete and you need to care for you whole body and mind, not just your voice.
Gaviscon Advance for the Treatment of Reflux: The active ingredients are sodium alginate (a seaweed extract) and the natural antacid potassium bicarbonate. What we actually know: When swallowed, the alginate forms a raft at the top of the stomach that physically blocks acid and non-acid reflux as well as neutralizing acid in the stomach. In research studies, Gaviscon has been shown to decrease proximal migration of reflux (how far up it goes towards the throat), improve symptoms of laryngopharyngeal reflux, is as effective as a proton pump inhibitor in the treatment of moderate GERD and it is helpful as add on therapy for patients having symptoms despite being on another reflux medication. For maximal effect, it is taken after each meal and before bedtime. Though not proven, I often prescribe this before a performance in those that have performance related reflux when singing or dancing. Gaviscon Advance Liquid is the preferred product and is available online from the United Kingdom. The US versions are somewhat different and likely less effective.
Glutagenics for Mild Reflux and Gastric Discomfort: This is a powder of aloe, DGL, and glutamine. What we actually know: Aloe has anti-inflammatory and anti-bacterial properties, DGL decreases aspirin induced gastric ulcers, glutamine can aid in the repair of the gut and protect the esophagus during radiation.
Gould’s Gargle for Throat Pain or Irritation: 1 cup water, .5 tsp kosher salt, 5 tsp baking soda, 5 tsp light corn syrup or maple syrup. What we actually know: This mixture is hydrating as it is saline, and clinically soothing to a sore throat.
Aloe Manuka Honey Slurry for Throat Pain or Irritation: 2 oz aloe vera juice with manuka honey mixed in until the solution is slightly thickened. Gargle and swallow with this several times per day. What we actually know: Aloe has anti-inflammatory and anti-bacterial properties. Manuka honey also has anti-inflammatory and anti-bacterial properties. Both may be helpful in wound healing.
Arnica: For vocal fold hemorrhage and inflammation (this should be diagnosed by a physician).30C potency tablets: Place 4 beneath the tongue 2 times per day. What we actually know: Plastic surgery literature and research shows that this may help to decrease and speed the recovery of bruising in facelifts and nasal surgery. There is some controversy as to whether this is accurate. There is no research on its effect on vocal fold hemorrhages but there is minimal risk with possible benefit.
Apple Cider Vinegar: Most likely this is very bad for reflux and throat. We do not recommend its use for any ailment. We work hard to decrease the acid in our diet for our reflux, yet some believe apple cider vinegar is good for this. What we actually know: Apple cider vinegar is acid and has the same pH as hydrochloric acid. Apple cider has been moderately studied. While it does decrease cholesterol and diabetes in rats, it has not been shown to be helpful in reflux and digestion.
Diet: Maintain a healthy, well-rounded diet of mostly vegetables and some meat or fish. Avoid processed foods when possible. Avoid eating within 2-3 hours of bedtime.
Rest: Be sure to get 7-8 hours of sleep per night and take rest breaks if feeling fatigued throughout your day.
Exercise: Maintain good health through regular exercise to keep body in shape, to maintain proper alignment for breathing and voice use, and to reduce stress levels
Relaxation: Meditation, gentle stretching or Yoga, progressive relaxation, and mindfulness techniques can also help reduce stress and tension in the body and calm the mind.