Why does hypothyroidism cause constipation?

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Constipation: The Embarrassing Hypothyroidism Symptom That May Save Lives

Lemon juice alkalizes the body. Yes lemons are acidic outside the body, but inside the body they have an alkalizing effect. An alkaline body helps prevent disease and maintain wellness.

I take my thyroid medication with plain water first thing when I wake up. Then I wait at least an hour to have breakfast to ensure nothing interferes with the absorption of my medication. I have warm lemon water just before my breakfast. (I wait several hours after taking my thyroid meds to take other medications, supplements, and vitamins to ensure there is no interference with the thyroid hormone absorption.)

Magnesium

Magnesium has been a real life-changer for me. All the things that I’ve mentioned above have been helpful in improving my constipation. However the real change came when my doctor tested my magnesium and found it to be far below the normal range. Nutrient deficiencies including magnesium are a common issue for those of us with hypothyroidism and should be tested.

Magnesium is the relaxation mineral. Constipation is a common symptom of magnesium deficiency. Muscles line the digestive tract. Magnesium relaxes the muscles and helps the stool move more easily.

Other symptoms of low magnesium include:

insomnia

irritability

anxiety

depression

restless leg syndrome

heart palpitations

poor heart health

Diabetes

brain fog

dizziness

PMS

kidney stones

ringing in the ears

muscle cramping

eye twitches

headaches

I struggled with eye twitching for over ten years. An eye exam showed my eyes were fine and yet I had the constant twitching. Guess what…my eye twitching (along with painful persistent headaches) went away once I started on magnesium.

Serum magnesium is the test routinely taken in the doctor’s office and in the hospital but this type of testing misses a large percentage of people with magnesium deficiency. Thankfully I have a doctor that tests my red blood cell magnesium levels called RBC Magnesium which tests the level of magnesium inside of the red blood cells. Have you had your RBC Magnesium level tested?

In order to gauge my dose of magnesium my doctor had me start at a low dose and work up until I experienced loose stools and then backed off slightly. She advised I take magnesium glycinate. There are many different magnesium supplements available in stores but not all of them are easily absorbed. Magnesium glycinate is one of the most absorbable forms of magnesium.

I take Pure Encapsulations Magnesium Glycinate every night before bed (it helps me sleep too). I also rub Magnesium Oil on my body (my doctor has me rub it on my legs) to increase my magnesium levels. I now go ‘number 2’ regularly every day. That’s a miracle for me.

For weeks I went back and forth on whether this was a topic that I wished to write about here on Hypothyroid Mom. It is very embarrassing to talk about my constipation and I hesitated about sharing it. However I hope that by writing about my personal experience, those of you suffering with constipation will see how important it is to discuss with your doctor. I am not saying that everyone will have colon polyps, hemorrhoids or diverticulosis from chronic constipation as happened to me or develop colon cancer, but an unresolved constipation issue could put your life at risk and should be discussed with your doctor.

By shining light on our symptoms, even the most embarrassing ones, we will CONQUER them!

READ NEXT: A dental exam uncovers undetected hypothyroidism in a young girl

How to deal with AutoImmune Disease: Hypothyroid Mum tackles constipation!

  • Magnesium. Magnesium has been a real life-changer for me. All the things that I’ve mentioned above have been helpful in improving my constipation. However the real change came when my doctor tested my magnesium and found it to be far below the normal range. Nutrient deficiencies including magnesium are a common issue for those of us with hypothyroidism and should be tested. As with all supplements, speak with your doctor about whether this is right for you and what dosage you should take. My doctor regularly tests my magnesium levels. Magnesium is the relaxation mineral. Constipation is a common symptom of magnesium deficiency. I take magnesium glycinate every night before bed. I take hot baths with Epsom salts (magnesium sulfate) and rub magnesium oil on my body to increase my magnesium levels. I now go ‘number 2’ regularly every day. That’s a miracle for me!
  • For weeks I went back and forth on whether this was a topic that I wished to write about on my blog. It is very embarrassing to talk about my constipation and I hesitated about sharing it. However I hope that by writing about my personal experience, those of you suffering with constipation will see how important it is to discuss with your doctor. I am not saying that everyone will have colon polyps, haemorrhoids or diverticulosis from chronic constipation as happened to me, or develop colon cancer, but an unresolved constipation issue could put your life at risk and should be discussed with your doctor. By shining light on our symptoms, even the most embarrassing ones, we will CONQUER them.

    I know this is a tricky subject to talk about…but do feel free to discuss and ask Dana and I questions below…

    Hypothyroidism: What You Should Know About Your Treatment

    Hypothyroidism, or underactive thyroid, is a medical condition where the thyroid gland fails to produce enough hormones to keep the body’s metabolism working properly. The condition is quite common—it affects more than 27 million adult Americans,1 mainly women over 40 years old and the elderly of both sexes. Up to 13 million Americans have undiagnosed hypothyroidism.2

    Doctors typically prescribe a medication called levothyroxine, a synthetic form of thyroid hormone replacement. However, some people with hypothyroidism have difficulty tolerating or absorbing the traditional medication, in which case your doctor might consider prescribing a more “pure” levothyroxine formulation available in a gelatin capsule. It may offer advantages over traditional tablets, especially if you have certain gastrointestinal (GI) issues.

    Diagnosis and Treatment
    The broad range of hypothyroidism symptoms are similar to those of many other diseases and might include fatigue, forgetfulness, dry skin, coarse hair or hair loss, weight gain, cold intolerance, weakness, constipation, elevated cholesterol, muscle aches and depression. This combined with the fact that symptoms can vary with the severity of the thyroid hormone deficiency makes hypothyroidism an often overlooked diagnosis.

    When your doctor tests your blood level of thyroid-stimulating hormone (TSH), a higher blood level signals a more underactive gland. But TSH levels can temporarily fluctuate with non-thyroid illness as well, and an elevated TSH value may be normal for people over 70 years old.3

    Effective communication between you and your doctor is critical to the success of hypothyroidism treatment. Tell your doctor about your symptoms, medications and supplements you are taking, allergies, other medical conditions you have, and family history of disease. Also alert your doctor if you experience new symptoms or start taking a new medication or supplement. Both doctors and patients should keep an open mind in terms of what could be causing new symptoms.

    In most cases, treatment of hypothyroidism is lifelong. After the initial treatment, your doctor will continue to monitor your progress and may adjust the dosage of levothyroxine to make sure it is right for you. To help get your TSH levels to the desired goal, it is extremely important to take your medication exactly as prescribed, consistently, usually early in the morning, at least one hour apart from food or other pills and with water (as opposed to orange juice or milk) which will allow for optimal absorption). Ideally, the same manufacturer should always be used.

    The commonly prescribed treatment, levothyroxine tablets, is a synthetic version of a hormone called thyroxine, or T4, produced by the thyroid gland. But some people have erratic thyroid laboratory results with this treatment or find it difficult to tolerate. The excipients, or inactive ingredients, commonly found in levothyroxine medications can rarely cause allergic reactions or GI problems, the latter particularly if you have celiac disease or lactose intolerance.4

    Allergic Reactions
    Traditional levothyroxine tablets contain a variety of excipient ingredients, such as food dyes, alcohol, magnesium stearate, povidone and talc that can cause allergic reactions. The Full Prescribing Information included with every levothyroxine prescription lists the ingredients.

    Exposure to even minute quantities of allergy-triggering ingredients can cause a reaction in susceptible people. For example, an allergy to a drug’s inactive ingredients can cause a rash or a GI reaction such as diarrhea by aggravating the underlying celiac disease or lactose intolerance.5 Often, people who experience these side effects simply stop taking their levothyroxine medicine, a common reason for undesirably high TSH levels and a return of thyroid disease symptoms. If you experience a reaction after taking the medication, consult with your doctor or pharmacist.

    Celiac Disease
    Celiac disease, which can occur at any age, is an autoimmune disorder of the GI tract triggered by consuming gluten (wheat, barley and rye). In adults, signs and symptoms vary and may include: unexplained iron-deficiency anemia, fatigue, weight loss, diarrhea, bloating, arthritis, bone loss or osteoporosis, depression, an itchy skin rash, and infertility. People with celiac disease are nearly four times more likely to develop an autoimmune thyroid condition, such as Hashimoto’s disease, the most common cause of hypothyroidism. Between 1.5% and 6.7% of people with autoimmune thyroid disorder also have celiac disease. Celiac disease affects one in 133 healthy people to one in 22 people who have immediate relatives (parent, child or sibling) who have the disease.6 Because traditional levothyroxine medications contain gluten, and even minute amounts of gluten can affect the intestines of celiac patients, they can conceivably cause celiac symptoms to worsen.7

    People with celiac disease may only have subtle symptoms, but they can still develop complications of the disease over time. Long-term complications include malnutrition, which can lead to anemia, osteoporosis, and miscarriage. Untreated celiac disease can lead to a higher risk for GI cancers. A study has shown untreated celiac disease causes malabsorption of levothyroxine; absorption may improve after celiac disease treatment.8 It is extremely important for celiac patients to avoid gluten.

    Lactose Intolerance
    Lactose is an inactive ingredient found in traditional levothyroxine medications. Lactose intolerance is the inability to digest lactose, a sugar found in milk and other dairy products. Many foods also contain lactose, including baked goods, cereals, salad dressings, mayonnaise, puddings and artificial sweeteners.

    Between 30 and 50 million Americans are lactose intolerant.9 Common symptoms include abdominal discomfort or pain, nausea, vomiting, diarrhea, constipation and gas after consuming foods containing lactose. Lactose intolerance often produces digestive tract discomfort 30 minutes to two hours after consuming milk products.

    The condition can be hard to diagnose, as many people occasionally suffer from symptoms similar to those produced by lactose intolerance. Other conditions, such as irritable bowel syndrome or celiac disease, can also produce similar symptoms. Diagnostic tests are available, but an easy way to tell if you have lactose intolerance is to see if your symptoms subside after eliminating lactose-containing products from your diet for a few weeks.

    If you have lactose intolerance, even the small amount of lactose contained in pills, in cumulative combination with small amounts from food or medication, may be enough to cause discomfort.

    Conditions Causing Poor Absorption of Traditional Levothyroxine Tablets
    A landmark study in The New England Journal of Medicine showed that people with poor stomach acid production from various causes have lower absorption of the tablet form of levothyroxine.10 Others with conditions such as inflammatory bowel syndrome, Helicobacter pylori (H. pylori) gastritis, and atrophic gastritis typically cannot optimally absorb levothyroxine tablets and generally require a higher dose. A class of commonly prescribed drugs called proton pump inhibitors potently lower stomach acid production. Since these acid blocking drugs are often taken as needed or “off and on,” this can cause a “moving target” for physicians and potentially cause problems in regulating thyroid hormone levels with traditional T4 tablets. Taking certain drugs or supplements (notably: iron or calcium supplements), some foods, and various conditions of the GI tract can also affect T4 absorption.

    Another Option for Some Patients with Hypothyroidism
    If you have one of the above conditions, your doctor may want to consider prescribing a newer form of levothyroxine available in a soft gelatin capsule. The medication consists of T4 and only three inactive ingredients: glycerin, gelatin, and water—far fewer than in traditional levothyroxine tablets. The capsules, which are bioequivalent to the leading levothyroxine tablets, are free of dyes, gluten, lactose, sugar, alcohol and other ingredients that can cause allergic reactions or worsening of your GI symptoms.

    In a recent study, the capsules, in contrast to traditional levothyroxine tablets, showed constant dissolution regardless of stomach acidity, which should theoretically enable better control of hypothyroidism for people with gastric disorders.11 The gelatin capsules were recently noted in national guidelines on hypothyroidism.4 More research in this area is pending. If you have hypothyroidism but have difficulty tolerating your medication, particularly if you have an allergic reaction to the excipients or suffer from celiac disease, lactose intolerance, or a condition that affects gastric acidity, and your thyroid blood test results are erratic, the gelatin capsule form of levothyroxine is a good option to discuss with your doctor.

    Peer Review by Grazia Aleppo, MD, FACE, FACP
    Although I believe that subjects who have celiac disease may need to be on this type of preparation, it is also true that—to date, many patients have been tolerating levothyroxine, even in the presence of celiac disease or lactose intolerance.

    Updated on: 12/16/13 View Sources

    2. Shomon M. Thyroid Disease Is Far More Widespread Than Originally Thought: 13 Million May Be at Risk and Undiagnosed. Colorado Thyroid Disease Prevalence Study. Updated August 12, 2013. http://www.thyroid-info.com/articles/thyroid-prevalence.htm. Accessed December 10, 2013.

    3. Vadiveloo T, et al. Age- and Gender-Specific TSH Reference Intervals in People With No Obvious Thyroid Disease in Tayside, Scotland: The Thyroid Epidemiology, Audit, and Research Study (TEARS). J Clin Endocrinol Metab. 2013;98(3):1147.

    4. Garber JR, Cobin RH, Gharib H, Hennessey JV, et al. Association Taskforce of Hypothyroidism in Adults. Clinical practice guidelines for hypothyroidism in adults: co-sponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association . Endocrine Pract. 2012; doi:10.4158/EP12280.GL.

    5. Swerlick R, Campbell CF. Medication Dyes as a Source of Drug Allergy. J Drugs Dermatol. 2013;12(1):99-102.

    8. Collins D, Wilcox R, Zubarik R. Celiac disease and hypothyroidism. Am J Med. 2012;125(3):278-82.

    9. Prevalence, Age and Genetic of Lactose Intolerance: Data from NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.foodreactions.org/intolerance/lactose/prevalence.html. Accessed December 10, 2013.

    11. Virili C, Santaguida MG, Cellini M, Del Duca SC, et al. Pilot Study With Softgel Thyroxine Preparation in the Treatment of Patients With T4 Malabsorption Due to Gastric Disorders. Data presented at ENDO 2013, Endocrine Society 95th Annual Meeting. Abstract. https://endo.confex.com/endo/2013endo/webprogram/Paper6139.html. Accessed December 10, 2013.

    Constipation or hard stools–the embarrassing aspect of hypothyroidism!

    Q: Did you hear about the new movie Constipation?
    A: Yes, it hasn’t come out yet.

    Q: Why are hypothyroid patients so mean?
    A: Because they don’t give a crap!

    Tah-dahhhh. 🙂

    Yup, though it’s great fodder for a good laugh ….constipation is the awkward subject of hypothyroidism — i.e. what the condition does to our bowel movements. Patients will report small, round, hard stools, for example. I always and humorously termed them “deer do-do”.

    Or they will report not going to the bathroom enough, aka constipation. Or when we’ve finally able to go, our stools can be hard, dry, compacted.

    In fact, constipation is said to be the most frequent gastrointestinal complaint a doctor will hear (which makes you wonder how many have undiagnosed hypothyroidism, which is rampant thanks to the use of the lousy TSH lab test).

    Why does hypothyroidism cause us to have stool problems?

    With any of the following…

    • being undiagnosed hypothyroid
    • being poorly treated with T4-only meds like Synthroid, levothyroxine, Eltroxin, etc.
    • simply not being on enough NDT or T3 due to a TSH-obsessed doctor

    …many of us start to notice a change in our stools. Hypothyroidism slows down our internal metabolism, which in turn slows down the elimination process. Those muscles involved in pushing our waste products out via our intestines become sluggish and weaker. And it can be sneaky–coming on slowly and we may not recognize at first that it’s NOT normal.

    Additionally, just as our skin and hair can become drier due to our hypo state, there might also not be enough water in our bodies to make our stools softer.

    Are there other reasons for constipation?

    Other causes can include:

    • Being on certain iron supplements like ferrous sulphate
    • Not drinking enough fluids
    • Certain medications like pain killers, the older tricyclic antidepressants like amitriptyline, some blood pressure meds, etc
    • Certain autoimmune diseases like lupus, etc.
    • Being too inactive or sedentary
    • High intake of cheeses or extremely low-fiber foods
    • Obstructions in our intestines
    • Intestinal inflammation
    • Pregnancy in some

    But in hypothyroid patients, the most common cause is our decreased metabolism due to being undiagnosed or poorly treated!

    How do I best reverse my constipation/hard stools/infrequent elimination?

    Based on reports from thyroid patients all over the world, the first successful way is to get on a better medication, which has proven to be Natural Desiccated Thyroid (NDT). The latter contains the same five hormones that a healthy thyroid produces: T4, T3, T2, T1 and calcitonin. In other words, though the purpose of T4 is to convert to the active T3, being on NDT doesn’t force you to rely on conversion alone, which can have all sorts of problems. With NDT, you are also getting some direct T3, just like your own thyroid would have been giving you.

    Even if you can’t get it, adding synthetic T3 to that synthetic T4 has done wonders for others.

    Thyroid treatment alert: Even if you get on NDT, it’s important to remember that you have to raise high enough. It’s all-too-common for patients to stay too low, either due to a doctor who says “Come back in six weeks (or more)” or a doctor obsessed with keeping you in the erroneous TSH “normal” range, which leaves us hypothyroid. Take the time to study what patients have learned in the proper way to use Natural Desiccated Thyroid, here, and expect to have to guide your doctor!

    And if you find that in raising, you start getting strange hyper-like symptoms while you know you are still hypo, time to learn why here. i.e. those hyper-like symptoms are not because NDT doesn’t work–they are because the NDT is revealing one and/or two problems which need treatment.

    Eight additional ways to help with constipation

    Glad you asked! In addition to improving your thyroid treatment, here are more things you can try and see which works best for YOUR relief…

    1. Drink more fluids! Those include water, of course, which I personally like adding lemon juice to. Or any other healthful fluid (Sorry, that doesn’t mean more Coca Cola or Dr. Pepper). Other potentially healthy fluids include your favorite herbal teas, or those vegetable juices, or healthy clear soups.
    2. Move around more if you are able. Being sedentary doesn’t help that metabolism.
    3. Increase your fiber intake. Depending on what you can or cannot eat, examples of higher fiber foods include beans, bran cereal, whole grain products, veggies like carrots or split peas or lima beans, fruits like raspberries or blackberries…or even flax seed meal or chia seeds added to a food.
    4. Check out those prunes! Yes, prunes and even prune juice have a great reputation as a great laxative for that constipation. You just have to find the right amount of them. Here’s a study showing the efficacy of using prunes.
    5. Ask your doctor to try a different medication to see if that helps. It’s known that the old tricyclics for depression can cause constipation, for example. Here’s a list of meds which may cause constipation.
    6. Adding a magnesium supplement. Patients found out that taking magnesium, a mineral known to relax, can help with constipation until other causes are treated. We simply raise it until we find that dose that results in softer stools. We feel it’s wise to test our RBC magnesium to make sure we can handle supplementation.
    7. Yoga is said to help constipation. I’ve never tried it because NDT did the trick. But this is an interesting idea that certain yoga poses might help a lot. This video (on the top of latter link page) explains.
    8. Olive oil, yes, olive oil! Olive oil is said to lubricate your your intestines and if taken daily (morning and evening), can help move those stools out. Usual recommendations are one tablespoon each time you take it.

    Anyhow, hang in there! Oops, nope, that doesn’t work. OK, hang tight!! Oops, no, that doesn’t work either. Let’s just say this….

    MORE TO READ:

    How hypothyroidism affects motility: https://www.hindawi.com/journals/grp/2009/529802/

    Important note: STTM is an information-only site based on what many patients worldwide have reported in their treatment and wisdom over the years. This is not to be taken as personal medical advice, nor to replace a relationship with your doctor. By reading this information-only website, you take full responsibility for what you choose to do with this website’s information or outcomes. See the Disclaimer and Terms of Use.

    Hypothyroidism and Constipation

    Thyroid Advisor May 6, 2018

    Last Updated on April 13, 2019

    Constipation is a common gastrointestinal concern that all of us experience at one point or another.

    While many people think constipation is not a big deal, it never occurs without reason. Constipation is almost always a sign of some underlying health problem which only intensifies the importance of taking it seriously.

    In this post, we focus on constipation and its potential association with hypothyroidism.

    Keep reading to learn more about this subject.

    Causes of constipation

    Constipation doesn’t mean the same thing to all people.

    For some people constipation refers to hard stools, straining (difficulty passing stools) and incomplete emptying after a bowel moment. For others, the term constipation means infrequent passage of feces or stool.

    So, what is the accurate definition of constipation? It would be pointless to discuss its relationship with hypothyroidism without knowing what it, actually, is.

    Constipation is defined as bowel movements that are difficult to pass and infrequent.

    In fact, a person is considered constipated if he or she has three or fewer bowel movements a week. Constipation can be occasional (goes away quickly) or chronic (persistent). Chronic constipation refers to difficulty passing or absence of stool lasting for several weeks.

    Unlike occasional constipation that is awkward, but not a huge threat to one’s health, the chronic type has a major impact on a patient’s quality of life.

    The reason we have constipation is that stool or waste moves too slowly through the digestive tract.

    In addition, this problem occurs when the stool can’t be successfully expelled from the rectum. Different causes may contribute to chronic constipation, such as rectal cancer, anal fissure, bowel obstruction, bowel stricture (narrowing of the colon), colon cancer, and others.

    Other causes include problems with nerves around colon and rectum and conditions that affect hormones such as diabetes, hyperthyroidism, pregnancy, and hypothyroidism.

    Constipation is a symptom of hypothyroidism

    Hypothyroidism, or an underactive thyroid, is a defined as a disorder of the endocrine system wherein the butterfly-shaped gland doesn’t produce a sufficient amount of thyroid hormone for proper function.

    Hypothyroidism occurs due to a number of causes including treatment for hyperthyroidism, autoimmune disease, thyroid surgery, radiation therapy, and some medications.

    Symptoms of hypothyroidism vary and they depend on the severity of your condition. Many people don’t even know they are hypothyroid because symptoms develop over the years, they don’t pop up unexpectedly. Plus, signs of hypothyroidism are similar to those of other conditions thus making it more difficult for people to understand what’s going on.

    One of the most common symptoms (and the least discussed) of hypothyroidism is constipation. Others include weight gain, fatigue, low libido, abnormal menstrual cycle, memory loss, depression, hair loss, dry and pale skin, dry hair, cold intolerance, muscle cramps, and irritability.

    Constipation being a symptom of hypothyroidism isn’t the only link between two conditions. Let’s inspect this relationship more thoroughly.

    Constipation and hypothyroidism in children

    Despite the fact that constipation is a common concern, most people feel uncomfortable talking about it. That’s why we don’t see many articles and hypothyroidism-related blogs discussing this subject. However, in order to manage your condition properly, it is important to address even those things that one may find embarrassing.

    The relationship between constipation and hypothyroidism is not explored as well as it should be. Bennett W.E. et al explored the prevalence of hypothyroidism among children with constipation and found that only a small portion of children with this gastrointestinal concern had problems with the underactive thyroid gland.

    That means that hypothyroidism is an unlikely cause of constipation in hypothyroid children. That being said, it is recommended that children with severe constipation undergo thyroid hormone evaluation.

    Goto S. et al explain that hypothyroidism may be associated with either severe constipation or megacolon that mimics Hirschsprung’s disease, a condition that affects large intestine and impairs passing of the stool. Hirschsprung’s disease is present at birth i.e., and it is a congenital condition that occurs due to missing nerve cells in the baby’s colon.

    However, the mechanisms underlying this relationship are not very clear, scientists report.

    Using rats, they found that hypothyroidism significantly impairs colonic motility and function. Colonic motility refers to bowel movements, and two primary types of impaired function are diarrhea and constipation.

    Constipation and hypothyroidism in adults

    While many studies have been conducted on hypothyroidism subject, many of them didn’t focus on constipation. In many cases, this was only one part of the whole research, but it doesn’t mean the evidence is weak. You’ll be surprised to know that a growing body of evidence confirms the link between constipation and hypothyroidism.

    For example, The American Journal of Digestive Diseases published a study which explored intestinal disorders in hypothyroidism. The research found a severe functional deficiency of the small intestine and colon. Stimulation of small intestine showed a complete absence of motor response in patients with severe constipation.

    Not only did the study confirm the existence of constipation in hypothyroid patients, but it also revealed that stimulation of small intestine could be a prognostic test which could show whether a patient would respond to hormonal therapy. The inadequate intestinal function could dampen efficacy of the treatment.

    In 2014, the Indian Journal of Endocrinology and Metabolism featured the study which reviewed current evidence on hypothyroidism, gastrointestinal (GI) motility and development of bacterial overgrowth in your small intestinal. The SIBO “small intestinal bacterial overgrowth” is a condition wherein the bacteria in your stomach overgrow and gets out of balance. The paper shows that hypothyroidism reduces the gastroesophageal motility and it is important for patients with indigestion to evaluate thyroid functions.

    In healthy people, normal small gastrointestinal motility prevents overgrowth of bacteria, but more than half patients with hypothyroidism have SIBO. While diarrhea is rarely reported, constipation is a common concern in hypothyroid patients.

    Gastrointestinal hypomotility in hypothyroid persons could promote overgrowth of bacteria thus causing chronic symptoms affecting digestive health and function. While many people associate SIBO with diarrhea, constipation is a common symptom too, especially in hypothyroid patients.

    A team of scientists from Turkey, whose findings were published in the Gastroenterology Research and Practice, also confirmed that hypothyroidism has a negative influence on GI motility. In addition, changes in the motor activity of digestive system could lead to constipation and gastric distension (bloating) in hypothyroid individuals.

    Turkish scientists also confirm what we’ve already known – that a limited number of studies on this subject have been conducted. However, evidence shows hypothyroid patients have a major reduction in gastric emptying, but some studies found no relationship between deficiency in thyroid hormone, acid secretion, and gastric excretion.

    On the other hand, further research found that depletion of thyroid hormones can, indeed, inhibit secretory functions of the digestive tract, thus leading to constipation and other GI concerns.

    Why does hypothyroidism cause constipation?

    As seen throughout this post, current evidence confirms the relationship between constipation and hypothyroidism. You’re probably wondering why that happens in the first place. While exact mechanisms aren’t fully investigated, the culprit could be the fact that insufficient levels of thyroid hormones slow down the body’s functions.

    Just like the above-mentioned studies revealed, hypothyroidism slows function of digestive tract thus causing irregular bowel movements or making it difficult for a person to eliminate waste from the body.

    Moreover, digestive tract including both large and small intestine are lined with muscles. The proper function of these muscles is important for healthy digestion and bowel movements. In order to move waste or stool through the intestine to the rectum and out of the body, muscles need to contract.

    Due to hypothyroidism contraction of muscles slows down and weakens. As a result, stool also moves slowly, and you experience infrequent bowel movements or difficulty passing stool.

    Not only is constipation uncomfortable and frustrating, particularly when it’s chronic, but it can also decrease the efficacy of medications you’re taking. After all, therapy needs to be fully absorbed in order to work, but digestion-related problems like constipation impair absorption.

    This only emphasizes the importance of management of constipation.

    Things to avoid when constipated

    Most people have constipation at some point in their life. Occasional constipation is one thing, it’s not that frustrating, but chronic or persistent constipation can have a negative impact on a patient’s quality of life especially if hypothyroidism is also involved.

    While the uncomfortable problem, constipation can be managed successfully.

    Effective management of constipation is all about learning what to do or things you should avoid. Below, you can take a look at some things to avoid doing when constipated:

    • Drinking caffeine and/or alcohol – both caffeine and alcohol have dehydrating effects. Proper bowel movements require hydration but drinking too much coffee, or alcoholic beverages could only aggravate constipation
    • Eating too much processed food – these foods contain all sorts of ingredients that are used to enhance flavor but don’t deliver important nutrients. Your digestive system has enzymes to break down and absorb different types of food, but these enzymes don’t really work well with processed foods. Impaired digestion is the biggest risk factor for constipation
    • Too much dairy – they contribute to bloating, which makes it difficult for the body to pass the stool
    • Sedentary lifestyle – yet another factor that increases the risk of constipation or it aggravates your condition. Lack of physical activity decreases gut movement, weakens muscles, and decreases blood flow to digestive tract thus slowing down metabolism
    • Iron and calcium supplements – while they are useful for prevention of deficiency and conditions that occur due to low levels of these minerals, iron and calcium supplements can slow down contractions in GI system
    • Excessive use of laxatives – although laxatives are an effective way to tackle constipation, the excessive use can make your body get used to laxatives, thus making it difficult to improve your digestion naturally
    • Other mistakes to avoid include adding too much fiber too fast, ignoring your body’s needs, skipping meals, just to name a few

    Managing hypothyroidism-caused constipation

    When you have hypothyroidism, it all comes down to proactive approach and management of symptoms you experience and constipation isn’t the exception from this rule. The first and most important step toward successful management of constipation is to treat hypothyroidism.

    Chronic constipation is almost always a sign of some underlying health problem meaning that’s what you need to manage first in order to make this GI concern go away.

    Sometimes this is easier said than done because hypothyroidism can be very tricky to control, but with doctor’s help and lifestyle modifications, you can do it.

    Other things hypothyroid patients should do to manage constipation are:

    • Consult your doctor about medications and supplements you’re taking
    • Exercise regularly
    • Lower intake of processed foods
    • Stay hydrated throughout the day
    • Consider using laxatives, but don’t use them too much, this is yet another topic to discuss with your doctor
    • Manage stress
    • Don’t ignore, delay, or put off the urge for a bowel movement

    Conclusion

    Constipation is one of the most common gastrointestinal problems, and it can be either occasional or chronic.

    Hypothyroidism can cause constipation due to hormone depletion that slows digestive functions and weakens muscle contractions. More studies are necessary to elucidate this subject entirely.

    Constipation, Mayo Clinic https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253

    8 Tips to Relieve Hypothyroidism-Related Constipation

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    Low thyroid hormone, or hypothyroidism, has many effects on your health, including your bowel movements. Constipation, in fact, is one of the most common symptoms of hypothyroidism, along with dry skin, sensitivity to cold, hair loss, difficulty concentrating, and fatigue, according to the American Association of Clinical Endocrinologists (AACE).

    Constipation is defined by having three or fewer bowel movements a week, or by bowel movements that are painful and unproductive, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Relieving constipation starts by treating your hypothyroidism but also involves making a few key lifestyle changes.

    Having hypothyroidism means your thyroid hormone levels are low. Because your thyroid plays a role in helping manage your bodily processes, systems throughout your body might slow down when these levels are low, according to the AACE.

    Digestion and passing stool are among the processes that can be affected by low thyroid hormone levels.

    It’s important to talk to your doctor about both your thyroid and your constipation to make sure you’re taking the best steps to manage both.

    “There are multiple different causes of constipation, so not everyone who has constipation can attribute the constipation to hypothyroidism,” says Jacqueline Jonklaas, MD, an associate professor of endocrinology and metabolism at Georgetown University in Washington, D.C. “Other causes of constipation may include side effects of drugs, dehydration, blockages in the gastrointestinal system, problems in the nerves controlling the gastrointestinal system, and diabetes.”

    Constipation can also become more common as you age, even with normal thyroid hormone levels, she adds.

    Still, Dr. Jonklaas explains, hypothyroidism can increase your risk of constipation.

    How to Relieve Constipation

    You don’t have to accept constipation as part of your hypothyroidism. Strategies you can use to get relief include:

    Treat hypothyroidism. “If someone with hypothyroidism has constipation, it should be treated by treating the underlying hypothyroidism,” Jonklaas says. The AACE says treatment typically involves taking replacement hormone once a day by mouth. Stay in touch with your doctor so you can work together to narrow down the correct dosage for you. If constipation continues after a few months of hypothyroidism treatment and lifestyle changes to combat constipation, then you might need to talk to a gastroenterologist about other causes, she notes.

    Review your medications. The American Gastroenterological Medical Association (AGMA) recommends talking to your doctor or pharmacist about all the over-the-counter and prescription medications and supplements you’re taking to find out whether one or more of them might be contributing to constipation. You might need to stop taking medications that contribute to constipation or switch to something else.

    Drink more water. Making sure you’re adequately hydrated is part of addressing constipation, Jonklaas says. Aim to drink 6 to 8 glasses of water a day. Getting enough fluids is particularly important if you’re going to be using fiber supplements.

    Eat more fiber. National recommendations call for adult women to get at least 28 grams of fiber daily in their diet, while men should aim for 30 grams, according to the U.S. Department of Agriculture. Eating more fiber-rich foods — such as fruits with skin on, vegetables, berries, beans, and whole grains — could help with constipation. You may have heard that specific groups of vegetables, such as broccoli and kale, could increase your risk of a low-functioning thyroid, but that’s a controversial issue that’s still being studied, according to the AACE. Best advice? Talk to your doctor or a dietitian to develop a meal plan that works for you. Increase fiber in your diet gradually over several days or weeks until you reach your daily goal. Fiber supplements, such as those containing psyllium seed husks, may also help manage constipation, according to the AGMA.

    Get more exercise. Aim for at least 150 minutes of moderate physical activity each week, which is the national recommendation for exercise. Increasing physical activity should be part of constipation management, according to a review of constipation treatment strategies published in the February 2017 issue of the Handbook of Experimental Pharmacology.

    Consider a laxative. You can get over-the-counter oral laxatives that are inexpensive and generally safe, such as milk of magnesia, which is recommended by the AGMA. You can also try suppositories. If you’re not sure whether or how to use laxatives, talk to your doctor about what would be best in your situation.

    Try bowel retraining. This is a strategy to help you gain control of your bowel movements. You might need to relearn your bathroom habits or establish a regular schedule for having a bowel movement. Avoid holding in a bowel movement when you need to produce one or straining to have a bowel movement when you do not feel the need to go. The NIDDK recommends talking to your doctor about techniques for bowel retraining to help your body have bowel movements at more regular times of the day.

    Consider biofeedback. The guidelines for constipation management developed by AGMA say biofeedback — a type of therapy that can be used to help people learn to relax their pelvic floor muscles — can improve your bowel habits.

    Constipation may be a common symptom of hypothyroidism, but it’s also one you can proactively manage, even as you and your doctor work on improving your thyroid hormone levels.

    PMC

    Discussion

    A medical position statement from the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) recommends thyroid hormone evaluation in children only in cases of severe, refractory constipation, and in most cases prior to consultation with a pediatric gastroenterologist(2). At our institution, the majority of patients referred to our pediatric gastroenterology clinic for constipation have already tried unsuccessfully to manage the condition in conjunction with their pediatrician before referral. These children often have had symptoms for months or years prior to referral and might therefore be considered refractory (although, admittedly, the degree and duration of constipation in all children referred to our clinic was not assessed in this study). Even among this selected patient population, our data suggest that thyroid function tests are unlikely to be abnormal in the absence of other clinical indications or risk factors for hypothyroidism, such as concomitant growth failure, medications, or genetic predisposition (as in trisomy 21).

    This retrospective review is limited by the fact that only a small percentage of children with constipation who were seen in our office were tested for hypothyroidism (16.6%) and it is not clear if there is a difference between the tested and untested populations. For this analysis, we decided to assess all patients with thyroid testing, rather than patients with a specific diagnosis (such as constipation), to better understand the utility and practice patterns for thyroid hormone testing in a pediatric gastroenterology referral practice. We also did not make a prospective effort to identify children with recognized hypothyroidism or a family history of hypothyroidism, although it is anticipated that this would have been discussed as a routine part of our clinical care. Furthermore, it is possible that children who presented with constipation were identified as having hypothyroidism in their pediatrician’s office and were referred to endocrinology instead of to our gastroenterology office. This is likely to be uncommon, however, since very few of the children referred to our office for constipation have any thyroid testing prior to the office visit, although this was not assessed systematically in all patients. Despite these concerns, the very low incidence of hypothyroidism in our referral population suggests that testing for hypothyroidism in children who have constipation as their only symptom is unlikely to be helpful.

    Large-scale epidemiologic studies estimate that while 4.6% of the U.S. population has elevated TSH, only 0.3% of the population (including children) has clinically significant hypothyroidism(12). Assuming that our results are representative, the likelihood of identifying a new case of hypothyroidism among constipated children without other clinical indicators (in our population, approximately 0.2%, or 1/443) is no greater than the likelihood of finding children with hypothyroidism by random population screening (0.3%). The yield of thyroid testing improves when the denominator is changed: in patients with both constipation and slow growth, 2.5% (1/40) were hypothyroid; in patients with slow growth alone, 2.2% (2/93) were hypothyroid. Thus, our data suggest that while slow growth increased the likelihood that a child has hypothyroidism, the presence of constipation did not affect the likelihood that a child had hypothyroidism (P = 0.6, z–test, SigmaPlot 11). Furthermore, the financial cost of finding a single case of unrecognized hypothyroidism is high. Therefore, we question the wisdom of routine thyroid function testing in children with constipation unless there are other compelling clinical data to suggest the diagnosis.

    In conclusion, we have reviewed all thyroid tests ordered by our pediatric gastroenterology office over a 5 year period, and found that only a small proportion of those we tested whose symptom was isolated constipation had hypothyroidism (0.2%), while those evaluated for constipation with slow growth or slow growth alone were much more likely to be hypothyroid (2.5% and 2.2%, respectively). Identifying a single case of hypothyroidism over this time period in a child who presented with constipation alone cost at least $18,653. While it might be argued that this is a reasonable price to pay, constipation alone did not increase the likelihood of hypothyroidism above the population prevalence for this disease.

    Although there are some limitations to our analysis, our data suggest that careful consideration should be given when ordering free T4 and TSH concentrations in children with constipation without other clinical indicators of hypothyroidism. This question needs further investigation before these results can be applied, ideally with prospective observation of a large pediatric cohort.

    Synthroid (Levothyroxine) Side Effects & Adverse Reactions

    If you are still feeling extremely tired, and the onset of tiredness occurred after you started synthroid, it may be necessary to consider that your body doesn’t respond well to a synthetic chemical or this particular drug. You may want to discuss alternative options with your doctor. If no alternatives exist, your doctor may consider prescribing a eugeroic or wakefulness-promoting agent so that you don’t drift off to sleep throughout the day.

    Tremors: Some individuals notice that while using synthroid, they experience tremors or shakiness. Among those that experience tremors from synthroid, most are considered mild and do not cause significant functional impairment – they are relatively benign. They may occur most frequently in the hands and/or feet.

    If you are experiencing tremors from synthroid, these should be discussed with your doctor. It is possible that your dosage may need adjusting and/or that a different medication may reduce the occurrence of tremors. Additionally, prescription of an adjuvant medication may decrease tremors or shakiness.

    Weight changes: Most synthroid users experience some degree of weight change; sometimes significant and other times modest. Changes in weight are most common during the first several months of treatment, and as the body acclimates itself to the synthroid, weight changes often subside. However, many users report chronic, ongoing weight changes that persist throughout their entire term of treatment with synthroid.

    Synthroid is known to affect appetite, metabolism, gastrointestinal function, and possibly gut bacteria – in certain users. If synthroid is reducing your appetite, is ramping up your metabolism, and causing diarrhea – you’re likely going to lose some weight. If synthroid is making you insatiably hungry, causing food cravings, decreasing your energy, and interfering with your ability to exercise – it may cause some weight gain. (Read: Synthroid and Weight Gain).

    Although some weight loss is thought to be more common than weight gain among synthroid users – both have been reported. It is therefore important to avoid overgeneralizing that everyone taking this medication will experience exactly what you’ve experienced in terms of weight change; some users may fluctuate in the opposite direction. (Read: Synthroid & Weight Loss).

    Note: Understand that most users will not experience every single aforementioned synthroid side effect. If you have a question about a particular side effect that you’re experiencing while taking synthroid, consult a medical professional. Also realize that certain adverse reactions (e.g. chest pains and/or rapid heartbeat) may be caused by too much synthroid; consult your doctor if you have any signs of hyperthyroidism.

    Variables that influence Synthroid side effects

    If you’re taking synthroid, it is necessary to consider variables that influence the severity and number of side effects that you’re likely to experience. Influential variables include things like: synthroid dosage, co-administered drugs, term of administration, and time of dosing. Although the dosage may be the most influential variable, all variables should be contemplated if you’re experiencing side effects from synthroid.

    1. Synthroid Dosage (Sensitivity)

    The dosage of synthroid taken on a daily basis can have a profound effect on whether you’re likely to experience unwanted side effects. Dosing with synthroid needs to be as precise as possible to avoid side effects and severe adverse reactions. Individuals prescribed synthroid at suboptimally high levels are the most likely to experience noticeable, unwanted side effects.

    There are many problems associated with too much synthroid. Since synthroid is an exogenous form of thyroxine (T4) hormone, ingesting too much synthroid could lead to side effects resembling hyperthyroidism. Furthermore, synthroid is also “synthetic” and not bioidentical, which in turn could increase propensity of adverse reactions solely based on the lack of biological compatibility, especially at high doses.

    Low-dose synthroid users are less likely to experience side effects from the medication and more likely to still experience symptoms of hypothyroidism (or another condition being treated with synthroid). At lower doses, it is easier for the body to accommodate the non-bioidentical, synthetic material and tolerate some hormonal stimulation. That said, when a certain threshold of hormonal stimulation is surpassed with high-dose synthroid – side effects are virtually guaranteed.

    Note: Medical professionals should be aware of the fact that synthroid and levothyroxine-based medications are narrow therapeutic index (NTI) agents. If the dosing is improperly calibrated even slightly, you may experience adverse effects. Be sure to work with a doctor that prescribes the minimal necessary amount for an optimal TSH level.

    • Source: https://www.synthroid.com/medication/check-your-pill
    1. Co-administered substances

    If you’re solely taking synthroid (and no other medications or supplements), you won’t need to consider this variable as influencing your side effects. However, if you’re taking synthroid and a cornucopia of pharmacological and/or supplemental agents – it is necessary to consider that there may be interactions. Something as simple as taking a multivitamin along with synthroid is known to decrease its effect, which could lead to suboptimal therapeutic outcomes and/or an increased incidence side effects.

    Prior to taking another drug and/or supplement with synthroid, discuss potential contraindications with a medical professional. If you’ve been taking synthroid along with another medication and/or supplement, but weren’t specifically instructed to do so by your doctor, it could be that the simultaneously administered combination triggered side effects. You may also want to consider whether the co-administered substances have synergistic and/or antagonistic neurophysiological effects.

    For example, someone taking synthroid along with a psychostimulant (e.g. Adderall) may find that the combination synergistically provokes anxiety, heart palpitations, and side effects associated with overstimulation; this may be especially noticeable if synthroid dosage is too high. On the other hand, some drugs and/or supplements may be helpful when taken on the same day as synthroid. For example, individuals experiencing hypertension may benefit from taking a beta blocker along with synthroid to reduce blood pressure.

    Always realize that co-ingested substances can either cause contraindications (interactions), as well as potentiate or mitigate various neurophysiological responses to synthroid. Be sure to review the dosages of the co-administered substances as well as times of administration with a medical doctor to minimize likelihood of interaction-based side effects.

    1. Term of administration

    The cumulative term of synthroid administration may also affect the side effects that you’re likely to experience during treatment. Some side effects that you experience during a short-term (e.g. first few weeks of treatment) may subside over a moderate and/or longer-term of treatment. On the other hand, some side effects that may have been nonexistent over a short-term, may only emerge after an extended, long-term of synthroid treatment.

    Short-term: Nearly everyone experiences some side effects when they first start taking synthroid (and many other medications). Side effects are often most prominent during the first few weeks of treatment. For example, you may notice hair thinning and/or loss, mood changes, and nervousness over the short-term.

    However, many of these short-term effects diminish and/or subside with continued treatment. A reason many short-term side effects subside is because a user’s neurophysiology has adapted to the synthroid. Additionally, the doctor will have had adequate time to pinpoint a precise synthroid dosage for optimal TSH levels.

    Moderate term: After several months of treatment, many short-term side effects begin to diminish. You may notice less hair loss (or that your hair is no longer thinning), your mood and energy has improved, etc. At this point the doctor is likely to have precisely calibrated your synthroid dose and your neurophysiology may have adjusted to the medication.

    You may still experience some unwanted side effects, but many short-term side effects will have improved. However, you may also notice the onset of some new side effects that didn’t occur during the short-term. The emergence of new side effects should be carefully monitored, as they may progressively worsen with continued treatment.

    Long-term: Over an extremely long-term (e.g. years) of treatment, many synthroid users find that short-term side effects have completely subsided and that they can tolerate the medication well. However, some side effects that they had never experienced over short/moderate terms may emerge. At this point, it may be difficult to confirm with 100% certainty that the synthroid is the cause of the side effects.

    Many people find it difficult to distinguish long-term side effects of synthroid from normal aging. You may notice the onset of achy joints, swelling, memory problems, cognitive deficits, and/or weight changes. Since the long-term effects of synthroid aren’t well documented in scientific literature, most medical professionals assume that these problems are a result of lifestyle issues rather than from the medication; and in some cases it may be a combination of both.

    1. Dosing specifics

    Medical documentation indicates that synthroid is to be administered as a single dose, once daily. This dose is suggested to be administered in the morning, at least 30-60 minutes prior to eating breakfast. Additionally, synthroid is recommended to be taken at least 4 hours prior to any other drugs or supplements, especially those that are known to interfere with its absorption.

    If you’ve been taking synthroid along with food and/or later in the day than is medically recommended, it may decrease the likelihood that you’ll attain therapeutic benefit. Time of synthroid dosing is of critical importance not only to ensure that synthroid is properly absorbed, but to minimize likelihood of side effects and/or interactions. To decrease propensity of side effects related to dosage timing, synthroid is recommended to be taken at the exact same time each day.

    Synthroid (Levothyroxine): Do the benefits outweigh the side effects?

    If you’ve been taking synthroid, it is necessary to track whether the therapeutic benefits attained from the medication outweigh side effects and adverse reactions. A subset of synthroid users may be unable to tolerate the medication as a result of severe adverse effects experienced while taking the drug. For these individuals, it will be obvious that their neurophysiology cannot handle the synthroid and a change of thyroid medication will be necessary.

    On the other hand, another subset of synthroid users may experience no significant side effects. They may find that synthroid successfully keeps their TSH level within a healthy range and significantly improves their physical and mental energy. For those that derive nothing but benefit from synthroid without any significant side effects – continued usage is a “no brainer.”

    Most synthroid users will fall in between the extremes of “intolerability” and “optimal tolerability.” You may find that synthroid treats your hypothyroidism, but also causes dry skin, moodiness, and modest weight changes. Assuming that the medication is effectively treating your medical condition with just a few unwanted side effects, it is usually worth continuing.

    However, if after taking synthroid you’re getting some therapeutic benefit, but you also experience: severe brain fog, fatigue, depression, and anxiety from the medication – discontinuation and/or an alternative medication may be warranted. Overall functionality should be improved as a result of taking synthroid – not further impaired. Remember that while your doctor prescribed this medication because he/she believes the benefits are likely to outweigh the side effects – not everyone responds favorably to this treatment.

    It is ultimately a personal decision as to whether you’d like to continue taking synthroid, switch to another medication, and/or alternative intervention. You may find it helpful to keep a journal of your entire synthroid treatment to determine how you feel over a long-term span, rather than being prisoner to short-term, transient, or moment-by-moment side effects. If you feel as if synthroid isn’t a good fit for your neurophysiology, discuss this with your doctor.

    Possible ways to reduce Synthroid (Levothyroxine) side effects

    If you’re taking synthroid and experiencing unwanted side effects, below are some side effect mitigation strategies that you may wish to implement. Prior to implementing any of these strategies, consult a medical professional to verify efficacy and safety. Examples of some strategies for reducing unwanted synthroid side effects include: dosage recalibration, review dosing instructions, continue using, and/or revision of adjunct agents.

    1. Dosage recalibration

    If the dosage of synthroid that you’re taking is too low, you run the risk of experiencing symptoms of hypothyroidism (or the condition being treated with synthroid). On the other hand, if the dosage of synthroid is too high, side effects may be extremely likely. The goal of your doctor should be to determine the minimal effective dose of synthroid to normalize your TSH levels.

    Synthroid is a medication with a NTI (narrow therapeutic index), and as such, if the dosage is slightly “off” – unnecessary side effects may ensue. Have your doctor reassess your synthroid dosage and reevaluate your TSH plus other thyroid parameters. If your doctor determines that your dosage was too high, a reduction may mitigate various synthroid side effects.

    1. Review dosing instructions

    Instructions for dosing with synthroid should be reviewed prior to initial administration. Many people taking synthroid listen to their doctor’s dosing instructions, as well as those given by a pharmacist, but fail to actually implement them. Time of dosing as well as whether synthroid is taken without food – are important factors that affect therapeutic response rates and side effects.

    Synthroid is recommended to be taken at least 30 to 60 minutes before breakfast in the morning. If you’re experiencing side effects from taking synthroid 30 minutes before breakfast, you may need to increase the gap between synthroid ingestion and food consumption to 60 minutes. Additionally, if you’ve been somewhat inconsistent in timing of administration – this could increase side effects.

    Be sure that you’re taking synthroid on an empty stomach, as a standalone agent (without other medications unless instructed by your doctor), at a precise time each morning, and at least 30 to 60 minutes before consuming food. Following these exact dosing instructions may prevent certain side effects from occurring and maximize likelihood of therapeutic efficacy.

    1. Continued usage

    In many cases, side effects experienced when starting synthroid will diminish and/or subside after several weeks (or months) of treatment. When any new exogenous medication is introduced to the body, it disrupts homeostatic processes and can trigger side effects. However, with continued administration and dosage calibration, a user’s neurophysiology adapts to the presence of synthroid and side effects (e.g. hair loss) subside after several months.

    If you’ve been using synthroid for under 3 months, side effects are common and to be expected. However, if you’ve been using synthroid for considerably longer than 3 months (e.g. 1 year) and they are difficult to cope with, you may need to switch thyroid medications, consider adjunct medications to offset the side effects, and/or discontinue treatment. Always discuss the severity of synthroid-related side effects with your doctor.

    1. Revise adjunctive agents

    If you’re taking other drugs and/or supplements along with synthroid, it is understood that these could either: interact with synthroid, potentiate synthroid-related side effects, or offset synthroid side effects. Discuss potential medication contraindications with your doctor, as well as side effects that could be caused by potentiation of synthroid-induced neurophysiological effects. Assuming synthroid is being administered at an optimal dose, other agents aren’t administered for at least 4 hours after taking synthroid, and there aren’t any contraindications – interaction side effects are unlikely.

    However, you will want to work with your doctor to determine whether certain medications and/or supplements could be beneficial to eliminate from your current regimen. It may turn out that the side effects you thought were from synthroid, were actually from another co-administered substance. That said, your doctor may also recommend adding another medication and/or supplement to your regimen to counteract synthroid-induced side effects (e.g. an antihypertensive agent to treat hypertension and/or nervousness); be open to these recommendations as they may help significantly with side effects.

    Have you experienced Synthroid side effects?

    If you’ve taken synthroid, share a comment mentioning whether you’ve experienced significant and/or noticeable unwanted side effects. Document the particular side effects as well as their respective severities (on a scale of 1 to 10) and mention when you first noticed them during your treatment. If you’re a short-term user, it is important to realize that many side effects will diminish and/or completely subside after several months of treatment.

    However, if you are a longer-term user, leave a comment noting whether any side effects have lingered throughout your treatment and/or emerged over a long-term of administration. To help others get a better understanding of your situation, share some details such as: the condition you’re treating with synthroid (e.g. hypothyroidism), your current dosage, other medications and/or supplements that you take, your time of synthroid dosing, etc.

    For those that have experienced side effects from synthroid, share any strategies you’ve found beneficial for reducing them (e.g. using another medication). Understand that if you’re experiencing severe side effects from synthroid, you may want to consider alternative pharmaceutical options, bioidentical hormones, and/or correcting the underlying causes of your underactive thyroid (e.g. stress, diet, environmental toxins, etc.). Not everyone can tolerate synthroid and it should not be considered a utopian hormonal intervention; no medication is an optimal fit for every user.

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    Synthroid

    Medical Editor: Charles Patrick Davis, MD, PhD

    Last reviewed on RxList 3/13/2018

    Synthroid (levothyroxine sodium) is a synthetic compound identical to T4 (levothyroxine) produced by the human thyroid gland used to treat hypothyroidism due to many causes (for example:

    • thyroid removal,
    • thyroid atrophy,
    • functional T4 deficiency,
    • radiation treatment of the thyroid,
    • and other causes).

    Synthroid is also used for pituitary TSH suppression. Synthroid is available in generic form. Common side effects of Synthroid include:

    • fever,
    • hot flashes,
    • sensitivity to heat,
    • sweating,
    • headache,
    • nervousness,
    • irritability,
    • nausea,
    • sleep problems (insomnia),
    • changes in appetite or changes in weight,
    • changes in menstrual perdiods,
    • and temporary hair loss.

    Notify your doctor if you experience serious side effects of Synthroid including rapid heartbeat, fluttering in your chest, or chest pain.

    Synthroid is prescribed in tablets that range from 25 to 300 mcg in strength and is usually taken once a day with a full glass of water (about 8 ounces) 30 to 60 minutes before breakfast for best adsorption into the body. Children can take the medicine if the tablet is crushed and put into about 1 to 2 teaspoons of water; do not store or delay giving this crushed pill suspension. Doctors often may have to slowly increase the dose; patients should not increase or decrease this medication themselves. Because some preparations of the drug may contain iodine or lactose, patients should tell their doctors about such allergies or reactions to these components. Many drugs can inhibit Synthroid’s adsorption by the body; other medications may increase or decrease its effectiveness once it is adsorbed. Providing a complete list of medications to the doctor will help with getting the correct dose established for each individual patient. Pregnant and lactating females need to discuss the dose and use of this medication with their caregivers.

    Our Synthroid Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

    This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

    Welcome to the Holistic Wellness Center of the Carolinas – Research Based Functional Wellness

    It doesn’t just make newborns and Grandpa grumpy—constipation is a serious digestive issue that can significantly impact your health, and is common among those with Hashimoto’s hypothyroidism. Conventional medicine defines constipation as having hard stools with a bowel movement fewer than three times per week, and severe constipation as less than once a week. In functional medicine, however, good elimination is having one to three healthy bowel movements per day. Although harsh laxatives can override constipation, it’s best to address the underlying causes for lasting success.

    Hypothyroidism and constipation

    Constipation is a very common symptom of hypothyroidism, which slows down the body’s metabolism. Because conventional lab ranges to diagnose hypothyroidism are so broad, many people with low thyroid function are misdiagnosed. If you have thyroid symptoms, you should screen for hypothyroidism from a functional blood chemistry perspective, which includes evaluating for Hashimoto’s, an autoimmune thyroid disease that attacks and destroys the thyroid gland. Hashimoto’s is the most common cause of hypothyroidism today and requires autoimmune management.

    Why constipation is hard on the body

    Regular bowel movements are the body’s way of eliminating toxins, metabolized hormones, and waste from your body. When you’re constipated these compounds sit idle in the intestines and are absorbed back into the bloodstream for circulation. This can sap energy, make you more cranky, hinder the ability of your body to function optimally, and increase health risks such as for heart disease.

    Fecal matter sitting immobile in the digestive tract promotes an overgrowth of harmful bacteria and yeast. This creates inflammation in the gut and other digestive symptoms, such as gas, bloating, pain, allergies, and food sensitivities. Yeast overgrowths also promote itchy skin, vaginal yeast infections, fungal infections, and more.

    Constipation is also uncomfortable, if not painful. It makes people feel heavy and bloated, sometimes causing abdominal cramps, hemorrhoids, or anal fissures.

    Nutrition and constipation with Hashimoto’s hypothyroidism

    For some people, the cause of constipation is pretty straightforward and easy to address. They simply need to eat a whole foods diet rich in fiber and stay sufficiently hydrated. For people used to eating a diet heavy in fast foods, consuming plenty of vegetables and fruit can significantly improve bowel function.

    Nutritional support, such as with essential fatty acids, vitamin D, and quality vitamins and minerals, can also promote healthy bowel function.

    Probiotics are another powerful tool. Many people suffer from an overgrowth of harmful bacteria and not enough beneficial bacteria in the gut, which can contribute to constipation. Often boosting beneficial bacteria with probiotics or fermented and cultured foods can support healthy elimination.

    All of these tools also help manage autoimmune Hashimoto’s hypothyroidism.

    Food intolerances, leaky gut, constipation, and Hashimoto’s hypothyroidism

    Sometimes the root cause of constipation requires more sleuthing. The best place to start is with gut health and hidden sources of inflammation, as constipation can be a symptom of inflammation in the gut. Finding an undiagnosed food intolerance, such as to gluten, dairy, corn, or egg, is all it takes to relieve constipation for some. For instance, many people have found eliminating gluten from their diet significantly improves gut health and bowel function. After removing inflammatory foods from your diet, you may also need to dampen gut inflammation and repair a leaky gut with the support of clinical nutrition.

    This is also an important foundation in managing Hashimoto’s hypothyroidism.

    Brain health and constipation

    The digestive tract has a nervous system much like the brain’s, and the gut and the brain are very intimately connected. Many people suffer from an imbalance in neurotransmitters, chemicals that relay messages between neurons. These imbalances can not only affect mood, memory, and well-being, but also digestive functions and can play a role in constipation. Whenever a gut issue becomes chronic, one should take steps to investigate and support brain health.

    Contact our office here in Charlotte, NC for more information or to book an appointment with one of our natural medical practitioners : (704) 308-2557

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