The Hidden Cause of Constipation

Constipation isn’t just about what you eat — it’s about whether your gut is getting the right signals to move. 

In the episode, Dr Vikki Petersen explains why you may be suffering from constipation.

3 secrets:

1.Your Gut Runs on Nerve Signals
Your gut runs on nerve signals -which are highly energy dependent.

Vitamin B1 is required to convert glucose → energy
With lower B1 → weaker nerve signaling - the gut isn’t getting strong, signals and the result is constipation.

Research- thiamine deficiency rates from about 20% to 90% depending on the population studied. Obese people - deficiency of 15% to 29%. Diabetics - B1 75% lower in the blood.
High carbohydrate diet puts you at risk because glucose in blood requires more B1 to break down the carbs thereby creating a higher demand 

2.Your Gut Muscles Have to Respond
The nerves send the signal, but the muscles have to respond to the signal.
muscles need to contract and relax in sequence

Research -magnesium intake is commonly inadequate.
~60% of American adults do not meet the recommended magnesium intake. ~45% of Americans may be magnesium deficient.

When magnesium levels low, those signals weaken and slow the gut.
Constipation, reflux, and bloating often occur together -they are all motility disorders. 
stomach emptying slows → reflux
small intestine motility slows → fermentation of bacteria leading to infection, bloat, gas, SIBO, leaky gut, increased IAP. Leads to hiatal hernia.
colon motility slows → constipation

It’s all one issue: with constipation you cannot have a healthy gut.

Why?

Refined grains remove minerals- whole grains contain magnesium, refined don't.
Ultra-processed food diets
Certain medications - like PPIs, antibiotics, diuretics 

Magnesium dense foods: pumpkin seeds, chia seeds, flax seeds, sunflower seeds (also B1), almonds, legumes (also have B1), dark leafy greens. Dark Chocolate and avocado.

3. How Modern Diets Slow Your Gut - SAD (standard American diet) works against motility
Ultra-processed foods, sugar can:

disrupt the gut microbiome - more bad bacteria
reduce beneficial bacterial byproducts that stimulate motility
increase inflammation - fatigue, feeling “off” and mood changes
Causes B1 and magnesium depletion.

People are missing good compounds:

Polyphenols -plants, berries, tea, and herbs. Support beneficial bacteria and motility.
Fiber -start low and slow: Insoluble fiber feeds microbes that produce short-chain fatty acids.
with bad bacteria the fiber can eat that too - so you feel worse.

SCFA - produced when good gut bacteria ferment fiber. They cause production of serotonin and brain makes “happy” mood hormones. 

The Simple Foundations Still Matter

Basics still support motility:

Hydration 
Movement -activity stimulates intestinal contractions
Polyphenol-rich foods 
Reducing ultra-processed foods and - deplete B1
B1 is high in pork, beef and fish

TIPS

If hard stool → magnesium citrate or oxide - 200 - 400 mg/day
If stress,  or motility → magnesium glycinate ~300 -400 mg/day.

References:
1. Camilleri M. Gastrointestinal complications of diabetes.
2007, New England Journal of Medicine
2. Bharucha AE, et al. American Gastroenterological Association technical review on constipation. 2013, Gastroenterology
3. Mori H et al. Magnesium oxide in constipation. 2021, Nutrients
4. DiNicolantonio JJ et al. Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis. 2018, Open Heart
5. Lonsdale D. A review of the biochemistry, metabolism and clinical benefits of thiamin(e). 2006, Evidence-Based Complementary and Alternative Medicine
6. Makki K et al. The impact of dietary fiber on gut microbiota i