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Thyroid Storm

  • Medical Author:

    Robert Ferry Jr., MD, FAAP, is a U.S. board-certified pediatric endocrinologist. After taking his baccalaureate degree from Yale College, then receiving his doctoral degree and residency training in pediatrics at the University of Texas Health Science Center at San Antonio (UTHSCSA), Dr. Ferry completed fellowship training in pediatric endocrinology at the Children's Hospital of Philadelphia.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Thyroid Storm Related Articles

What Facts Should I Know about 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.

How do I know if I'm having a thyroid storm?

  • 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

What Causes Thyroid Storm?

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
  • Treatment with radioactive iodine
  • Pregnancy
  • Heart attack or cardiac emergencies

What Are the Symptoms of Thyroid Storm?

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.

How Is Thyroid Storm Diagnosed?

The following tests are usually performed to diagnose thyroid storm:

What Is the Treatment for Thyroid Storm?

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 nearest hospital because thyroid storm is an extremely dangerous condition that can lead to death.

What Is the Medical Treatment for Thyroid Storm?

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

What Is the Follow-up for Thyroid Storm?

  • 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.

How Do You Prevent Thyroid Storm?

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

What Is the Prognosis for Thyroid Storm?

  • Thyroid storm is a very serious condition that can result in death.
  • Early and aggressive treatment can improve the outcome

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?

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Reviewed on 2/25/2019
Sources: References

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