Antihistamines: very drying to vocal folds. Should be avoided when possible.

Arthritis: People with limited high ranges may be suffering from cricoarytenoid arthritis (an arthritis intrinsic to the larynx). This should be diagnosed by an otolaryngologist.

Asthma: Inhalers cause 20% dysphonia (lack of vocal sound), and often result in candidiasis on the vocal folds (a fungal infection). If this occurs, the singer must go on a course of diflucan or homeopathic equivalent to kill the candida infection. If you must be on an inhaler, get a spacer for it to further diffuse the spray, or follow the inhaler with a puff of purified water to wash off the vocal folds. Advair is the most detrimental to the vocal folds, and should be avoided if possible.

Birth Control Pills: Estrogen causes edema (swelling) of the vocal folds. 10% of women who take BCPs have voice problems. If you take birth control, you should request the lowest dose possible.

Corticosteroids: Drugs like Prednisone are used in cases of acute laryngitis to drastically reduce swelling quickly. Although this is effective in the short term, you will not get a "normal" voice from taking a steroid shot. Additionally, you must rest your voice for two weeks after taking such a shot, to avoid vocal hemorrhaging.

Dry Larynx: If this occurs, you should take Mucinex or Evoxac/Salagen as directed.

Laryngitis: This is a viral infection that will usually clear up on its own. Vocal rest, steaming and hydration are the keys to a speedy recovery.

Otolaryngologists: Singers should develop a relationship with an otolaryngologist that they trust. Every singer should have a "healthy exam", so that if they get into vocal trouble in the future, the doctor will have a baseline reading to do a comparison.

Mucolytics: These can be very helpful. They improve lubrication and can be useful when in dry environments (airplanes, theaters, high altitudes.) The brand name of this type of drug is Mucinex (also known as Humibid.) They are most effective when used intermittently, not continuously.

Muscular Tension Dysphonia: a hyperkinetic (overactive) disorder of the larynx, when someone tightens the musculature surrounding the larynx to the point where phonation ceases. Treatments can range from laryngeal massage, Alexander technique, and acupuncture to botox injections and removal of the false vocal folds.

Nodules: Nodules are always bilateral (on both sides) and symmetric. 80-85% of nodules are cured by speech therapy alone, and they are not generally precancerous. Voice therapy should be pursued for 6-8 weeks, and then a reevaluation should occur to see if improvement is being made. If no improvement has occured, then surgery may be considered.

Parasympathetics: These are drugs used for diarrhea and motion sickness (i.e. Immodium AD.) They are very drying to the vocal folds.

Polyps: This is a general term for any aberration of the vocal fold surface. The first thing to do is rest the voice, and then enter speech therapy.

Pregnancy: Causes hoarseness. Generally, women can sing up until their third trimester.

Reflux: Reflux accounts for half of all voice complaints seen by ENTs. It was first recognized in 1968, and is defined as gastric acid and proteolytic enzymes (pepsin and capsaicin) which come up from the esophagus and enter the pharynx. Symptoms of reflux include chronic throat clearing, hoarseness, increased mucous production, chronic cough, globus pharyngeus (lump in the throat), heartburn, laryngospasm, post nasal drip and halitosis. Treatment includes avoided late-night eating, alcohol, caffeine, spicy foods and mints. Additionally, you can take proton pump inhibitors, such as Nexium, Prevacid and Prilosec (which is available over-the-counter, but is the least effective.)  Foods that are ph-Balancing, like aloe vera juice, are recommended for people suffering from reflux.  Over-the-counter aloe vera juice can be really disgusting; the best-tasting brand (which I use myself) can be found by following this link (I recommend Strawberry-Kiwi):  http://www.marketamerica.com/lifehealthbalance/index.cfm?action=shopping.wpBrandsDetail&brandCode=233

Spasmodic Dysphonia: A sudden loss of speaking/singing ability and/or a squeezed quality to the voice, that fluctuates depending on stress and other factors. Treatment includes speech therapy, Alexander technique, acupuncture and Botox injections into the vocal folds.

Surgery: When being put under general anasthetic, singers should ask for the smallest intubation tube possible; men should ask for a 7 or smaller, women a 6 or smaller. This reduces risk of vocal fold damage during surgery.

Vocal hemorrhage: This is sudden loss of voice, often accompanied by a "pop" sound. You can permanently destroy your voice from one hemorrhage; if this occurs, you must go on two weeks of complete vocal rest.