HPLC_Greg said:The escalation order that reflects the mechanism: water and salt first, then soluble fiber, then magnesium or an osmotic agent, then a stimulant only…
Drug interaction alert relevant to constipation: if you take oral levothyroxine (Synthroid), GLP-1 agonists can reduce absorption due to delayed gastric emptying. My TSH drifted up after starting semaglutide.
Solution: take levothyroxine on an empty stomach, 60 minutes before any food, and have your TSH rechecked 6-8 weeks after starting or changing GLP-1 dose. My endo had to increase my Synthroid by 12.5mcg.
One thing that is still open after JenPlateau’s answer:
What the mechanism is, because if it is transit rather than water then fiber is the wrong lever?
VendorMark said:Drug interaction alert relevant to constipation: if you take oral levothyroxine (Synthroid), GLP-1 agonists can reduce absorption due to delayed…
Heartburn management on constipation: Gaviscon before bed has been my savior. The delayed gastric emptying means stomach acid just sits there.
Don't ignore persistent heartburn — chronic acid exposure can damage your esophagus. If OTC remedies aren't cutting it after 2 weeks, see your doctor for something stronger. You shouldn't suffer through this.
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Water and magnesium first, soluble fiber second, and dropping the bran entirely. Resolved in about a week after two months of getting it backwards.
KevinCompounds said:Heartburn management on constipation: Gaviscon before bed has been my savior.
Sulfur burps on constipation — the most underrated side effect nobody warned me about. 🤢 The smell is absolutely vile and comes on without warning.
What finally helped: eliminating eggs and cruciferous vegetables. Also, eating smaller portions and chewing thoroughly reduces the gas production.
If sulfur burps persist beyond 2-3 weeks, talk to your provider — it could indicate gastroparesis that needs medical attention.