September 20


Had enough of Hashimoto’s Constipation? How to relieve it…

By Amy Vespa, MS - Integrative Clinical Nutritionist

September 20, 2021

minutes read time


Constipation is a common and frustrating issue for many women. Especially older women or women with Hashimoto’s. It’s estimated that 20% of US adults suffer from constipation at some point. And millions of doctors visits are related to constipation. 

What can you do to relieve your constipation?

After reading this blog, you’ll feel relieved because you learned a few tips on how to get your bowels moving regularly to help relieve constipation and bloating.

What is constipation?

First, what’s constipation? The Rome III diagnostic criteria is what doctors use to diagnose constipation. Constipation is when you experience two or more of the following symptoms:

  1. Straining or pushing a lot when using the bathroom
  2. Hard or lumpy stools
  3. Not feeling empty
  4. Feeling like something is in the way
  5. Needing to manually help the bowel movement along
  6. Less than three bowel movements a week

Besides not being able to poop, you might experience other symptoms…

  • Low back pain
  • Stomach pain
  • Bloating
  • Gas
  • Anxiety
  • Fatigue
  • Heartburn 

All of which can make you feel worse. 

The cause of constipation is going to be different from one person to the next. But some common causes are…

  • Hashimoto’s or Hypothyroidism
  • Dehydration
  • Motility issues
  • Certain medications or supplements (especially iron)
  • Food sensitivities
  • Stress
  • Lack of physical activity

It’s important to mention constipation can include changes in bowel movement frequency. For instance, you’re having fewer or less comfortable stools for whatever is normal for you. 

Some people go twice a day. So a change to once per day would not be diagnosed as constipation, but it could be for that person. It's important to take note of what's normal for you. 

Always pay attention to changes in bowel habits.

Fiber + Water + Movement

When you search for constipation relief, you'll always get the top three areas that help…

  • Fiber
  • Water
  • Movement

Looking at how much fiber and water you consume and how much you move can get things moving.

The first place to start with helping constipation is with fiber. There are two types of fiber - insoluble and soluble. 

Insoluble fiber doesn’t get digested. Instead helps push contents through your digestive tract and create softer, bulkier stools. The other type of fiber - soluble fiber - dissolves in water and helps soften stool. Fiber also feeds the beneficial bacteria in our gut. This helps improve overall digestion.

In total, we should get 20-30 grams of fiber each day. Insoluble fiber is in vegetables, beans, nuts, whole wheat, and berries. Soluble fiber is in apples, beans, barley, citrus, oats, peas, and psyllium.

Just as important as fiber is water. Increasing fiber without water can cause more constipation. The extra bulk can cause stool to become hard and stagnant. Drinking enough water will ensure that the fiber keeps everything moving along. 

Rule of thumb - drink half your body weight in ounces of fluids. This can be water, herbal teas, and watery fruits and vegetables. For example, a 200 lb woman would want to shoot for 100 oz per day. 

Caution: Never exceed 100 oz per day due to dilution of minerals from the kidneys. 


If you struggle to drink enough water, make it more interesting with fruit and flowers! 

Add slices of cucumber, orange, lemon, lime, and/or strawberries to water and sip throughout the day. Or, make a large batch of cold-brew herbal tea, such as hibiscus, tulsi, or ginger and store in the fridge to enjoy all day. 

Ginger is also great to stimulate digestion!

And last, movement. You’ve probably heard that exercise helps constipation. A sedentary lifestyle can slow down the movement of food through your intestines. Moving your body can increase food movement and also literally move the colon to keep it toned. 

Any kind of movement is great! Try jogging, walking, yoga, pilates, dance, barre. Anything you enjoy will help your digestion (and your energy and overall health!) If you’re new to exercise, start with 2-3 days per week with the future goal of at least 30 minutes daily.

Suggested Remedies

If you’ve tried increasing fiber, water, and movement but still experience constipation, you may need some extra support! Here are a few things to try:

Increasing probiotic foods:

A question we often hear is “Do probiotics cause constipation?” Sometimes constipation can be caused by an imbalance of gut flora. This can also affect the movement of food through the intestines. 

A probiotic supplement can help. But so can lacto-fermented foods, such as…

  • Sauerkraut
  • Kimchi
  • Yogurt
  • Kefir
  • Kombucha
  • Miso
  • Tempeh

These foods can be found in the refrigerator section of the grocery store. Sauerkraut or fermented vegetables that are not in the refrigerator have been heated to the point of killing any beneficial bacteria. So stick to refrigerated ferments! 

Start with one tablespoon per day and work up to 1-2 tablespoons per meal of whichever fermented foods you enjoy. 

So...probiotics can get the bowels moving better for you!


This is a common Ayurvedic herb from India. Triphala is a combination of three fruits:  amalaki, bibhitaki and haritaki. These herbs are used to…

  • Clean out the digestive tract
  • Strengthen the liver
  • Boost the immune system 

Triphala can be taken daily as a tea (1 teaspoon in warm water) or pill. The best time to take it is before bed for occasional constipation. Or both bedtime and morning for severe constipation. When your bowels regulate, you can keep taking triphala! This supports digestive strength, daily detox support, and overall health.

Focusing on relaxation:

Stress and unprocessed emotions can contribute to decreased gut function. This can lead to constipation. Finding ways to fully relax physically and mentally each day can have a positive impact on constipation. 

Studies have shown that mindfulness-based stress reduction (MBSR) can change the way your brain processes thoughts, emotions, and sensation. It’s theorized these changes help reduce digestive distress. Try MBSR meditations and guided body scans for free on Insight Timer.

Repairing your metabolism & healing Hashimoto’s: With hypothyroidism, your metabolism will slow. With a slower metabolism, you have slower movement of food through your intestines. This creates thyroid constipation. While the above remedies will help get the bowels moving to relieve some discomfort, they aren’t going to repair the broken process. 

With hypothyroid and/or Hashimoto’s constipation, we want to focus on the foundation. Healing Hashimoto’s.  

Where to begin?

Whether you experience constipation occasionally or regularly it's uncomfortable. But there are many ways you can begin to help your constipation today. 

Start with fiber + water + movement. And, if those aren’t helping, experiment with one of the other options. It's possible to get your bowels moving regularly and make constipation a thing of the past!

In the comments, let me know what you’ve done to relieve your constipation. And if you’re still suffering, let me know which tip you’re going to try!

  • Thank you for this information.I also have hashimotos thyroid and chronic constipation primarily because I have food allergies from infant and childhood and eventual short career in nursing, latex exposure. Most of your food and herb recommendations cause hives and urticaria. What would you suggest?

    • I’m sorry to hear about your food allergies. None of the 3 things we recommended cause hives or urticaria. If you’re having hives or urticaria, it would be from the probiotics but more so from too much histamine in your body. This tells me that your allergies aren’t managed very well and you’re likely dealing with a more systemic issue. Triphala and stress management/breathing would cause hives or urticaria either.

  • Would you recommend the same for a 7 year old that is constipated but does not have Hashimotos? She had been like this for years. Would Triphala be safe for children?

    • I would not use a full dose of triphala on kids. Trifal is a liquid formulation meant for kids. But, kids struggling with constipation should definitely be checked by a GI doc or should be working with an adolescent nutritionist. Ensure your child is getting plenty of fiber and water as well! That makes a world of difference!

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