How To Recognize and Treat a Thyroid Storm

While the severe hyperthyroid condition called "Thyroid Storm" is not common, both patients with hyperthyroidism and hypothyroidism have the potential for experiencing this potentially life-threatening condition. Patients with thyroid disorders should be educated in recognizing the signs and symptoms of this acute condition.

1. Thyroid Storm is a condition of hyperthyroidism. While most cases of hyperthyroidism are not immediately dangerous or life threatening, a Thyroid Storm is a sudden and severe type of hyperthyroidism (acute). A person who experiences this condition is in need of immediate emergency care to prevent organ damage in the body and to prevent the organs from shutting down, which can result in coma or death. Acute hyperthyroidism, which increases the metabolism to a dangerously high level, causes severe hypertension and tachycardia (rapid heart rate), which can be two major causes for damage occurring in the body if the condition is not treated as soon as possible.
2. The signs and symptoms of Thyroid Storm are those of acute hyperthyroidism. The symptoms of severe hyperthyroidism caused by this condition include rapid heart rate and arrhythmias, severe and rapidly increasing blood pressure (hypertension), extreme sweating, chronic anxiety and panic attacks, very high energy alternating with chronic fatigue, mental confusion and disorientation, erratic behavior, sudden onset of fever, diarrhea, vomiting, severe muscle weakness and loss of consciousness. A sign of Thyroid Storm in blood tests would be highly elevated thyroid hormone levels (T-4 and T-3) and a very low (suppressed) TSH level. The TSH hormone comes from the pituitary gland and reacts adversely to highly elevated thyroid hormone levels and will drop to undetectable levels.
3. There are a number of causes for Thyroid Storm. The major causes of this condition include severe infections occurring in patients treated for typical hyperthyroidism, heart attacks occurring in hyperthyroid patients, sudden discontinued use of medication to control hyperthyroidism when still needed, overdosing hypothyroid patients with thyroid hormone replacement medication (thyrotoxicity) and complications from over-treatment with radioactive iodine, a procedure used to destroy diseased thyroid glands. Some doctors believe that some patients who have undiagnosed adrenal insufficiency and who are treated with thyroid hormone therapy without first correcting it can experience a Thyroid Storm. Their belief is that the uncorrected adrenal insufficiency will progress to an "adrenal crises" (life threatening), which in turn also triggers the onset of a Thyroid Storm.
4. There are effective treatments for Thyroid Storm. The treatment for this severe form of acute hyperthyroidism is the same as that used to control all types of hyperthyroidism, which is to slow thyroid hormone production. This is accomplished by use of "anti-thyroid drugs," which act as an agent to block the thyroid gland from over-producing hormones. Patients may also be treated with beta-blocker medications, which control rapid heart rate and elevated blood pressure. Due to rapid loss of body fluid from diarrhea and severe sweating, patients may also need body fluids replaced intravenously, which can also replenish loss of important electrolyte levels in the body. Corticosteroid anti-inflammatory medications may also be administered to patients to reduce inflammation in the body caused by Thyroid Storm and they may also be given drugs to reduce fever in the body.

When Thyroid Storm is suspected, it is extremely important to report to the emergency care unit of a hospital for immediate treatment of this somewhat rare but serious health condition.