Managing Constipation on GLP-1s Guide

Constipation is a common (but unpleasant, we know) symptom as your body adjusts to GLP-1s. Usually this is temporary and a result of starting medication or recently titrating up to a higher dose. It happens because GLPs slow transit of food through the intestines. This helps you feel full, but it also contributes to constipation, nausea, and acid reflux early on as your system adjusts to its new rhythm. 

Because the body excretes metabolized fat in the stool, regular bowel movements are important for weight loss and toxic excretion. Here are some recommendations to help get things moving:

• Get enough water (and add a little salt). Drinking enough water is very important, especially if you have increased your fiber intake (fiber without water can make stools firm). In order to help your body hold onto that water effectively, it’s also important to get enough sodium. Adding a pinch of salt to every 16-32 ounces of water can help keep the body and bowels properly hydrated. Brands we like to use include the unflavored powder from LMNT and Redmond’s Real Salt.
• Keep moving. To function effectively, your bowels need stimulation. Brisk walking after meals can do this (yet another reason to build that habit). So can deep belly breathing or techniques such as Breath of Fire, which can “massage” your bowels from the inside (try doing this for at least a few minutes every day on an empty stomach).
• Try magnesium citrate. This form of magnesium works to keep water in the stool and can aid in effective elimination. Low doses of 200-400 mg are usually effective, though up to 600-800 mg may be used daily. If your stools become too loose, back off on the dose. This is also meant to be a temporary aid. Long term use of magnesium citrate for bowel movements can lead to the body becoming dependent on it. When choosing supplements it’s important to look at the full ingredient list to minimize fillers and unnecessary ingredients. Pure Encapsulations and Life Extension offer Magnesium Citrate.
• Try MiraLAX. MiraLAX is over the counter and recommended by many GI doctors for management of chronic constipation. 
• Take 1-2 tablespoons of Milk of Magnesia. Doing this before bed almost always ensures a bowel movement the following morning. Keep this up for a few days to get the bowels cleared. To avoid overdoing it, don’t take magnesium when you’re taking Milk of Magnesia. We also don’t recommend taking Milk of Magnesia for more than two weeks at a time.
• Take stool softeners. If you’re having regular bowel movements but they are consistently hard, over-the-counter stool softeners such as Docusate or Colace can be helpful in addition to hydration.

Your symptoms should improve after three to four weeks. If they aren’t resolving, or if you get significantly worse, please reach out to the Calibrate Clinical Team via the Support Center in the app. If you are concerned your symptoms may be urgent, please seek care from your primary doctor or urgent care.