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Thyroid Storm

Thyroid Storm Overview

The thyroid gland, located at the front part of the neck, is responsible for making substances (thyroid hormones) that are important for all body cells to work properly.

In certain conditions, the thyroid becomes over-active and produces too much of its hormones, a situation called hyperthyroidism. People with hyperthyroidism have problems that reflect over-activity of the organs of the body, resulting in symptoms such as sweating, feeling hot, rapid heartbeats, weight loss, and sometimes eye problems. When the levels of thyroid hormones become very high in a patient who has hyperthyroidism, the symptoms get worse and can result in a serious condition called thyroid storm. One major sign of thyroid storm that differentiates it from plain hyperthyroidism is a marked elevation of body temperature, which may be as high as 105-106 ºF. Thyroid storm is unusual, but when it occurs, it is a life-threatening emergency. People experiencing symptoms of thyroid storm should be taken to an emergency department.

Thyroid Storm Causes

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

Thyroid Storm Symptoms

Rapid heart beats
Greatly increased body temperature
Chest pain
Shortness of breath
Anxiety and irritability
Disorientation
Increased sweating
Weakness
Heart failure

When to Seek Medical Care

If you have any of the following conditions, then 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 individual to an emergency department immediately.

Exams and Tests

The following tests are usually performed: blood tests to check blood cell count, electrolyte levels, sugar level, and thyroid hormone levels. Liver function tests are also usually performed.

Thyroid Storm Treatment - Self-Care at Home

People experiencing thyroid storm are not able to function normally. This is a life-threatening emergency. People experiencing symptoms of thyroid storm should be taken to the emergency department.

Medical Treatment

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
Iodide to block thyroid hormone release
Block the action of thyroid hormones on the cells by drugs called beta-blockers, such as propranolol (Inderal)
Treatment of heart failure if present

Next Steps

Following the start of treatment, careful monitoring, usually in the intensive care unit, is necessary.
Following recovery from thyroid storm, options for definitive treatment are radioactive iodine or antithyroid medications; surgery is rarely needed.