Whether you are on Team Sunscreen or Team Sunshine, you are probably aware of the importance of Vitamin D for your health. After all, its role in many medical conditions, including those of muscles and bones, is clearly shown in numerous studies — while its deficiency is said to be an endemic throughout the world.
But can Vitamin D supplements influence your singing? If so, how?
Since its discovery in early 1900's, Vitamin D has been shown to have a significant role in the absorption of calcium, magnesium and phosphate, which are crucial in skeletal and muscular health (1). For the past few decades, it has also been on the list of recommended supplements especially for those living in colder climates, younger children, and those at risk of having a deficiency.
It is a funny vitamin. It is not found much in food; only in oily fish, red meat, egg yolks, liver and some fortified foods (1). But most mammals can synthesise it when exposed to sunlight. So technically, it is not even a vitamin: it can be called a hormone instead (2).
Consider how often you are exposed to the sun though — with the lifestyle most of us lead these days, it is not surprising that Vitamin D deficiency is widespread in the European population, and an estimated 1 billion people worldwide have insufficient levels. In the UK, the recommendation is that everyone should consider taking a daily Vitamin D supplement during autumn and winter (1).
So it finds our way into our fortified cereals, eggs, and milk, and we take supplements to ensure adequate levels for our musculoskeletal and immune system health. And because the voice is basically made up of muscles and soft tissue, voice teachers recommend Vitamin D supplements to singers.
But is it truly a helpful supplement for your voice?
Let's dive in.
Effects of Vitamin D Deficiency
To see if the voice can benefit from extra Vitamin D, we first need to look at what its deficiency actually does in the body. It causes a wide range of negative outcomes, from cognitive decline to lower muscle function and strength (3). So it makes sense that the laryngeal muscles could be affected by low levels of Vitamin D.
So far so good.
Vitamin D deficiency was also found to be linked to vocal pitch by an earlier study in 2003 (4). Its deficiency can cause muscles to atrophy, which can include the thyroarytenoid muscle that determines the tension and length of the vocal folds. In addition, vocal fold bowing can occur, resulting in lower loudness levels and unintentional airiness in the voice. All of these combined would lead to increased effort and thus, vocal fatigue.
What happens in real life though?
Luckily, researchers have designed a study to compare whether there is a correlation between Vitamin D levels and phonatory symptoms (3).
So How Does It Affect The Voice...or, Does It?
38 patients (19 with low levels of Vitamin D, 19 with normal levels) were asked about whether they experienced dysphonia (changes in vocal timbre, loudness or pitch), phonatory effort and vocal fatigue. Vocal samples from these patients were also recorded, analysed acoustically and findings were compared between these two groups.
Interestingly, results of acoustic analysis and self-report questionnaires showed no significant difference in these vocal symptoms between groups. Meaning, insufficient or normal levels of Vitamin D did not have any significant influence on the dysphonia, phonatory effort or vocal fatigue.
Wait — does that really mean that Vitamin D has absolutely no effect on your voice whatsoever?
Well, this is where the whole body comes into play. Even if the deficiency of Vitamin D does not directly cause dysphonia or vocal fatigue, it still plays a role in hormonal and immune system health. Lower levels can cause hormonal imbalances, lowered immune response, and even autoimmune diseases.
And we all know how important hormones are for the vocal health...right?
The study mentioned here had a very small sample group of 38 patients. There is always the possibility that with a larger sample group, findings may differ.
But there is also the issue of muscle fibre type: Muscles of the larynx are different than those of extremities, which were found to have lowered function due to Vitamin D deficiency.
So further studies are definitely needed to clarify the relationship between the voice and Vitamin D levels.
The importance of Vitamin D is non-negotiable. But even though its effect on musculoskeletal system is proven by numerous studies, there is no evidence that its deficiency can influence your singing.
Of course, if you have low levels, go ahead and keep supplementing under a physician's care. It benefits so much more than just the voice.
But if you are taking supplements regularly just to "help your voice", and you currently do not have a deficiency, it may be doing more harm than good: Too much Vitamin D can result in a build up of calcium in the body, weakening the bones and damaging the kidneys and the heart (1).
Finally, remember to always consult your doctor and have regular blood tests to check if you actually need the supplements or whether they are working.
NHS. (2020). Vitamin D. Retrieved January 24, 2022, from https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/
Norman, A. W. (2008). From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. The American Journal of Clinical Nutrition. 88 (2): 491S–499S. doi:10.1093/ajcn/88.2.491S
Hamdan, A.-L., Ziade, G., Sarieddine, D., Tabri, D., Allaw, F., Btaiche, R., & Azar, S. (2017). Effect of vitamin D deficiency on voice. American Journal of Speech-Language Pathology, 26(3), 865–872. https://doi.org/10.1044/2017_ajslp-16-0010
Visser, M., Deeg, D. J., & Lips, P. (2003). Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): The Longitudinal Aging Study Amsterdam. The Journal of Clinical Endocrinology and Metabolism, 88, 5766–5772.
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