Weathering a Thyroid Storm:

The Diagnosis and Treatment of a Form of Hyperthyroidism

Although many thyroid disorders have the potential to pose a serious health risk, most are classified as chronic conditions that respond well to long-term treatment.

Typically, thyroid conditions emerge gradually, with symptoms developing slowly over an extended period of time. It can take months or even years for patients to notice signs indicating that there may be a problem. After diagnosis, most thyroid disorders can be well-controlled with strict adherence to a prescribed treatment plan, allowing patients to enjoy a relatively normal life free of serious health problems.

However, a small sub-class of thyroid illnesses poses more immediate health risks and often requires emergency medical intervention. Chief among these is the sudden-onset thyroid crisis that is known as a ‘thyroid storm.’ This week, we’ll take a look at this rare but dangerous thyroid disorder, exploring its causes and treatments, tell-tale symptoms, and the steps you should take if you suspect that you or a loved one may be experiencing a thyroid storm.

What is a Thyroid Storm?

Like most other thyroid disorders, the illness known as a ‘thyroid storm’ involves an imbalance in the production and distribution of thyroid hormones within the body. However, unlike most other thyroid disorders, a thyroid storm occurs suddenly, resulting in a significant hormonal imbalance that can be life-threatening if not treated immediately.

In many ways, a thyroid storm is similar to an advanced case of hyperthyroidism, which is the medical term for an overactive thyroid gland. In hyperthyroidism, the thyroid gland produces too much thyroid hormone. The resulting imbalance leads to symptoms such as weight loss, anxiety, ‘jittery’ feelings, and excessive energy.

A thyroid storm can be described as a case of severe, sudden hyperthyroidism. The physiological malfunctions that can take months or years to develop in classical hyperthyroidism occur in a much-compressed time span, causing many of the symptoms and secondary health problems associated with hyperthyroidism to occur all at once. As a result, the intensity and severity of the symptoms are increased considerably, often resulting in an emergency health crisis that can prove fatal if not treated properly.

What are the Symptoms of a Thyroid Storm?

To a large extent, the symptoms of a thyroid storm resemble the symptoms of hyperthyroidism, although they are typically much more intense. However, some of the tell-tale symptoms that indicate the onset of a thyroid crisis include: a very high fever (up to 105º), heart palpitations, rapid heart rate, shortness of breath, chest pains, a rapid increase in blood pressure, dementia or confusion, weakness, heavy perspiration, and nausea and vomiting. In most cases, the sudden onset of a wide range of serious symptoms at once will make it clear to bystanders that the affected individual is in need of emergency treatment.

Who is at Risk for a Thyroid Storm?

Statistically speaking, thyroid storms are very rare occurrences. Individuals without a prior history of thyroid problems almost never experience thyroid storms. Patients who have a family history of thyroid disorders or have undergone treatment for thyroid disorders -- especially hyperthyroidism -- stand the greatest chance of being struck by a thyroid storm.

Specific risk factors include:

• discontinuation or inconsistent use of hyperthyroidism medication
• excessive treatment of hypothyroidism, resulting in overproduction of thyroid hormone
• radioactive iodine treatment for a thyroid disorder
• a severe illness or health crisis, such as infection, disease, heart attack, or stroke, usually in a patient with hyperthyroidism

How are Thyroid Storms Treated?

Effective intervention and treatment of a thyroid storm involves returning the level of thyroid hormones in the body to normal levels as soon as possible. For this reason, it is vital to ensure that patients who may be experiencing a thyroid storm seek emergency treatment as soon as possible.

The standard treatments that are used to return thyroid hormone levels to the normal range include prescription compounds such as PTU, methimazole, sodium iodide, potassium iodide, and Lugol’s solution. Depending on the specific symptoms that the patient is experiencing, other treatments may be needed to control other problems such as heart palpitations and high blood pressure.

In the past, thyroid storms were often fatal. Today, however, the survival rate associated with these crises has improved significantly. The key to successful treatment is seeking emergency care at the first sign of a possible problem.

If you suspect that you or a loved one may be experiencing a thyroid storm, seek emergency medical treatment immediately. Be sure to check back each week for more of the news and information that can help you achieve and maintain optimal thyroid health.