Today we’ll be talking about no one’s favorite subject: poop. Or, if you have Hashimoto’s, like me, the lack thereof. But first, a disclaimer: I am not a doctor. I don’t even play one on t.v. All suggestions provided here are exactly that – suggestions based my personal experience. If you have persistent or recurring constipation, consult your doctor immediately; unresolved constipation can lead to serious consequences and may be an indication of an underlying issue, separate to your autoimmune disease.
The state of your bowels is a good indication of your gut health and, by extension, your overall wellbeing. Depending on your condition (Crohn’s, Graves‘), maintaining healthy bowel function may be an ongoing struggle. For those of us with Hashimoto’s, constipation is a hallmark symptom of our hypothyroidism. The thyroid regulates a number of our bodies’ systems and when it slows down (hypo = under-active) everything it touches slows down with it, including our bowels. Although thyroid hormone medication should correct this, I can tell you it’s not always that easy.
How do you know if you’re constipated? Most doctors agree that we should be aiming for one bowel movement per day, but how often we go varies from person to person. Anything between once per day and once every three days is considered ‘normal’, but frequency isn’t the only factor: consistency (as in texture) is key. The Bristol Stool Chart identifies poop in all it’s various states from rabbit pellets to puddles. Achieving perfect poop means scoring a ‘4’ (the smooth snake) every time. If we’re consistently scoring anywhere from a ‘3’ (cracked log) to a ‘1’ (rabbit pellets), there’s a problem.
Other symptoms include straining, having to sit on the toilet for extended periods, abdominal discomfort, and a sense of incomplete elimination.
If you’re experiencing issues, consider keeping a bowel diary – recording the timing and frequency of your movements, Bristol Stool Chart scores, fluid intake, and context can help you (and your doctor) identify patterns. Easy non-invasive DIY gut health tests are another valuable source of information for discussions with your doctor or naturopath. Again, do not hesitate to contact your doctor if you’re in distress or unable to resolve matters within a few days.
Managing an autoimmune disease often means optimising every aspect of our health just to feel ‘normal.’ Elimination is no exception to this rule. If we want regular, efficient bowel movements without pain or strain, we need to work harder (sorry) than the average person.
It’s easier to stay out of trouble than it is to get out of trouble. We all know what we should be doing to support our health. It’s simple, but not always easy, and always worth repeating. Not surprisingly, our good health ‘basics’ are also preventative measures against constipation and the best place to start:
- Get eight hours of good quality sleep (when did you last do that?)
- Drink eight glasses of water per day (there’s an app for that)
- Move – as much as you are able (go gently if you have exercise intolerance)
- Avoid caffeine – it dehydrates you and interferes with sleep
- Manage your stress levels – your mood affects your poop
- Eat high fiber green vegetables (we’ve got you covered – see the sprouts recipe below)
You’re already doing All The Things? And there’s still no movement? Sometimes we autoimmune folk need to be beyond-perfect just to move the needle. These extra-credit moves can help produce results, and are easily incorporated into your daily routine:
- Squatty Potty – if I were Oprah, you’d reach down and find a Squatty Potty under your chair. It’s that good. By putting you in the correct position, it ’unkinks’ your colon and reduces straining for faster, more complete elimination. Get one.
- Self-Massage – quick, easy, free, and it WORKS. Give yourself a gold star if you use peppermint oil, which has naturally soothing properties.
- Apple Cider Vinegar & Lemon Water – jump-start your digestive system with a glass of diluted apple cider vinegar or lemon juice fifteen minutes before meals.
- Ginger & Lemon Tea – not only does ginger has anti-inflammatory and anti-oxidant properties, but it also stimulates your bowels. Steep thinly sliced ginger and a squeeze of lemon in boiling water, and drink it all day long.
- Stroll – try taking a walk one hour after every meal. Movement begets movement.
- Magnesium – magnesium softens your stools by pulling water into your intestines. Add a supplement or ramp up your intake of green vegetables, including brussel sprouts (see recipe below).
Cook Your Way Out Of Trouble
My go to solution for most problems is food (read into that what you will). Happily, the culinary remedy in this case is also my go-to serves-one dinner: Roast Brussels Sprouts Topped With Bacon & Green Sauce. High in both fiber and magnesium, Brussels Sprouts both resolve and prevent constipation. I make a point of eating them in front of my kids just to prove a heaping bowl of vegetables won’t kill you; in fact, it will sort you out and keep you well, quick smart. Brussels Sprouts – along with broccoli, kale, and cauliflower – are goiterogens. If you have heard worrying things about the impact of goiterogens on thyroid function, I encourage you to read what Dr. Datis Karrazian and Dr. Sarah Ballantyne say on the subject. If you’re still concerned, know that cooking cruciferous vegetables reduces their goiterogenic content, so there’s no need to miss out on the benefits. And the benefits are HUGE.
Roast Brussels Sprouts With Bacon (& Green Herb Sauce)
- 1 lb Brussels Sprouts, trimmed and quartered if you have tiny sprouts, leave them whole or cut in half
- 3-4 slices of bacon, cut horizontally into ½ inch pieces
- 4 tbsp olive oil
- 1 tsp sea salt
- 1 tbsp balsamic vinegar
- 3 tbs Green Herb Sauce (recipe below)
- Preheat oven to 450. Line a baking tray with baking paper. (Note: baking paper is reusable, so you can simply wipe it down after you’ve transferred your sprouts and save it for next time.)
- In a bowl or directly on the baking sheet, drizzle your sprouts with olive oil and toss to coat. Spread them out on your tray so they have a little breathing space. Sprinkle with sea salt and top with bacon pieces (I try to make sure each spout gets its own piece of bacon, but it’s not essential).
- Roast for 20-30 minutes without disturbing (every oven is different; mine is slow). You want to give the sprouts a chance to cook through and carmelize around the edges without burning the bacon. Normally when roasting vegetables, I’d advise shaking things around, but in this case the bacon does best when it’s sitting safely above the fray and stays there. When the sprouts are fork-tender and the bacon is just this side of mahogany, you’re done. Pull the tray out and transfer the sprouts to a bowl.
- If you are in a hedonistsic mood, now is the time to grab your Balsamic vinegar. Splash a tablespoon over your sprouts and stir through. Or, if you’re feeling virtuous and want a double hit of anti-oxidants, top them with Green Herb Sauce – it’s a potent zingy mouthful that balances out the richness of the bacon.
Green Herb Sauce
- high speed blender – this is essential; without one, it will taste like lawn clippings.
- 1 bunch parsley, washed (with stems)
- 1 bunch coriander, washed (with stems, roots removed) (you can substitute or add dill, basil, chives, mint – any green leafy herb)
- 2 spring onions, halved; use white and green parts
- 2 cloves garlic, peeled
- 1 jalapeno, seeded
- 1 lime, juiced
- 2 tsp sea salt (adjust to taste)
- ½ cup olive oil (adjust as needed; you're aiming for the consistency of mayonnaise, not salad dressing)
- Place all the ingredients in a high speed and whizz them up, scraping down the sides after 20 seconds.
- Taste adjust seasoning and texture as needed, by adding more salt, lime juice, or olive oil.
- More method than recipe, this sauce lends itself to all kinds of substitutes. Use whatever leafy green herbs you have on hand. If you don't have a lime, use a lemon. If you don't have a jalapeño, use a thai chile.
- If you want something creamy and dairy isn't a problem (and you're willing to sacrifice the 'healthy' label), mix half the sauce with a big fat dollop – or two – of creme fraiche or Greek yogurt.
- If you want creamy but need it to be dairy free, do the same using mayonnaise or cashew cheese.
- If you can tolerate seeds, mix in a big spoon of tahini; or, for a seed-free, green tahini-esque sauce, add a heaping tablespoon of cashew butter. Basically, you can't go wrong.