Hypothyroidism with constipation help? - Thyroid UK

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Hypothyroidism with constipation help?

Giraffes profile image
13 Replies

On 50mcg to 75mcg levothyroxine, been on the same for 8 years.

Problems with constipation and gut absorption. I am on a low fiber diet due to having hiatus hernia surgery. Wheat and lactose allergy. Anyone else with IBD problems too, advise on best control of my constipation, please??

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Giraffes
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13 Replies
jsy_girl profile image
jsy_girl

Hi giraffes. That’s so miserable sorry to hear that. I can see you were given lots of advice 3 months before about:

Ensuring your thyroid results are optimal and whether there was room to increase your dose

Making sure your vitamins were in the optimum range

Taking magnesium citrate

Taking vitamin C

Drinking a lot more water (3litres)

Potential dietary changes within the confines of your medical history.

Did any of these work out? Do you have your blood results to share for thyroid / vitamins?

Giraffes profile image
Giraffes in reply to jsy_girl

Hi jsy_girl, I think you are defo correct about getting more blood test done. Used medicheck before, but they all need you to be two weeks without medication and vits to get best results.May be I need to bite the situation and get them done again. Thanks for advice.

jsy_girl profile image
jsy_girl in reply to Giraffes

Hello - depends on what you want to see. If you want to see how they are for what you are currently supplementing you don’t need to wait 2 weeks.

I follow this approach:

Stop biotin 5-7 days before

Take D , B12 and folate up to the day before

Baseline b12 requires 4-5 months

Stop iron 7 days before

Definitely worth seeing where you are with your levels as it may not be helping your conversion to T3 which in turn may be impacting the constipation. :)

Giraffes profile image
Giraffes in reply to jsy_girl

Sounds like a plan I can go with. Thanks

Sybilla14 profile image
Sybilla14

Have you tried supplements like magnesium citrate or vitamin C (ascorbic acid), for example or eating fermented foods? I cannot tolerate magnesium citrate myself but it is generally recommended for bowel movements. I take 4,000mg of ascorbic acid daily (in 2-3 doses) and find it helps with regularity without causing discomfort. I also make my own sauerkraut and kimchi and they have done wonders for my digestion.

Giraffes profile image
Giraffes in reply to Sybilla14

Wow! Sybilla your own sauerkraut would love the recipe. I am on mag and vit c, d bit complex zinc as well.All for natural remedies too!

Sybilla14 profile image
Sybilla14 in reply to Giraffes

It’s actually quite simple! All you need is to very thinly slice the cabbage (I use organic) and then rub it with salt - 20g of salt to 1kg of cabbage. Let it sit in a bowl for an hour or so and then transfer it into a fermentation jar, I bough a Lakeland one from Amazon. Pack it on very tightly and top up with salt water (water weight in grams x 0.025= salt in grams) so it is all submerged. You need to keep it in warmish and dark place for about a week and press it down every day as the bits above the water can spoil. Once it’s fermented and tastes yummy put in the fridge, it will keep for a couple of weeks or so. I eat some every evening and have to pace myself 🙂

Giraffes profile image
Giraffes in reply to Sybilla14

Add cabbage to my shopping list, thank you so muchx

SlowDragon profile image
SlowDragonAdministrator

First step is to get FULL thyroid and vitamin testing done

As per previous post

75mcg levothyroxine is only one step up from starter dose.

Are you on lactose free diet

healthunlocked.com/thyroidu...

Calm vitality magnesium powder is cheap and easy to use and helps improve constipation. Any magnesium must be four hours away from levothyroxine. Best taken afternoon or evening

guidelines on dose levothyroxine by weight

Even if we don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

Giraffes profile image
Giraffes in reply to SlowDragon

Thanks Slowdragon, amazing research to study, will go though this and then I can use this to take to my GP to get the help I obviously need.Let's hope it will resolved soon. Thanks.

humanbean profile image
humanbean

One thing I've found helpful is Triphala - easily found on Amazon, Ebay and on supplement websites. Some manufacturers add other things to the Triphala, for example psyllium husk and linseed, but I avoid those and take only the Triphala alone.

I also take magnesium citrate and vitamin C every day.

Please do your own research and decide for yourself if it is safe for you. The product I bought suggests a dose of 1 - 2 capsules, once or twice a day. I've never taken more than 2 in a day, and after things started moving I cut down to 1 a day. At the dose I use it (a very cautious dose) I don't get diarrhoea, but it can take a while to work at the start - it took about 3 days to get a result but it has continued working since then.

Giraffes profile image
Giraffes

Thanks humanbean. Will do some research on this fab product and give it a go. Your support is great to have.

milkwoman profile image
milkwoman

Liquid magnesium citrate works very well for me. In the US, this is available at the local pharmacy in several flavors (grape, lemon lime, cherry). Comes in 8 oz bottles and I drink 2-3 oz before bedtime (not every night - only as needed). I’ve also drunk it when I feel I’m having issues (abdominal discomfort and cannot poop). It’s very gentle on the system and gets things going within a couple hours.

I also eat dried plums (aka prunes) to help keep things regular.

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