The thyroid, a butterfly-shaped gland at the base of the neck, plays a crucial role in regulating your body's metabolism, including blood pressure, temperature, and heart rate. When thyroid hormone production decreases, it slows down bodily processes, affecting overall health, including the digestive system.
Hypothyroidism, characterized by low thyroid hormone levels, often leads to constipation. This condition can be challenging to address, as constipation is defined by having three or fewer bowel movements per week or experiencing painful or unproductive bowel movements. Normal bowel function varies, so understanding your baseline is key to recognizing when something is amiss.
Additional criteria for constipation include:
Dry or hard stools
Painful or difficult bowel movements
A sensation of incomplete bowel emptying
Causes of Constipation
As food progresses through the digestive tract, nutrients are absorbed, and waste moves from the small intestine to the large intestine (colon). The colon absorbs water from the waste, forming stool. Constipation occurs when the colon absorbs too much water, making the stool hard and difficult to pass.
Besides hypothyroidism, other common causes of constipation include:
Inadequate fiber intake
Insufficient fluid intake
Physical inactivity, particularly in the elderly
Certain medications or supplements
Excessive use of laxatives
Ignoring the urge to defecate
Specific medical conditions or diseases
Relieving Constipation Due to Hypothyroidism
Treat Your Thyroid
The primary approach to addressing constipation related to hypothyroidism is to manage the thyroid condition itself with thyroid hormone replacement therapy. Low levels of thyroid hormones (T4 and T3) can slow down digestive motility, leading to constipation. Thyroid hormone replacement medications, such as levothyroxine or liothyronine, compensate for insufficient hormone production.
Most individuals with hypothyroidism will need lifelong thyroid hormone replacement. Finding the right medication and dosage may take time, but once optimized, it should improve thyroid function and bowel habits. If constipation persists despite adequate thyroid treatment, other factors affecting bowel function should be evaluated.
Consider Your Diet
Diet is crucial for maintaining regular bowel movements, regardless of thyroid status. Some foods can speed up or slow down gastric motility.
Fiber plays a significant role in bowel function and comes in two types:
Insoluble Fiber: Helps stool move through the intestines. Found in fruit and vegetable peels, whole grains, and wheat bran.
Soluble Fiber: Attracts water into the stool, softening it and easing passage. Found in fruits, vegetables, legumes, seeds, and oat bran.
High-fiber foods include:
Chickpeas, edamame, lentils, and split peas
Barley
Whole wheat products
Berries (especially raspberries and blackberries)
Pears
Brussels sprouts
Artichoke hearts
Avocados
When increasing fiber intake, do so gradually to avoid bloating. Hypothyroidism patients should be cautious with fiber consumption as it can affect thyroid medication absorption. It is advisable to take thyroid medication in the morning and wait a few hours before eating or taking other supplements.
Consult a nutritionist to create a meal plan that balances fiber needs with thyroid and digestive health.
Drink Plenty of Water
Adequate hydration is essential for easy stool passage. Insufficient water intake can slow stool movement and cause discomfort. Increasing dietary fiber necessitates higher water intake, with most recommendations suggesting 6-8 glasses per day, unless fluid restriction is advised due to other health conditions.
Increase Physical Activity
Regular exercise helps maintain digestive motility. Sedentariness can slow stool movement and lead to harder stools. Engaging in physical activity, including exercises to strengthen pelvic muscles and techniques like biofeedback, can improve bowel function.
Use Laxatives When Needed
Occasional use of over-the-counter (OTC) laxatives can be helpful. Various types of OTC laxatives include:
Bulking Agents: Contain fiber to increase stool bulk and fluid.
Osmotic Agents: Retain water in the stool, softening it (e.g., milk of magnesia, Miralax®).
Lubricants: Coat the stool to ease passage.
Stool Softeners: Add water to the stool to reduce straining.
Stimulant Laxatives: Induce intestinal contractions to speed stool passage.
Consult your doctor about the appropriate laxative type, especially if constipation is recurrent. Overuse of laxatives can lead to a cycle of diarrhea followed by rebound constipation.
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