Thyroid stormThyrotoxic 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).
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
The thyroid gland is located in the neck, just above where your collarbones meet in the middle.
Thyroid storm occurs in people with uncontrolled hyperthyroidism due to a major stress such as:
- Heart attack
Rarely, thyroid storm can be caused by radioactive iodine therapy for Graves disease. This can occur even a week or more after treatment.
Graves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occ...
Symptoms are severe and may include any of the following:
- Change in alertness (consciousness)
- Increased temperature
- Pounding heart (tachycardia)
- Bulging eyeballs
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)
A TSH test measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It prompts the thyroid g...
Triiodothyronine (T3) is a thyroid hormone. It plays an important role in the body's control of metabolism (the many processes that control the rate...
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.
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
Pulmonary edema is an abnormal buildup of fluid in the lungs. This buildup of fluid leads to shortness of breath.
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.
Jonklaas J, Cooper DS. Thyroid. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 213.
Marino M, Vitti P, Chiovato L. Graves' disease. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 82.
Tallini G, Giordano TJ. Thyroid gland. In: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. Rosai and Ackerman's Surgical Pathology. 11th ed. Philadelphia, PA: Elsevier; 2018:chap 8.
Thiessen MEW. Thyroid and adrenal disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 120.
Thyroid gland - illustration
The thyroid gland, a part of the endocrine (hormone) system, plays a major role in regulating the body's metabolism.
Review Date: 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.