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You should see a specialist if your voice changes: Last longer than 2 to 3 weeks Dont improve with rest or hydration Include voice loss without a clear illness Cause pain when speaking or swallowing Make it hard to breathe or swallow Come with a lump in the neck or coughing up blood People who rely on their voice for work, such as teachers, coaches, singers, healthcare workers, or customer service professionals, should seek care sooner if symptoms begin affecting daily communication, Gross recommends

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Notably, an inflection point was identified at a serum cotinine level of 487 ng/ml, beyond which total testosterone levels decreased with increasing serum cotinine levels