What you should know about a Thyroid Storm

The thyroid gland plays a significant role by controlling our metabolism and how our body uses energy.

But still, some think thyroid conditions are just “hormone problems” and may not take them as seriously as they should.

The hormones released by the thyroid gland affect every major organ in your body including brain development, digestive function and your mood, among others.

So, it’s very important to get a proper diagnosis and proper care for thyroid conditions, like hyperthyroidism, hypothyroidism, Hashimoto’s Thyroiditis, Grave’s disease and of course thyroid cancer.

But there’s another serious condition that can erupt for people with thyroid conditions — a thyroid storm.

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What is a thyroid storm

The term thyroid storm has been around for decades, but information on why it happens and how to treat it have been lacking. Here’s what we know…

Anyone who has been diagnosed with an overactive thyroid is at risk of a thyroid storm, though according to recent estimates, it affects less than one person in every 100,000 yearly in the U.S.

Thyroid storm, a severe form of thyrotoxicosis (or thyroid crisis), occurs when the thyroid gland, located at the base of your neck, releases large amounts of thyroid hormone suddenly.

This causes systolic blood pressure (top number, when your heart is contracting) to rise, while diastolic (bottom number) blood pressure plummets.

When this happens, a person’s heartbeat may speed up, they may have difficulty breathing. This quickly becomes a medical emergency that could lead to multiple organ failure, heart failure, or other related causes.

Some signs that may precede include a fever of 100 degrees or more, systolic blood pressure of 130, unusual or unexplained changes in consciousness, diarrhea, vomiting and jaundice.

Causes and latest recommendations

Because the condition is rare, Takashi Akamizu, M.D., Ph.D., professor of medicine at Wakayama Medical University in Japan, and other doctors have felt much more information was needed to properly handle this condition.

He and a team of researchers decided to review existing studies as well as the results of surveys they conducted in Japanese hospitals to compare to the existing 2016 guidelines for managing thyroid storm.

His review article was published in the journal Thyroid, and for the first time, proposed guidelines based on solid evidence which were endorsed by the American Thyroid Association (ATA).

The guidelines present specific key points that Dr. Akamizu says those with hyperthyroidism need to know about thyroid storm:

While surgical removal of the thyroid was linked to a greater risk of developing thyroid storm, he says that ”nowadays, thyroidectomy itself rarely causes the storm if thyroid function is preoperatively controlled [with the strategy your doctor orders].”
The most common trigger for thyroid storm was inconsistent use of prescribed antithyroid medicines or stopping the medication use without any discussion with or agreement of the doctor.
Infection, especially of the upper respiratory tract, was the next most common trigger.
Both iodine and antithyroid medications, given to normalize thyroid hormone levels, can be given at the same time. Other guidelines suggest giving the drugs first, then the iodine. Dr. Akamizu cites research findings that indicate taking both simultaneously helps thyroid levels return to normal more quickly.
In those with congestive heart failure, the commonly used drug, propranolol, should be used with caution.
Aspirin should not be taken because it could increase thyroid hormone levels above what is desirable.
Be aware of these signs and symptoms of thyroid storm and get medical help right away.

Currently, there is no specific laboratory test that can diagnose a thyroid storm. But blood tests are often ordered as part of the evaluation to look for high levels of thyroid hormones in the blood. The thyroid-stimulating hormone (TSH) test can also provide additional information about what is going on in the body.

Once thyroid storm is recognized, physicians start medical interventions immediately. Common treatments for thyroid storm include antithyroid medications, potassium iodide, beta-blockers to control heart symptoms, and steroids. Once the patient is stabilized and has made steady improvement, maintenance therapy is applied with measures to prevent a recurrence of thyroid storm.

Thyroid conditions can be difficult to diagnose because the symptoms can be easily confused with other conditions. Common conditions include: