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Of the various signs seen in hypothyroidism, constipation is a classic sign.

Constipation which is essentially slow, weak or sluggish contractions of the gut form a characteristic symptom in hypothyroidism. This is more so in geriatric patients as this study indicates.

Hence of the millions of people suffering from thyroid condition both of diagnosed and undiagnosed category, constipation features high on the list of symptoms presented. Let us see the relationship between hypothyroidism and constipation and the ways to relieve the constipation effectively.

How constipation occurs

A person is said to be constipated when the number of bowel movements per week is three or lesser.

Constipation is also diagnosed based on other symptoms such as straining during a bowel movement, hard or lumpy stools and sensation of blocked or incomplete bowel movements. In some cases people use manual efforts such as digital evacuation to improve bowel movement.

When food passes via colon or large intestine, the water content in the digested food is absorbed. The resultant waste product is termed as stool. The stool moves via the colon to the rectum from where it is evacuated. As it passes to the rectum water is continuously absorbed to make the stool solid before it is eliminated.

Constipation occurs when the colon is not contracting sufficiently or when too much of water is removed from digested food. The stool movements slow down because of this.

How hypothyroidism causes constipation

The reason for the constipation is because of the slowing down of body functions. This is due to insufficient amount of thyroid hormone secretion. The digestive tract slows down because of reduced contraction of muscles in the digestive tract.

In a normal digestive tract, the muscles lining the small intestine and large intestine contract, which helps to move digested food via intestine.

In case of hypothyroidism, the contraction is slowed down. In addition to slow digestive process, the elimination of stool also slows down. The constipation changes into a chronic condition.

Will thyroid hormone treatment work to relieve constipation

The first step is to make sure the thyroid hormone treatment is well optimized. Insufficient hormone treatment can also cause constipation issues. Here are some treatment suggestions:

Focusing on treating constipation

As we age the function of thyroid gland declines. This is one of the reasons for constipation to affect older people more. While dietary fiber supplements are often the main treatment recommended for constipation, they may not be effective or worse can compound the issue of bacterial growth in the intestines.

Hypothyroidism is related to higher growth of bacteria in the small intestine.

A 2007 study done on 50 patients with overt hypothyroidism indicates link between gastrointestinal symptoms and overt hypothyroidism. The hypothyroidism caused by autoimmune thyroiditis triggers excessive bacterial overgrowth. This can cause intestinal manifestations including flatulence, abdominal discomfort and bloating.

Hence adding fiber to your diet will not help in hypothyroidism due to the bacterial overgrowth.

Another 1986 study indicates that while dietary fibers help to inhibit cancerous growth in the colon by binding the carcinogens and other potential toxins, fermentation of the fibers can lead to cell proliferation and enhancement of tumor. Fibers such as bran, pectin, agar, alfalfa, carrageenan and pysllium can cause more harm than good when used for treatment of constipation.

Using thyroid hormone treatment

Levothyroxine is the common treatment option for hypothyroidism. But levothyroxine does not always relieve symptoms of hypothyroidism including constipation. This is because it contains just T4 hormone. The T4 is converted to active thyroid hormone, T3 in our body.

But in many people the Levothyroxine treatment does not result in conversion of T4 to T3. This leaves you with unchanged symptoms. A better option would be to use thyroid hormone treatment that has both T3 and T4 such as natural desiccated thyroid.

The treatment option is usually decided upon conducting comprehensive testing of thyroid functions including Free T3 and T4, TSH, thyroid antibodies and reverse T3.

Getting constipation under control

Controlling the constipation is therefore a process that involves a combination of proper thyroid hormone treatment and using conventional treatment methods. These involve using safe supplementary fibers and home treatment options like baking soda, Vitamin supplements etc.

This can help in relieving the constipation, while treating the thyroid condition.

Other treatment options include restoring oxidative metabolism and production of energy in digestive tract. For stimulating the defective metabolism due to hypothyroid condition, T3 hormone and sunlight exposure is recommended. Slower metabolism due to low thyroid function causes inflammation which further exacerbates constipation symptoms.

Thus a two pronged approach towards treatment of constipation found in hypothyroidism can help in effective relief from constipation. When left untreated chronic constipation can cause complications such as rectal prolapse, hemorrhoids or even fecal impaction.

Changes in lifestyle, exercise and diet in addition to thyroid treatment and constipation relieving medications can resolve the condition without leading to unmanageable complications.

A comprehensive assessment of the condition, symptoms and proper diagnostic tests will help in planning an effective treatment and better resolution of the symptoms and underlying disease.