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Weathering the perils of thyroid storm

Your thyroid gland produces thyroid hormone, which regulates your metabolism, growth and temperature. When your thyroid gland malfunctions, you may seem a little off balance. If it makes too little thyroid hormone, you feel sluggish and tired. If it makes too much, you’re shaky and anxious.

If your thyroid gland makes way too much thyroid hormone for a long time — and you’re unaware that you have a problem with your thyroid — you can be thrown into a perilous condition called thyroid storm.

Deepika Reddy, MD, Endocrinologist, explains how hyperthyroidism progresses to thyroid storm and details its treatment.

Your Thyroid

“In some cases, your hyperthyroidism can sort of simmer along, but if you leave it untreated, it can result in a rip-roaring, life-threatening condition, called thyroid storm.”

Your thyroid gland is about the size and shape of a large butterfly. It’s under your Adam’s apple at the base of your neck, right below your voice box (larynx). Your thyroid gland makes the thyroid hormone, called thyroxine (T4).

Thyroxine is the accelerator for every action in your body. Sometimes your body overproduces the thyroid hormone in a condition called hyperthyroidism, says Dr. Reddy.

Hyperthyroidism

Hyperthyroidism is the overproduction of thyroid hormone. It’s often caused by an autoimmune disorder called Graves disease, Dr. Reddy says. Other causes are toxic nodular goiter, toxic multinodular goiter and thyroiditis.

Symptoms of hyperthyroidism include weight loss, tremulousness, palpitations, heat intolerance, diarrhea, anxiousness and goiter, says Dr. Reddy.

“In some cases, your hyperthyroidism can sort of simmer along, but if you leave it untreated, it can result in a rip-roaring, life-threatening condition, called thyroid storm,” says Dr. Reddy.

Thyroid storm is also known as thyrotoxic storm and accelerated hyperthyroidism.

Thyroid Storm

Thyroid storm results when your hyperthyroidism is left untreated or is uncontrolled.

Symptoms of thyroid storm, according to the American Association of Clinical Endocrinologists, include:

  • Tachycardia – substantially elevated heart rate
  • Mental status changes
    • Delirium
    • Psychosis
    • Stupor
    • Irregular heartbeat, such as atrial fibrillation
    • Low blood pressure
    • Shortness of breath
    • Shaking
    • Sweating
    • Nausea
    • Abdominal pain

If the condition persists without treatment, according to the National Institutes of Health, thyroid storm may result in:

  • Coma
  • Congestive heart failure
  • Pulmonary edema
  • Death

“There’s not an insignificant mortality rate associated with thyroid storm, requiring ICU-level care,” Dr. Reddy says.

Treatment for Thyroid Storm

Thyroid storm requires immediate and aggressive treatment. Go to an emergency room or call 9-1-1 if you have:

  • Change in consciousness
  • Dizziness
  • Rapid, irregular heartbeat

Dr. Reddy notes that “we read about thyroid storm in training and initially we were told it’s not very common. But as long as I’ve been here at Scott & White, I’ve seen at least 8 or 10 people in thyroid storm. It’s actually not that uncommon.”

Treatments for thyroid storm — once your physician team gets you stabilized —include:

  • Medication
  • Radioactive iodine ablation
  • Surgery

Your physician will discuss which option is best for you.

Trauma or infection may precipitate an occurrence of thyroid storm, according to the NIH. Your physician team may run a series of tests to determine the precipitating factors for your thyroid storm episode.

For more information about hyperthyroidism, visit Baylor Scott & White website or find a physician near you. 

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Weathering the perils of thyroid storm