When new clients work with me as their nutritionist they are sometimes surprised when I ask them about their bowel movements. I’m sure it can feel a bit unusual for some folks to talk about detox and constipation.

But understanding my client’s regularity can be a really helpful indicator of their gut health and their ability to eliminate toxins, reduce inflammation, and support balanced hormones. 

How is our body’s ability to detox and constipation linked? 

Our body has several different channels to remove “toxins”. I put toxins in quotes because our ideas about what type of substances our body needs to remove can be a bit narrow. While it’s true that our body may need to try and eliminate environmental toxins that we get exposed to (say through polluted air), it also needs to be able to process food compounds, supplements, and spent hormones in order to keep our body running smoothly.

Our gut and liver is part of our body’s main detoxification pathway. Different compounds are brought to the liver for processing and they are broken down and prepared for elimination in a two-part process called Phase 1 and Phase 2 liver detoxification. 

Once the liver has done its job and prepared the substances for elimination, it’s time for the gut to do its part and carry these toxins out to the toilet in a bowel movement. The way that detox and constipation are linked is that if we are not regularly having bowel movements to eliminate these toxins, they can accumulate in the body and lead to inflammation and related health issues (even hormone imbalances). 

What is considered constipation?  

Once people understand the link between detox and constipation they want to know if their gut is functioning normally. Ideally, we should be having 1-3 well-formed bowel movements each and every day. Pooping less than once per day is considered to be constipation and is likely contributing to impaired detoxification and inflammation. Even for some folks I work with, just having one bowel movement a day can feel like mild constipation. 

Regardless of how long you’ve been experiencing constipation, it’s not ‘normal’ and shouldn’t be overlooked. No matter if you’re only having one bowel movement per day or one per week, it’s important to make sure that your digestion and detoxification processes are optimized. 

What are some root causes of constipation? 

It’s important that you work with your doctor if you’re experiencing constipation as it can sometimes be caused by a dangerous blockage or other undiagnosed medical condition.

Experiencing constipation can be very uncomfortable (even painful) and sometimes it needs immediate resolution depending on the severity. But that aside, it’s important to take a root cause focused lens when it comes to detox and constipation. 

In functional medicine, symptoms (like constipation) are seen as clues that can help us uncover deeper sources of imbalance that need our attention. Using an evidence-based approach and an advanced understanding of how various systems in our body work together, a functional practitioner can help uncover and resolve underlying issues with detox and constipation versus just masking them. 

There are many potential reasons why someone may experience constipation, but some of the most common ones that I have seen as a nutritionist are: 

1. Side effects of supplements or medications

Constipation can be caused by certain supplements or medications that we take. For example, iron supplements can lead to constipation as can taking fiber supplements without adequate water or in folks with gut dysbiosis. If you are concerned about whether or not a supplement or medication you’re taking may be causing constipation, make sure to communicate with your healthcare provider (e.g., nutritionist, doctor, etc.). 

2. Under-eating and/or low fiber intake 

Intuitively, it makes sense that we would experience infrequent bowel movements if we are eating too little as there is less material for our body to dispose of. On top of that, under-eating can slow our digestion and lead to sluggish elimination. Although reducing food intake is frequently touted as a way to improve detoxification, I am a big proponent of fueling our detox with nourishing foods. 

If we are eating too little, it’s also likely that we are not going to get adequate fiber. The recommended amount of fiber for women and men is 21-25g and 30-38g per day respectively. Fiber can be supportive for detox and constipation as a bulk-forming compound (think of it as sweeping clean the colon) and also as a way to feed good gut bacteria. Prebiotic fibers can encourage healthful levels of bacteria in the gut which are important for reducing inflammation, supporting a balanced immune system, enhancing nutrient absorption and (of course) having regular bowel movements. 

Read: 11 Causes of Decreased Appetite (and How It May Harm Your Hair)

3. Dehydration 

Hard, dry stools can be more difficult to pass and lead to constipation. Staying hydrated is a good way to ensure that we have regular bowel movements that are soft, but well formed. I typically suggest that clients aim to drink roughly half of their body weight in ounces of water per day. So, if someone weighs 150lb then their goal is to drink 75oz of water each day. 

Above and beyond drinking enough water, it’s important to make sure that the water you drink is pure and safe. If possible, avoid drinking water out of plastic bottles (single-use or reusable) as they are known to release microplastics and leach harmful chemicals into the water. I always try to drink water out of reusable glass or stainless steel containers. You can also check to see how safe your drinking water is by consulting the Environmental Working Group’s tap water database. They also provide suggested filtration options based on your water’s unique contaminants. 

4. Sedentary lifestyle 

Did you know that someone can still be considered ‘sedentary’ even if they go to the gym every day? When thinking about our activity levels as they relate to gut health and regularity it’s important to reduce the amount of time that we spend sitting (when possible). For example, using a standing desk for part of the day or taking frequent breaks from sitting to go for a short walk or stretch can be very helpful in keeping things moving in our digestive tract. 

5. Gut microbiome imbalance and/or poor digestion 

Our gut is home to trillions of microbes and we collectively refer to these as our microbiome. The microbiome can become imbalanced (or, dysbiotic) if there is too much or too little of the beneficial bacteria or if it hosts harmful microorganisms. One symptom of a gut microbiome imbalance is constipation. So, besides being unpleasant and uncomfortable, constipation may be a sign that your microbiome needs some TLC. 

Poor digestion can also result in constipation. There are many different ways that maldigestion can impact detox and constipation. For example, low stomach acid can reduce our body’s ability to properly break down high-protein foods which can lead to protein putrefaction in the gut (as well as inflammation and dysbiosis). Adequate stomach acid is also an important trigger for our body to release digestive enzymes, so poor digestion can also compound.

6. Hormone imbalances

While impaired detox and constipation can contribute to hormonal imbalances (for example, leading to estrogen excess), certain hormones can also influence our regularity. 

One symptom of under-active thyroid can be constipation. Comprehensively assessing thyroid function is important if you’ve experienced constipation, especially if you also experience other symptoms consistent with hypothyroid such as dry skin, fatigue, elevated cholesterol, and cold hands and feet. 

It’s also possible that elevated cortisol levels and fluctuations in steroid hormones like estrogen and progesterone could affect regularity as well. 

What tests are best for detox and constipation? 

Sometimes the cause of constipation isn’t so straightforward and may require further testing. For example, someone with chronic constipation may need to work with a gastroenterologist to make sure that there are no structural issues or obstructions in their bowels. 

Other functional medicine tests that I prefer for clients struggling with constipation include:

1. GI MAP 

The GI MAP is an at-home PCR stool test that can comprehensively assess the gut microbiome, digestion, and inflammation in the gut. 

2. DUTCH Complete 

DUTCH is an acronym that stands for Dried Urinary Test for Comprehensive Hormones. This test is able to assess cortisol levels (in a diurnal rhythm) as well as levels of many steroid hormones that may impact regularity. 

3. Thyroid Panel Complete + Thyroid Antibodies (TSH, Free T4, Free T3, reverse T3, Anti-TPO antibodies, Anti-TG antibodies) 

Comprehensively assessing thyroid function is important for anyone experiencing constipation – this means running more tests than just thyroid stimulating hormone (TSH).  

What are some ways to support detox and constipation? 

Sometimes while waiting for answers from tests that can help us identify underlying issues leading to impaired detox and constipation we may still benefit from tips and tricks to get things moving. Many times when I work with clients one-on-one as their nutritionist I will utilize a few nutritional supplements to help them experience more regular bowel movements and start feeling better. 

Nutritionist’s Top Supplements to Help Clients Experiencing Constipation

Here are my top supplement to help relieve constipation. Click here to order!

FDA Disclaimer: This information has not been evaluated by the Food & Drug Administration or any other medical body. I do not aim to diagnose, treat, cure or prevent any illness or disease. Information is shared for educational purposes only. You must consult your doctor before acting on any content in this document, especially if you are pregnant, nursing, taking medication, or have a medical condition.