When you have hypothyroid symptoms you probably are familiar with constipation. It is a clear sign things are not working right in your body and in hypothyroidism, when you don’t have enough thyroid hormone, particularly T3 you can experience constipation regularly. 

If you have abdominal pain, bloating or abdominal distention, excessive gas, and or constipation which may or may not be associated with excessive straining you may have irritable bowel syndrome or IBS. Conventional medicine defines constipation as less than 3 bowel movements a week. Natural medicine might define it as less than one a day. You really don’t want stool sitting in your colon for three days. You will reabsorb much of the water and many toxins including estrogen for recirculation in to the body which is not good. For our purposes here, we will say less than one bowel movement per day is considered constipation. 

You may have alternating constipation and diarrhea with the above mentioned symptoms which can also be categorized as IBS. To get a diagnosis of IBS, other gastrointestinal issues need to be excluded as causing your symptoms. There is no test for IBS or markers to make a diagnosis so it is diagnosed based on symptoms. You need to have abdominal pain at least one day per week in the last 3 months associated with two or more of the following symptoms: pain related to bowel movements, pain and a change in how often you go or pain along with a change in the appearance of your stools. People with IBS generally are very sensitive to pain in their gut, have inflammation in the colon (which makes the nerves in the colon extra sensitive), changes in transit time (the time it takes food to travel through the GI tract from mouth to anus) and a change in the types and amounts of bacteria found in the colon. 

IBS is thought to be the most common GI issue in the Western world and seems to affect more women than men. You might be more at risk for it if it runs in your family, if you have had some kind of gut infection, if you have been given antibiotics or even if you have had some kind of stressful or traumatic event occur in your life. 

This disorder affects quality of life, causes people to miss work, and costs the healthcare industry in the US around 20 billion a year. 

If you are suffering from constipation, IBS related or not, here are some things you can try. 

Galactooligosaccharides or GOS at 3.5 grams a day. You don’t want to start out taking that much or you can make gas and bloating much worse so work your way up to a dose that high. A study using that amount found it improved gas and bloating as well as constipated stools over 4 weeks. 7.0 grams a day also helped to reduce anxiety.  

The top three things you can do to get rid of constipation are fiber, fluids and exercise! Adding ground flaxseeds, slippery elm powder, psyllium husks, oat bran, chia seeds or pectin can be very helpful. It may take awhile to see some improvements as one study showed three months of treatment with either ground flax or psyllium husks at 6 grams a day improved constipation, bloating, and abdominal pain. The flax appeared to work better for the participants in this study.

Fiber from fruit, especially blackberries and kiwi fruit, improved bowel movements significantly. If you are dealing with blood sugar issues, you want to be mindful not to overdo it on the fruit but these two fruits seem to be really good at getting things moving quicker. Keep fruit servings to no more than 4 serving a day. You also want to be sure you are consuming plenty of leafy green salads, beets, whole grains (not all grains are bad for all people), tons of veggies and nuts and seeds if you tolerate them. 

Drinking water. Make sure you are getting around half your body weight in ounces. Maybe a little more if you are sweating in warmer weather and try electrolytes with your water if you are not ever feeling refreshed by drinking. 

Moderate exercise, especially in the morning is helpful to get things moving as well. Our bowels wake up in the morning and sometimes that morning walk is all they need to increase transit time. 

If you are desperate to get things moving, licorice root can be used short term. You can ask your doctor for a prescription for lactulose if you are in the US. Everywhere else in the world you can buy it over the counter. It can speed up transit time or get things moving as I like to say. Take with slippery elm, oat bran, and licorice root. If you can. 

If you tolerate dairy, you can eat Activia yogurt. It is the only way you can get the specific probiotic that moves your bowels. If you are dairy intolerant a different strain, Bifidobacterium lactis HN019,  found in Garden of Life Raw Probiotics, Genestra HMF Multi strain, Now Foods Women’s Probiotics 20 billion and more can help you out. 

Improving how your liver works can also be helpful. When the liver is congested it can be what is causing the constipation so taking turmeric, globe artichoke, dandelion (all parts of the plant) and beets. You can make a raw beet salad consisting of equal parts shredded beets, carrots and dandelion greens. Make a dressing of olive oil and vinegar or lemon juice and season with a bit of salt. Very good for your liver. Eat it as a condiment with meals. It is delicious too. I am not a fan of beets but I am a fan of this salad. 

What about diarrhea? Some of you likely experience that too. This is more rooted in anxiety so supporting your nervous system with things like caraway, fennel or dill seeds, peppermint, cardamom, ginger, chamomile, lemon balm all help with abdominal pain and bloating. Saffron works amazingly well to lift depression and can help diarrhea. The nervous system can be supported with verbena (vervain), rhodiola, or panax (korean) ginseng. 

If you have severe gut pain and inflammation you can try to take a product called Iberogast which will fix the underlying issue of inflammation and the sensitivity of the nerves in the gut. You can also try licorice root again, chamomile, or turmeric. A combination of peppermint and caraway essential oils (eco-certified and organic) reduce inflammation too. I just want to note, that in some countries essential oils are sold in pharmacies and I don’t recommend ingesting oils unless supervised by someone qualified to help you do that. 

Food allergies or sensitivities are a big trigger for diarrhea, especially gluten. A study showed that all symptoms of IBS were reduced within 6 months of a gluten free diet. A low FODMAP diet also improved IBS but it eliminates a ton of really good for you foods so you should not do this long term. 

If you are over 45 and have had major changes in your bowel movement patterns should send you to the doctor to have your health checked. If you have blood in your stool, you have something else going on. Other signs there is something going on other than IBS or constipation related to hypothyroidism is weight loss, fever, and a family history of colon cancer. 

Ok! I hope this information was helpful. If you have a question related to your thyroid or thyroid health, please reach out at helpforhashimotos@gmail.com or go to my website, www.outofthewoodsnutrition.com and fill out the contact form with subject, podcast question. You can also sign up for my newsletter and get my report on five things your doctor won’t tell you about hypothyroidism. 

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