Patient's Query
Hello Doctor,
I have suffered from severe chronic constipation for the past three years and have a bowel movement once in six to eight days. These are very difficult movements, painful and very much straining. Also I have constant bloating and abdominal pain and often feel like I cannot empty my bowels completely.
I have tried fiber supplements, Miralax, Senna, and various lifestyle changes, but none have given me relief. I feel tired all the time as well.
Recent laboratory results showed the following:
TSH at 9.8 mIU/L
Free T4 at 0.5 ng/dL.
Hemoglobin at 10.2 g/dL.
Ferritin at 18 ng/mL.
Could my hypothyroidism and anemia be causing my constipation? What are the prescription medications?
Please help.
Hello,
Welcome to icliniq.com.
I am I understand your concern.
The results of your lab work are very suggestive of a major role of untreated hypothyroidism in your severe chronic constipation. A TSH (thyroid-stimulating hormone) of 9.8 mIU/L with a low free T4 ( thyroxine ) confirms an underactive thyroid .
Low levels of thyroid hormone slow the motility of the gut so that the intestines move stool through them much more slowly than is normal. This can result in infrequent bowel movements , hard stools , bloating , abdominal discomfort , and a feeling of incomplete evacuation .
Additionally your hemoglobin is 10.2 g/dL and your ferritin level is 18 ng/mL which suggests iron deficiency anemia which can add to worsening fatigue and overall muscle and bowel function.
When your thyroid is low, your whole digestive system slows down. Treatment of the underlying hypothyroidism with levothyroxine is therefore critical and often leads to a significant improvement in bowel frequency over several weeks as hormone levels normalize.
Iron deficiency also must be managed carefully since some oral iron supplements can temporarily worsen constipation. If the constipation persists after the thyroid problem has been corrected, prescription medications are available to help. These medications work by increasing intestinal fluid secretion or by stimulating bowel motility. Examples include Linaclotide and Lactulose.
The main thing now is to treat the thyroid imbalance and anemia -- both of which are clearly contributing to your symptoms and total exhaustion. Please send me your lab results and set up a consult with me so I can help you adjust your dosage and give you more information on your treatment.
Please feel free to ask if you have any additional questions or concerns; I am here to help. If you found this information helpful, I would greatly appreciate your feedback. Wishing you comfort and steady improvement ahead.
Thank you.
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