Thyroid Storm

What is Thyroid Storm?

  • Located at the front part of the neck, the thyroid gland is responsible for making substances (thyroid hormones) essential for all body cells to work properly.
  • In certain conditions, the thyroid becomes over-active and produces too much thyroid hormone in the body, a state called hyperthyroidism.
  • People with hyperthyroidism have problems from over-activity of several organs, resulting in symptoms such as sweating, feeling hot, rapid heartbeats, weight loss, and sometimes eye problems.
  • When thyroid hormone levels become very high, the symptoms worsen and can result in a serious condition called thyroid storm or thyrotoxic crisis.
  • One major sign of thyroid storm that differentiates it from oridnary hyperthyroidism is a marked elevation of body temperature, which may be as high as 105-106 F (40.5-41.1 C).
  • Thyroid storm is unusual, but is a life-threatening emergency when it does occur. People experiencing symptoms of thyroid storm should be promptly taken to an emergency department.
Picture of the Thyroid Gland
Hyperthyroidism:Keep Your Thyroid in Check

Thyroid Storm Causes

Thyroid storm can be considered to be an extreme degree of hyperthyroidism and typically occurs in an individual with untreated hyperthyroidism. Precipitating factors, including trauma and stresses, have been identified, including:

  • Infections, especially of the lung
  • Thyroid surgery in patients with overactive thyroid gland
  • Stopping medications given for hyperthyroidism
  • Too high dose of thyroid hormone replacement
  • Treatment with radioactive iodine
  • Pregnancy
  • Heart attack or cardiac emergencies

Thyroid Storm Symptoms

10 Questions to Ask Your Doctor About Thyroid Disease

  1. Are my symptoms consistent with thyroid disease?
  2. Could my symptoms be the result of anything else?
  3. What investigations do I need to have performed to make a diagnosis?
  4. How safe are these investigative tests and procedures?
  5. What exactly is a thyroid biopsy, and how is it performed?

When to Seek Medical Care fo Thyroid Storm

If you have any of the following conditions, call your doctor immediately:

  • Fever
  • Very rapid heart beats
  • Confusion and disorientation
  • Significant fatigue and exhaustion

Friends or family members of anyone experiencing symptoms of thyroid storm (who may not be able to function normally) should take the affected individual to an emergency department immediately.

Thyroid Storm Diagnosis

The following tests are usually performed to diagnose thyroid storm:

Hyperthyroidism:Keep Your Thyroid in Check

Thyroid Storm Treatment

People experiencing thyroid storm are not able to function normally. Thyroid storm is always a medical emergency. People experiencing symptoms of thyroid storm should be taken to the closest hospital, because thyroid storm is a life-threatening condition.

Thyroid Storm Medical Treatment

Treatment of thyroid storm consists of life support measures to support vital organ function along with attempts to reduce thyroid hormone release. A complete evaluation to determine the cause of thyroid storm will also be carried out along with treatment of underlying or precipitating diseases or conditions. Treatment and supportive measures can include:

  • A complete evaluation to determine the cause of thyroid storm
  • Intravenous fluids and electrolytes
  • Oxygen if needed
  • Fever control with antipyretics (fever-reducing medications) and if needed cooling blankets
  • Intravenous corticosteroids such as hydrocortisone
  • Medications to block the production of thyroid hormones, such as propylthiouracil (PTU) or methimazole (Northyx, Tapazole)
  • Iodide to block thyroid hormone release
  • Drugs called beta-blockers, such as propranolol (Inderal) to block the action of thyroid hormones on the body
  • Treatment of heart failure if present

Thyroid Storm Follow-up

  • Following the start of treatment, careful monitoring is necessary, usually in the intensive care unit.
  • Following recovery from thyroid storm, options for definitive treatment include radioactive iodine or antithyroid medications. Surgery to remove the thyroid gland is rarely needed.
  • Follow-up with the doctor after discharge is important to monitor the thyroid condition and formulate a plan for curative treatment.

Thyroid Storm Prevention

Thyroid storm can be prevented with early treatment of hyperthyroidism and recognition of the warning symptoms of thyroid storm.

Thyroid Storm Prognosis

  • Thyroid storm is a very serious condition that can result in death.
  • Early and aggressive treatment can improve the outcome
Reviewed on 11/17/2017

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care

REFERENCE: MedscapeReference.com. Thyroid Storm

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