Thyroid and Constipation

by Mary Shomon Patient Advocate

Constipation is a common symptom of hypothyroidism, even after treatment for the underactive thyroid. Let’s look at the link between hypothyroidism and constipation, and some effective solutions to resolve this uncomfortable condition.

Doctor with model of digestive tract.

What is constipation?

Constipation is defined as:

  • Having three or fewer bowel movements per week
  • Needing to strain when making a bowel movement
Woman with stomach pain.

What are the symptoms of constipation?

In addition to the three or fewer bowel movements per week, here are some other common symptoms of constipation:

  • Stools that are dry, lumpy and/or hard
  • Pain when passing stool
  • A sensation of incomplete or blocked bowel movements
  • Abdominal bloating
  • Gas
  • Fatigue
HIgh fat foods.

What causes constipation?

If you are constipated, there are some common causes:

  • Dehydration or insufficient fluid intake
  • Your colon is not contracting strongly enough to move stool effectively, which can result from hypothyroidism.
  • You’re eating too much meat and cheese.
  • Insufficient fiber intake
  • Physical inactivity
  • Medications, especially pain medications
  • Iron supplementation
Senior woman talking to doctor.

When to see a doctor

You should see your doctor for an evaluation if your constipation:

  • Is chronic, and lasts more than a few weeks
  • Is accompanied by any rectal bleeding
  • Is accompanied by abdominal pain, cramps, nausea, vomiting,
  • Is accompanied by significant weight loss
Doctor checking young woman's thyroid.

Your first step in treatment

If you are hypothyroid, your first step in dealing with constipation is to ensure that your treatment is optimized, with appropriate thyroid blood-test levels and the right thyroid hormone replacement medication. Learn more about optimal treatment and levels in the article: Is Your Thyroid in the Normal Range, But Not Optimal?

Healthy, high fiber foods in heart shaped bowl.

Increase your fiber intake from food

Experts recommend that you get from 25 to 35 grams of fiber per day to resolve constipation. Swap out low-fiber, binding foods (like processed grains, cheese, and meats) for whole grains, and choose high-fiber foods like vegetables, fruits, greens, and beans. And don’t forget the high-fiber prune — a popular and effective constipation remedy. Also, include healthy fats and oils such as olive oil and coconut oil. Remember to increase your fiber intake slowly to minimize gas and bloating.

Fiber supplement capsules.

Use fiber supplements

You may want to add a supplement to reach your daily fiber goal. Some recommended supplements include:

  • Psyllium powder or capsules
  • Flaxseeds
  • Over-the-counter products like Metamucil, and Benefiber
  • Other fiber supplements

Remember that if you dramatically increase your fiber intake, you should have your thyroid levels rechecked. Fiber can slow absorption of your medication and affect your dosage requirements.

Woman holding supplements in hand.

Try other supplements

Other supplements can help with chronic constipation, including:

  • Senna
  • Triphala, an Ayurvedic supplement for constipation
  • Cascara sagrada
  • Aloe vera juice
  • Fish oil supplements
Sour cream.

Add probiotics

Probiotics are good bacteria that you need for digestion. You can add probiotic-rich foods — yogurt, sauerkraut, kimchi, and kombucha — to your diet. It’s also helpful to add a probiotic supplement that includes acidophilus.

Magnesium capsules.

Add magnesium

Low magnesium levels are common in people with hypothyroidism. Low magnesium makes elimination more difficult, so supplementation can help with regularity and minimizing constipation. It’s best to take magnesium supplements at bedtime — they can also help with sleep.

Pouring glass of water from pitcher.

Get enough liquid

Sufficient intake of liquids — especially water — is essential for constipation. Aim for at least 64 ounces of water or beverages without caffeine each day.

Two women exercising walking upstairs.

Get daily exercise and movement

Regular daily exercise and movement can help with regularity and reduce constipation. Even a daily walk or a few minutes of weight-bearing exercise can help. Yoga and stretching can also be helpful in managing constipation.

Osteopath adjusting female patient.

Try osteopathic manipulation

Osteopathic physicians — known as DOs — can produce hands-on musculoskeletal adjustment and treatment that may relieve constipation for some people. Here is a resource to find a DO near you.

Senior woman pouring liquid laxative.

Try a laxative

Physicians consider laxatives a last-resort treatment because you can become dependent on them. But there are some cases when they are an important part of constipation treatment. Laxatives include:

  • Stimulants that help your intestines contract, such as Senokot and Dulcolax
  • Stool softeners, such as Colace and Pericolace
  • Saline laxatives, such as Milk of Magnesia.
  • Lubricant suppositories or enemas
Mary Shomon
Meet Our Writer
Mary Shomon

Mary Shomon is a patient advocate and New York Times bestselling author who empowers readers with information on thyroid and autoimmune disease, diabetes, weight loss and hormonal health from an integrative perspective. Mary has been a leading force advocating for more effective, patient-centered hormonal healthcare. Mary also co-stars in PBS’ Healthy Hormones TV series. Mary also serves on HealthCentral’s Health Advocates Advisory Board.