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April 25, 2023 7 min read

Levothyroxine is a common medication used to treat hypothyroidism, a condition in which the thyroid gland does not produce enough thyroid hormones. While the medication effectively manages hypothyroidism symptoms, some patients may experience side effects, such as constipation. This has led many people to wonder whether levothyroxine can cause constipation and what they can do to manage this potential side effect. So, let us help answer your question. Read on!

Understanding Hypothyroidism and Levothyroxine

Hypothyroidism, or underactive thyroid, is a thyroid disease in which the thyroid gland produces inadequate amounts of thyroid hormones, particularly thyroxine (T4) and triiodothyronine (T3). These hormones play a critical role in regulating metabolism, growth, and energy production, among other processes. Levothyroxine, a synthetic form of thyroxine (T4), is a commonly prescribed medication to treat hypothyroidism by replenishing the deficient hormones and restoring hormonal balance.

What is constipation?

Constipation is a common digestive problem that is characterized by fewer bowel movements and difficulty passing stool. It's generally defined as having fewer than three bowel movements per week. In addition to infrequent bowel movements, constipation can also cause other symptoms such as abdominal discomfort, bloating, and straining during bowel movements.

There are many potential causes of constipation, including a low-fiber diet, dehydration, lack of physical activity, certain medications, and medical conditions such as hypothyroidism. Additionally, some people may also be more prone to constipation due to factors such as age, pregnancy, or a history of bowel problems. Constipation is also a common symptom of hypothyroidism.

How does hypothyroidism cause constipation?

Thyroid hormones play a crucial role in maintaining gut health, as they regulate digestion and gastrointestinal motility throughout the digestive tract. When there is a deficiency of these hormones due to hypothyroidism, it can disrupt the normal functioning of the digestive system, leading to various digestive issues.

Under normal circumstances, the muscles in the colon contract rhythmically to propel waste toward the rectum. Simultaneously, the colon absorbs water from the waste to form solid stools for elimination. However, an insufficient amount of thyroid hormones can impede the functionality of the digestive tract and reduce muscle contractions in the colon. This leads to fewer bowel movements and, consequently, constipation.

An imbalanced thyroid gland can also give rise to a range of other digestive problems, such as bloating, diarrhea, and irritable bowel syndrome (IBS). Moreover, research indicates that people with hypothyroidism may also have higher rates of a condition called small intestinal bacterial overgrowth (SIBO). This condition occurs when there is an excessive amount of bacteria in the small intestines, leading to malabsorption of nutrients, inflammation, and further gastrointestinal symptoms.

Can levothyroxine cause constipation?

Levothyroxine is not commonly known to cause constipation. Instead, it aims to alleviate constipation by normalizing thyroid hormone levels and promoting healthy digestion. However, in some cases, patients taking levothyroxine may still experience constipation.

Why are you still constipated despite levothyroxine, and what can you do about it?

There are several reasons why you're still constipated despite taking levothyroxine. Here are some of the possible reasons:

1. Incorrect dosage

Finding the correct dosage of levothyroxine is crucial for effectively managing hypothyroidism. Under-dosing can result in various side effects, including constipation. Talk to your doctor if you feel like your dose is not optimal. They'll likely order a thyroid-stimulating hormone (TSH) test to assess your thyroid hormone levels. It's important not to adjust your dose without talking to your doctor first. This is because too high of a dose can lead to an overactive thyroid (hyperthyroidism), which isn't good for your health.

2. You just started taking levothyroxine

Levothyroxine may take some time to treat hypothyroidism and fully restore normal thyroid hormone levels in the body, which means that constipation may persist until the medication takes full effect. In this case, the best thing to do is be patient. If you've been taking the medication for 4 to 6 weeks and you're still constipated, talk to your doctor.

3. You're not taking levothyroxine correctly

Another possibility is that you may not be taking the medication correctly, such as not taking it consistently or not following the instructions provided by your doctor.

4. Levothyroxine may not be right for you

As frustrating as it sounds, levothyroxine is not for everyone. If you've been experiencing constipation since you started levothyroxine, then this synthetic medication may not be the most appropriate choice for you. Thankfully, there are other thyroid hormone replacement options you can consider.

Natural Desiccated Thyroid (NDT) is a popular alternative to levothyroxine. Many people find NDT to be more effective since it contains both T4 and T3 thyroid hormones instead of just T4, like levothyroxine. NDT is also popular among people who prefer a more natural approach to their treatment since it's derived from desiccated pig thyroid.

One great NDT to try is VitaliThy. This NDT Supplement is available to buy online, making it easy for you to get your hands on it.

5. Allergic reaction to inactive ingredients

In rare cases, some patients may have an allergic reaction to levothyroxine or its inactive ingredients, such as lactose or gluten. Allergic reactions can cause various symptoms, including gastrointestinal issues.

VitaliThy, a natural desiccated thyroid you can buy online, is a great option if you're allergic to levothyroxine. VitaliThy is free from common allergens like lactose and gluten. Plus, it's free from fish, shellfish, and eggs, as well as artificial coloring and flavoring.

6. Other medications or supplements

Certain medications or supplements can interfere with the absorption of levothyroxine, leading to reduced effectiveness and the persistence of hypothyroid symptoms, including constipation. Always discuss your current medications and supplements with your healthcare provider to identify potential interactions.

7. Underlying medical conditions

In some cases, constipation may not be caused by hypothyroidism. So taking levothyroxine won't relieve it. There may be underlying medical conditions, such as irritable bowel syndrome or intestinal obstruction, that can cause constipation and may require additional evaluation and treatment.

8. Unhealthy lifestyle

Factors such as diet, hydration, and physical inactivity can also affect bowel movement. For example, a low-fiber diet, dehydration, and a sedentary lifestyle can all contribute to constipation, even in the presence of normal thyroid hormone levels.

What lifestyle changes can you do to relieve constipation and increase thyroid function?

The following lifestyle changes may help increase your thyroid function and relieve constipation.

1. Diet for better bowel habits

Making some dietary and lifestyle changes may help to increase your thyroid function, relieve constipation, and improve your gut health. Here are some tips for a diet that promotes better bowel habits:

The role of fiber in regulating bowel movements

Fiber plays an important role in regulating bowel movements by adding bulk to the stool and helping it move through the digestive system more easily. When we eat high-fiber foods, they absorb water and swell in the intestines, which makes the stool softer and easier to pass.

Types of fiber and their effects on the digestive system

There are two types of fiber: soluble and insoluble. Soluble fiber dissolves in water and forms a gel-like substance in the intestines, while insoluble fiber does not dissolve in water and adds bulk to the stool.

Both types of fiber can help promote regular bowel movements. Soluble fiber helps to soften stools and make them easier to pass, while insoluble fiber adds bulk to the stool, which can help stimulate bowel contractions and move waste through the small intestine and large intestine more quickly.

Foods high in fiber and how to incorporate them into your diet

Here are some high-fiber foods and tips on how to incorporate them into your diet to treat constipation:

  • Fresh fruits: Apples, pears, bananas, and berries are all high in fiber and can help relieve constipation. Eat them with the skin on them for maximum fiber intake.

  • Vegetables: Leafy greens, carrots, and sweet potatoes are all great sources of fiber. However, it's best to avoid cruciferous vegetables as they may not be helpful for your thyroid gland.

  • Legumes: Beans, lentils, and chickpeas are all high in fiber and can be added to soups, stews, and salads.

Tips for increasing fiber intake without disrupting thyroid medication absorption

If you're taking thyroid medication, it's important to be aware that certain high-fiber foods can interfere with their absorption. However, there are still ways to increase your fiber intake without disrupting your medication. Here as follows:

  • Time your fiber intake: Take your medication on an empty stomach for at least 30 minutes before eating high-fiber foods. This allows time for the medication to be absorbed before the fiber enters your digestive system.

  • Consider fiber supplements: Fiber supplements such as psyllium husk can be a good way to increase your fiber intake without consuming too much fiber from food sources.

2. Increase your water intake

Increasing your water intake can help prevent constipation and promote better digestive health. Dehydration can contribute to chronic constipation by making the stool harder and more difficult to pass.

There isn't a specific amount of water that is needed to prevent constipation. However, a general guideline is to drink at least 8 cups (1.9 liters) of water per day to help maintain good hydration levels and promote regular bowel movements.

3. Exercise and physical activity for bowel health

Did you know that regular exercise and physical activity can help improve your bowel health? Exercise can help stimulate the muscles in your intestines, which can help move stool through your digestive system more easily.

Studies have shown that individuals who engage in regular physical activity have a lower risk of developing constipation and other bowel-related disorders. This is because exercise can help improve overall bowel function, including bowel motility and transit time.

Conclusion: Levothyroxine can cause constipation in some hypothyroid patients

In conclusion, while levothyroxine is an effective treatment for hypothyroidism, it can cause constipation in some individuals. Therefore, it's important for you to be aware of this potential side effect and take steps to manage your symptoms, such as increasing your fiber and water intake, engaging in regular physical activity, and working with your healthcare provider to adjust your medication dosage if necessary. And if you find that levothyroxine is not the best medication for you, there are always better alternatives available, like the NDT supplement VitaliThy.

Wojciech Majda
Wojciech Majda


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