Thyroid Storm Symptoms, Causes, and Treatment

In most instances, thyroid disease is a gradual process in which initial symptoms can mimic other conditions, and therefore go largely unnoticed. Thyroid storm, however, is an emergency situation that can mean the difference between life and death if not treated as soon as symptoms present themselves.

Symptoms of Thyroid Storm (thyrotoxicosis):

• Increased body temperature


• Tachycardia (rapid heart rate)


• Nausea/vomiting


• Frequent loose bowel movements


• Heart palpitations


• Heart failure


• Pulmonary edema


• Confusion

Fever associated with thyroid storm can reach as high as 106 degrees. There is also a marked increase in thyroid hormone levels in the blood.

This condition can be caused by the following factors:

Causes of thyroid storm may include:

• Stopping the required hyperthyroidism medications


• Ingesting too much of thyroid hormone


• Radioactive iodine treatments


• People with hyperactive thyroid conditions who experience severe infection or illness


• Myocardial 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, or disorientation, needs to be hospitalized ASAP! A medical history and diagnostic testing will be conducted to check:

• Blood cell count


• Electrolytes, such as sodium, potassium, and calcium


• Blood sugar level


• Thyroid hormone levels will also be tested.


• Liver function test

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 given to prevent the release of thyroid hormone. Beta blockers such as propranolol (Inderal, Inderal LA) to control heart rate, and IV steroids to enhance circulation.

Delayed treatment can result in:

• Coma


• Heart failure


• Liver failure


• Stroke


• Death


• Treatment also includes:


• Administration of IV fluids and electrolytes.


• Oxygen via nasal cannula or face mask


• Medication and cooling towels to control fever,


• Vitamins


• Antibiotics,


• Iodine to block secretion of thyroid hormone


• Possible dialysis.


• Sedatives to induce rest.


• propranolol and dexamethasone to block hormone synthesis.


• Antithyroid drugs and potassium iodine.

Thyroid storm is a preventable condition by strictly adhering to the hyperactive thyroid regimen prescribed by your doctor. Fast and aggressive treatment makes for a better outcome for this disease. That is why it is important to know the signs, symptoms, and warning signs of an impending thyroid storm, as it is a dire medical emergency that requires treatment as soon as symptoms are first noticed.

Be sure to follow-up with your health care provider to monitor thyroid hormone levels in the event that dosage may need to be changed.

by Barb Hicks, RN/LMT