Expert Advice

Tips to Manage Stubborn Hypothyroid Constipation

Acella Pharmaceuticals is partnering with Nicole German Morgan, RDN, LD, CLT, to bring greater awareness to the importance of thyroid care and education. This post is sponsored by Acella Pharmaceuticals.

Disclaimer: The information provided is for educational purposes only and does not substitute professional medical advice. Consult a medical professional or healthcare provider before beginning any exercise, fitness, diet, or nutrition routine. Acella Pharmaceuticals does not endorse, promote or sponsor any products or brands mentioned in this article. The views expressed here are those of the author.

If you are living with hypothyroidism and experiencing constipation, you should address correcting your thyroid levels with your doctor as it may be the root cause of your symptoms. There is increasing evidence that there is a connection between the gut microbiome and thyroid function.1,2 In my practice I often see hypothyroid patients present with gut or digestive concerns, including constipation.

There are several measures that may help heal the gut, from lifestyle adjustments to foods and nutritional swaps that can help improve digestion.

Assess Your Fiber Intake

The Dietary Guidelines for Americans reports that over 90% of women and over 97% of men do not get enough fiber each day.3 Did you know that fiber from food helps to promote the growth of good bacteria? A high fiber diet is one way to promote more regular bowel movements. For most people, I recommend fiber intake to support a healthy microbiome. While the amount of fiber may vary from person to person, 25 to 35 grams of fiber is generally optimal.3

First, spend a day or two recording what you eat and counting the grams of fiber you eat per day to see how you are doing. Slowly increase the fiber in your diet, as it takes time for the body to adjust. I suspect that over time an increase in fiber may lead to a better balance of bacteria in the intestinal tract and likely less constipation.

Move Your Body

Regular movement is a great way to promote bowel regularity. If you are already active, more exercise will likely not lead to more bowel movements. Research seems to only show better bowel movements in those who were inactive to begin with and then began a new exercise regimen.4 In addition, check with your doctor or healthcare provider before beginning a new exercise regimen.

Add Supportive Foods

Many of these foods and drinks for constipation prevention are still debated in research. But, the options are often gentle enough that it is worth a try to see if you feel they are supportive.

One of my favorite foods to add for constipation relief is ginger. Ginger may improve the motility (the movement and flow) of the digestive tract.5 Ginger may even help the stomach empty, which is an excellent addition for those who suffer from hypothyroidism, as digestion is often a little sluggish.5

Another option is to try more hot liquid beverages, such as hot tea or warm water with lemon and honey. These hot beverages may also support more gastric motility.6,7

Some additional higher-fiber foods you can try are oats, popcorn, artichokes, beans, peas, lentils, sweet potatoes, Brussels sprouts, jicama, broccoli, avocado, raspberries, blackberries, coconut, pumpkin seeds, chia seeds, and more!

Over-the-Counter Options for Constipation

Sometimes probiotics, herbal supplements, magnesium citrates, or fiber powders may be beneficial short-term for constipation relief. However, it is important to work with your healthcare provider to find which supplement option may be better for you. We want to ensure that supplements are safe and effective and that they do not make the constipation worse.

Constipation is often a vicious cycle. Once we can create regular bowel movements and find the root cause of the issue, we can find relief. Hopefully, some of these insights can lead you in the right direction and give you some tips to discuss with your healthcare provider.

REFERENCES: 1. Knezevic, J., Starchl, C., Tmava Berisha, A., & Amrein, K. (2020). Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?. Nutrients, 12(6), 1769. 2. Fröhlich, E., & Wahl, R. (2019). Microbiota and Thyroid Interaction in Health and Disease. Trends in endocrinology and metabolism: TEM, 30(8), 479–490. 3. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. 4. De Schryver AM, Keulemans YC, Peters HP, et al. Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scandinavian Journal of Gastroenterology. 2005;40(4):422-429. doi:10.1080/00365520510011641. 5. Wu KL, Rayner CK, Chuah SK, et al. Effects of ginger on gastric emptying and motility in healthy humans. European Journal of Gastroenterology & Hepatology. 2008;20(5):436. doi:10.1097/MEG.0b013e3282f4b224. 6. Pooja M, P.M. S, Jeenath Justin DK. A Study to assess the effectiveness of Honey Warm Water on level of Constipation among patients undergone CABG with Constipation in selected Hospitals at Rajkot. Asian Journal of Nursing Education and Research. 2019;9(4):542-544. doi:10.5958/2349-2996.2019.00116.2. 7. Mishima Y, Amano Y, Takahashi Y, et al. Gastric emptying of liquid and solid meals at various temperatures. J Gastroenterol. 2009;44(5):412-418. doi:10.1007/s00535-009-0022-1


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Important Risk Information

Drugs with thyroid hormone activity, alone or together with other therapeutic agents, have been used for the treatment of obesity. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects.
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  • Use of NP Thyroid® in patients with diabetes mellitus or adrenal cortical insufficiency may worsen the intensity of their symptoms.
  • The therapy of myxedema coma requires simultaneous administration of glucocorticoids.
  • Concomitant use of NP Thyroid® with oral anticoagulants alters the sensitivity of oral anticoagulants. Prothrombin time should be closely monitored in thyroid-treated patients on oral anticoagulants.
  • In infants, excessive doses of NP Thyroid® may produce craniosynostosis.
  • Partial loss of hair may be experienced by children in the first few months of therapy but is usually transient.
  • Adverse reactions associated with NP Thyroid® therapy are primarily those of hyperthyroidism due to therapeutic overdosage.
  • Many drugs and some laboratory tests may alter the therapeutic response to NP Thyroid®. In addition, thyroid hormones and thyroid status have varied effects on the pharmacokinetics and actions of other drugs. Administer at least 4 hours before or after drugs that are known to interfere with absorption. Evaluate the need for dose adjustments when regularly administering within one hour of certain foods that may affect absorption.
  • NP Thyroid® should not be discontinued during pregnancy, and hypothyroidism diagnosed during pregnancy should be promptly treated.


NP Thyroid® (thyroid tablets, USP) is a prescription medicine that is used to treat a condition called hypothyroidism from any cause, except for cases of temporary hypothyroidism, which is usually associated with an inflammation of the thyroid (thyroiditis). It is meant to replace or supplement a hormone that is usually made by your thyroid gland.

NP Thyroid® is also used in the treatment and prevention of normal functioning thyroid goiters, such as thyroid nodules, Hashimoto’s thyroiditis, multinodular goiter, and in the management of thyroid cancer.
Revised 10/2023