Thyrotoxic storm; Thyrotoxic crisis; Hyperthyroid storm; Accelerated hyperthyroidism; Thyroid crisis; Thyrotoxicosis - thyroid storm
Thyroid storm is a rare life-threatening condition of the thyroid gland. It develops in cases of untreated hyperthyroidism, or overactive thyroid (thyrotoxicosis).
The thyroid gland is located in the neck, just above where your collarbones meet in the middle.
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 (wide pulse pressure)
- A very high heart rate
- A history of hyperthyroidism
- An exam of your neck may find that your thyroid gland is enlarged (goiter)
Other blood tests are done to check heart and kidney functions and to check for infection. Liver function tests provide added diagnosis and treatment information.
Thyroid storm is a medical emergency. It is life threatening. Often, the person needs to be admitted to the intensive care unit. Treatment may include:
- Oxygen therapy for breathing problems
- Fluids for dehydration
- 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
- Medicine to slow the heart rate
- Vitamins and glucose
The goal of treatment is to decrease thyroid hormone levels in the blood. Sometimes, high doses of iodine is given to try and stun the thyroid. Other drugs known as thionamides 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. In some severe cases, glucocorticoids (steroids) are given.
Antibiotics are given in case of infection.
When to Contact a Medical Professional
This is an emergency condition. Call 911 or the local emergency number if you have hyperthyroidism and experience symptoms of thyroid storm.
To prevent thyroid storm, hyperthyroidism should be treated.
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Last reviewed on: 2/1/2022
Reviewed by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.