Does Hashimoto’s Cause Constipation

March 14, 2023

When I say I’ve been down in the trenches with you, I’m not joking. I’ve experienced alllll the crappy (pardon the pun) symptoms of Hashimoto’s disease including the all too common constipation that my clients struggle with too. I had a raging small intestinal bacterial overgrowth – if you don’t know what that is read […]

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I'm Tessa

I'm a Nutritionist, Metabolic Balance coach, foodie, Mamma & Hashimoto's thriver. A few years ago Hashi's was kicking my in the butt. Now I help other women to regain their energy & maintain a healthy weight with ease. 


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When I say I’ve been down in the trenches with you, I’m not joking. I’ve experienced alllll the crappy (pardon the pun) symptoms of Hashimoto’s disease including the all too common constipation that my clients struggle with too. I had a raging small intestinal bacterial overgrowth – if you don’t know what that is read on – and it was so severe that I was hospitalised with chronic constipation. I’m happy to report that that chapter of my life is over, thank goodness!

So we’re talking about ahem, poo, today. This topic might be taboo for some of you but this conversation needs to be had because constipation could be amplifying many of your symptoms and there is actually a lot you can do about it. So let’s destigmatise talking about the wonderful satisfaction of a healthy poo each day and get real about how horrendous it can be when things aren’t working as they should be down there!

Below I share the actual foods, supplements and hacks I used to repair my motility and digestion.

Does Hashimoto’s cause constipation?

It’s really common for those with Hypothyroidism and Hashimoto’s disease to experience sluggish bowels and lots of frustration in the bathroom. Chronic constipation is a serious health complication that can have a huge impact on your health and sense of wellbeing. Getting relief from this most unglamorous symptom of Hashimoto’s can make a huge difference to how you feel. As I always say, there is nothing more satisfying than a healthy poo every morning and nothing worse than the sluggish, toxic feeling of being blocked up.

What counts as constipation?

Bowel motions fewer than daily that are dry, dark and resemble small balls or pellets, sometimes clumped together. It accompanies straining, difficulty passing with a feeling of incomplete evacuation. Often there will be discomfort when passing, excess gas and abdominal pain.

Honestly? The majority of the people I have worked with over the years would be able to tick most of the boxes above, constipation seems to be one of the side effects of our modern diets & lifestyles. But when it’s been 3 months or more of 3 or less bowel motions per week then you know it’s chronic which is often the case in Hashimoto’s.

How does Hypothyroidism affect your bowels?

So how can this little butterfly shaped organ at the other end of your body wreak so much havoc on your digestive system? It’s not Hashimoto’s directly that causes constipation, it’s actually the hypothyroidism that is responsible. Which is why it can be a symptom that creeps up on you gradually as your thyroid function slows and there is less and less thyroid hormones circulating due to the inflammation caused by autoimmunity. You see the muscles in your gut lining are negatively impacted when there is a thyroid hormone deficiency in your system, causing them to have weaker & fewer contractions in a process called peristalsis. Ordinarily a wave-like muscle contraction helps to move waste through the gastrointestinal tract so it can be eliminated but this process is impeded in thyroid hormone deficiency.

When your gut motility slows down for an extended period of time it can keep you trapped in a vicious cycle as the muscles aren’t flexing so to speak, so they weaken further. This is why it is so important that when you feel the urge to go, you go. Holding on can cause the tone in your colon muscles to weaken further.


Other reasons for constipation in Hashimoto’s disease

Small Intestinal Bacterial Overgrowth AKA SIBO is a common complication in Hashimoto’s sufferers as sluggish digestion leads to the translocation and build up of bacteria from the large intestine where it belongs to the small intestine. In a well functioning digestive system acidity from the stomach prevents too much bacteria from surviving the conditions of the small intestine but the affect of hypothyroidism doesn’t end with slowing motility. Frustratingly, hypothyroidism also reduces stomach acid production so that acidic environment required to keep too much bacteria from building up is not adequate, leaving those with Hashimoto’s/Hypothyroidism at risk of SIBO. Often the really chronic constipation cases are actually a small intestinal bacterial overgrowth. Don’t worry, I have a protocol for that in addition to the tips I share below.

The consumption of gluten is highly inflammatory in Hashimoto’s disease and disordered bowel motions are a common side effect. Many experience constipation when gluten regularly forms part of their daily eating. If you haven’t taken the leap already check out this blog Gluten, should you be eating it?

You’re eating the SAD (standard Australian diet) which is high in processed foods and low in fibre and plant foods. A healthy bowel motion everyday is bulked out and carried by fibre through the digestive tract. Vegetables, fruit, grains, nuts, seeds, legumes all need to feature in your daily eating.

Are you eating low fat to try and manage the Hashi’s weight gain? Oils help lubricate bowel motions and are an essential part of your daily eating. Do yourself a favour and introduce more healthy fats like olive oil and ghee back into your diet.

Dehydration is the most common aggravating factor of constipation I see in clinic. It was cause your bowel motions to be dry and difficult to pass.

Suboptimal magnesium levels is a common nutrient deficiency I see in Hashimoto’s/Hypothyroidism all the time and it will hinder the healthy muscle contractions in your colon too.

Food intolerances are causing GI inflammation and affecting your bowel motions and digestive health. Are you eating something you know doesn’t agree with you? Or perhaps you need to do some more sleuthing with a food journal to identify your triggers.

When you are constipated you can have uncomfortable digestive symptoms like abdominal discomfort & excess wind, hormone imbalances and painful, heavy periods due to oestrogen build up in the system, congested & dull skin and/or acne, brain fog, fatigue, liver congestion and difficulty releasing weight. In other words, it can make many of your Hashi’s symptoms worse.

Thankfully there is a lot you can do about it.

Healthy daily poo tips:

  • It’s important that you don’t ‘hold on’ when you feel the urge as it weaken these all important muscles.
  • Use a stool to elevate your feet into the squatting position when passing a bowel motion.
  • Ensure you are getting enough water each day to lubricate stools (35ml X kg of body weight plus more if you sweat).
  • Apply a hot water bottle on the abdomen prior to a warm oil massage. Starting at your belly button move in a clockwise in circular motion like a snail shell.
  • Daily movement is really important for peristalsis, even gentle walks around the block are beneficial. Yoga and squatting poses also helps to massage intestines and encourage bowel motions.
  • Get into a meal rhythm so you eat a roughly at the same time each day
  • Give yourself breaks in-between meals, grazing & snacking slows digestion down

Helpful foods:

  • Kiwi Fruit x 2 consumed with the skin on
  • Ensure you are having enough fats in your diet
  • 2 tbs of LSA with yogurt (dairy or non dairy) daily
  • Stewed apples & pears with the skin on
  • Fennel, Peppermint, Liquorice Root, Fresh Ginger or Marshmallow Herbal Tea
  • Black Tea or Coffee

Helpful Supplements:

  • Magnesium citrate 400-1200mg before bed
  • Partially Hydrolysed Guar Gum Fibre (PHGG) a prebiotic gentle fibre 1-2 tbs before bed <- The top supplement I use in clinic with great results
  • BioGaia Protectis Lactobacillus Reuteri DSM 17938 probiotic strain
  • Digestive enzymes to support stomach acid & bile production
  • Lactulose 15ml before bed

When things are really bad:

  • Consider a course of colonic irrigation
  • Colon cleanse magnesium oxide before bed 1/2-2tsp

I don’t recommend fibre supplements such as Metamucil, they are quite harsh and if taken in large doses can actually make your constipation worse. When you try any new fibre or prebiotic supplement you must always go low and slow. Start with a quarter or even an eighth of a dose and gradually build up. And of course, see you GP to rule out anything more serious.

In The Thrive Method getting your bowels moving is the first priority. We do a little two day cleanse with lots of easy to digest, high fibre meals and some high dose magnesium to give you a gentle laxative effect to get things moving before you start your personalised food plan. If your constipation is really chronic we’ll work on that for 2-4 weeks before you start your plan. It’s really important you are having daily bowel motions when you start any gut healing or new daily eating plan and weight is shifting as there are often a lot of metabolites and toxins flooding your system that need to be eliminated daily. And a healthy daily poo is THE best detoxification you can hope for.

I hope these tips can help you find some relief! Please share this with anyone who may need to hear it too.

Get in touch if you have any questions or are having trouble finding my favourite fibre recommendation PHGG.


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