Thyroid storm, or thyrotoxicosis, is an emergency life threatening event caused by a deluge of thyroid hormone dumped into the blood stream. This condition requires immediate medical attention or sudden death can be imminent.  Thyrotoxicosis can manifest in people with untreated hyperthyroidism.  Additionally, it can have an onset due to surgical procedures performed on the thyroid, trauma, as well as viral or bacterial infectious agents.  The patient is admitted to the critical care unit of the hospital for intensive treatment and care.

Symptoms of Thyroid Storm (thyrotoxicosis):

Increased body temperatureTachycardia (rapid heart rate)Nausea/vomitingDiarrheaHeart palpitationsHeart failurePulmonary edemaConfusionSeizureComaAbdominal painJaundice

There is a large increase in blood thyroid hormone level, accompanied by fever as high as 106 degrees. This condition can be caused by the following factors that include:

Stopping the required hyperthyroidism medications without consulting with the health care professionalIngesting too much of thyroid hormone causing an overdose Radioactive iodine treatmentsPeople with hyperactive thyroid conditions who are suffering from severe infection or illnessMyocardial infarction (heart attack) in a persons with hyperactive thyroid

Anyone who has an overactive thyroid, or hyperthyroidism can develop thyroid storm.  It occurs when the thyroid secretes a large amount of thyroid hormone in a small amount of time.

Anyone with an overactive thyroid who has a fever, rapid heart beat, with confusion, disorientation, should be hospitalized immediately. A medical history will be taken and diagnostic testing will be performed to analyze:

Blood cell countElectrolytes, such as sodium, potassium, and calciumBlood sugar levelThyroid hormone levels will also be testedLiver function test

Treatments:

The goal of treatment in people suffering with thyroid storm is to decrease thyroid hormone levels, or to inhibit their production and release into the blood.  This is accomplished in the following ways:

The administration of PTU and methimazole in high dosages, will inhibit production of thyroid hormone.Sodium iodide, potassium iodide, or Lugol’s solution can be administered to prevent the secretion of thyroxin. Beta blockers such as propranolol (Inderal, Inderal LA) to control heart rate, and IV steroids to enhance circulation.

Left untreated, thyroid storm treatment can result in:

ComaHeart failureLiver failureStrokeDeath

Treatment also includes:

Administration of IV fluids and electrolytesOxygen via nasal cannula or face maskMedication and cooling towels to control feverVitamins and AntibioticsIodine to block secretion of thyroid hormoneKidney dialysisSedatives to induce restPropranolol and dexamethasone to block hormone synthesisAntithyroid drugs and potassium iodine

If you have a hyperactive thyroid, it is important to take your medication as prescribed by your physician.  You can prevent thyroid storm by following your doctor’s orders.  Knowing the signs and symptoms of thyroid storm can prevent treatment delay and enable you to call 911 right away.