Hypothyroidism and Constipation: My Top 7 Tips to Improve Constipation
Over the years, many of my patients with hypothyroidism also complain of constipation, or trouble fully eliminating. And when you think about it for a second- it makes sense. As the thyroid gland controls metabolism, when it is not working properly, metabolism slows down and increases transit time (the amount of time it takes for food to go through your system). To make matters worse, patients with Hashimoto’s hypothyroidism are likely to also suffer from leaky gut (also known as intestinal permeability) that can also cause undesirable changes in bowel habits. To learn more about leaky gut and hypothyroidism, watch my video here.
Patients also ask- how many times a day should you have a bowel movement? There is various opinions on this subject, but from a Naturopathic perspective, I believe having AT LEAST 1 bowel movement a day is healthy. Making sure you are moving food through your system in a timely fashion is an important part of detoxification. Just like we need to take out the garbage in our house, our bodies should be eliminating the things they don't need on a daily basis.
Depending on how severe constipation is, some people turn to things like laxatives and stool softeners. Although these things can be helpful in a pinch, they are not a long term solution. If used for extended periods of time, these medications can cause a dependency and cause the bowels to essentially become “lazy”.
If you are looking for natural solutions for constipation, here are my top 7 tips:
1. Balance your thyroid gland. This is especially important if you have other symptoms of hypothyroidism, such as fatigue and weight gain. I make sure to test at least 4 markers of thyroid health: TSH, T4, T3 and TPO antibodies. TSH should ideally be around 1-2.5 mIU/L, T4 should be 10pmol/L or above, T3 should be 3pmol/L or above and TPO antibodies should be under 30kIU/L.
2. Keep it habitual. Aim to have a bowel movement at the same time every day. Simply just sitting on the toilet, relaxed for 10-15 minutes is a good habit to begin to encourage a bowel movement. Our bodies are very much tuned into the cycle and rhythms of the day. Making time for going to the washroom can foster better bowel movements.
3. Water makes a difference. Think about how your body moves food through-it needs lubrication! Try and increase water consumption, even by 1 glass daily.
4. Raise your legs up. Try using a stool or "squatty potty" when using the toilet. Lifting the legs relaxes some of the muscles around the rectum and can improve healthy evacuation.
5. Add more “mucilaginous” fiber to your diet. Both chia and flax get “slippery” once they sit in water for a few minutes, and this can help move stool through the body- plus they are a great source of fibre! Add 1-2 tbsp of chia or flax seeds to 1/3 cups of water. Let soak for 10 minutes and then eat (or slurp down) the mixture before going to bed, followed by a cup of water. This can improve the chance of a movement in the morning.
6. Relax more! In order to have a bowel movement, we need to be relaxed. In makes perfect sense (we don’t want to have a poop while running away from a bear in the woods!) Try to incorporate relaxation into everyday. Having a bowel movement requires the parasympathetic nervous system to be activated (the part of the nervous system that is responsible for resting and digesting). If we are constantly in a state of stress or high alert, it is difficult for our body to properly digest and evacuate.
7. Probiotics and other supplements can be a game changer when dealing with constipation. The problem with probiotics (like most supplements) is that they are not all created equal. Only certain probiotic strains have shown to be beneficial for helping ease constipation. When looking to purchase a probiotic, make sure you choose a brand that contains at least one of these strains proven to help constipation:
1. Bifidobacterium lactis
2. Bifidobacterium animalis subsp.
3. Lactobacillus rhamnosus GG
There are many other supplements that may be extremely beneficial when addressing constipation. As always, working with a health care provider to get to the root cause of the reason why constipation is happening will yield the best, long term results. It can also help to ensure that the right supplement is selected at the right dose.
I would love to hear your thoughts on this topic! Leave your comments below.