Thyroid stormThyrotoxic storm; Thyrotoxic crisis; Hyperthyroid storm; Accelerated hyperthyroidism; Thyroid crisis; Thyrotoxicosis - thyroid storm
Thyroid storm is a very rare, but life-threatening condition of the thyroid gland that develops in cases of untreated thyrotoxicosis (hyperthyroidism, or overactive thyroid).
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
The thyroid gland is located in the neck, just above where your collarbones meet in the middle.
Thyroid storm occurs due to a major stress such as trauma, heart attack, or infection in people with uncontrolled hyperthyroidism. In rare cases, thyroid storm can be caused by treatment of hyperthyroidism with radioactive iodine therapy for Graves disease. This can occur even a week or more after the radioactive iodine treatment.
Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. ...
Symptoms are severe and may include any of the following:
- Change in alertness (consciousness)
- Increased temperature
- Pounding heart (tachycardia)
Exams and Tests
The health care provider may suspect thyrotoxic storm based on:
- A high systolic (top number) blood pressure reading with a lower diastolic (bottom number) blood pressure reading may be low
- An increased heart rate
A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It prompts the thyroid g...
Triiodothyronine (T3) is a thyroid hormone. It plays an important role in the body's control of metabolism (the many processes that control the rate...
Other blood tests are done to check heart and kidney functions and to check for infection.
Thyroid storm is life-threatening and requires emergency treatment. Often, the person needs to be admitted to the intensive care unit. Treatment includes supportive measures, such as giving oxygen and fluids in case of difficult breathing or dehydration. Treatment may include any of the following:
- Cooling blankets to return the body temperature to normal
- Monitoring any excess fluid in older people with heart or kidney disease
- Medicines to manage agitation
- Vitamins and glucose
The final goal of treatment is to decrease the levels of thyroid hormones in the blood. Sometimes, iodine is given in high doses to try and stun the thyroid. Other drugs may be given to lower the hormone level in the blood. Beta blocker medicines are often given by vein (IV) to slow the heart rate, lower blood pressure, and block the effects of the thyroid hormone excess.
Antibiotics are given in case of infection.
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
Pulmonary edema is an abnormal buildup of fluid in the lungs. This buildup of fluid leads to shortness of breath.
When to Contact a Medical Professional
This is an emergency condition. Call 911 or another emergency number if you have hyperthyroidism and experience symptoms of thyroid storm.
To prevent thyroid storm, hyperthyroidism should be treated.
Marino M, Vitti P, Chiovato L. Graves' disease. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 82.
Thiessen MEW. Thyroid and adrenal disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 120.
Thyroid gland - illustration
The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.
Review Date: 2/22/2018
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.