Help explaining thyroid panel results

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by emsillystudent emsillystudent (New) New

Hi! Does anyone have a good way to explain hypo vs. hyper-thyroidism and the significance of the lab results? I was trying to explain hypothyroidism and the labs, and it took forever for the pt to finally "get it". I don't think it was because she wasn't smart - I think maybe I didn't do all that great of a job explaining it. I understand it in my head, but I have trouble putting it into words. If that makes any sense. Does anyone have a good, quick way to explain this?

I guess I should tell you what I told her so you can accurately judge. So I told her that, basically, the thyroid produces hormones that control the body's metabolism. Without the proper amounts of the thyroid hormones, (t3 and t4), the body doesn't use calories or oxygen appropriately (metabolism), which is why people with hypothyroidism often feel tired/sluggish (this was the case for this pt). I explained that the pituitary gland "regulates" the thyroid by producing TSH. If TSH is high, it means the thyroid is probably hypoactive because the pituitary gland is working extra hard to try to get the thyroid to work. If the TSH is low, the thyroid may be hyperactive - it's producing so much that there isn't as much need for TSH. I told her that beyond that, the reasons for low or high t3 or t4 could vary - maybe the pituitary gland isn't working right and so it's not accurately telling the thyroid what to do, or maybe the thyroid itself just isn't able to secrete the proper amount of the hormones. I explained that further testing is usually needed to determine the cause/significance of the abnormal lab values (iodine uptake, etc), but she really seemed to want more basic info regarding specifics of the individual values. I explained that it is not one value by itself that tells us what the problem is, and that it is up to the doc to order and interpret any further testing he deems necessary. Anything I could have explained better?

Thanks!!!

summerrose_10

summerrose_10

54 Posts

You explained it very well:yeah:.

This is what I tell people about the lab results. If your TSH is high, it indicates your pituitary gland is releasing higher then "normal" amounts of a hormone, this hormone, is called Thyroid Stimulating Hormone(TSH). This hormone (TSH) is telling your thyroid to get busy and do its job. It appears your thyroid is not working like it should, so your dr. has prescribed synthroid.further testing,... etc.etc.

If the pt. wants more info, you will know, he/she will ask more specific questions. I have found the more basic I keep it, the better the pt. understands. However, if they seem to want to know more detailed info about the negative feedback system etc, I get it for them.

Hope this helps:D

rubystar

rubystar

83 Posts

I think it's okay for us to understand these kinds of things but for patients this may be right over their heads. Maybe if you're giving a convoluted story draw them a simple diagram of the different parts and draw arrows. Trying to keep track of all the different concepts and different parts can be very difficult if its all just words.

kmoonshine

kmoonshine, RN

Specializes in Emergency. 346 Posts

Try relating it to something that the patient understands.

Perhaps say something like "TSH levels go up because the pituitary gland is sending out more horomone to get the thyroid gland to respond. Kinda like trying to call someone by phone but they don't answer - so you continue to call again and again until someone picks up the phone. Basically, the pituitary gland is trying to get an answer from the thyroid gland, so it continues to try to "call" by sending out more TSH."

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 16 years experience. 226 Articles; 27,608 Posts

hi! does anyone have a good way to explain hypo vs. hyper-thyroidism and the significance of the lab results? i was trying to explain hypothyroidism and the labs, and it took forever for the pt to finally "get it". i don't think it was because she wasn't smart - i think maybe i didn't do all that great of a job explaining it. i understand it in my head, but i have trouble putting it into words. if that makes any sense. does anyone have a good, quick way to explain this?

i guess i should tell you what i told her so you can accurately judge. so i told her that, basically, the thyroid produces hormones that control the body's metabolism. without the proper amounts of the thyroid hormones, (t3 and t4), the body doesn't use calories or oxygen appropriately (metabolism), which is why people with hypothyroidism often feel tired/sluggish (this was the case for this pt). i explained that the pituitary gland "regulates" the thyroid by producing tsh. if tsh is high, it means the thyroid is probably hypoactive because the pituitary gland is working extra hard to try to get the thyroid to work. if the tsh is low, the thyroid may be hyperactive - it's producing so much that there isn't as much need for tsh. i told her that beyond that, the reasons for low or high t3 or t4 could vary - maybe the pituitary gland isn't working right and so it's not accurately telling the thyroid what to do, or maybe the thyroid itself just isn't able to secrete the proper amount of the hormones. i explained that further testing is usually needed to determine the cause/significance of the abnormal lab values (iodine uptake, etc), but she really seemed to want more basic info regarding specifics of the individual values. i explained that it is not one value by itself that tells us what the problem is, and that it is up to the doc to order and interpret any further testing he deems necessary. anything i could have explained better?

thanks!!!

the average patient comes to u.s. healthcare facilities with reading, writing, comprehension, and conversational skills that fall at a 6th to 8th grade level, even if they have graduated from high school or completed a few college classes. you cannot use big words with most patients because, while some of them will admit that they do not understand what you've said, the majority will nod at you and pretend to comprehend.

many patients do not know what words such as continence, secretion, hyperactive, and hypoactive mean. many patients do not know about the existence of a pituitary gland. many patients will never fully understand the positive and negative feedback systems of the endocrine system, no matter how much you explain it to them.

instead of saying "hyperactive" or "hypoactive," say "fast" or "slow." instead of using the word "secrete," the word "release" might create a better understanding.

remember the acronym kiss: keep it simple, stupid. i'm not implying stupidity on anyone's part, but the acronym indicates that the simpler the instruction, the more understanding that will be conveyed.

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