Thyroid Storm Treatment, Causes, symptoms, and Diagnosis
Thyroid storm is a complicated form of Hyperthyroidism, it is a rare and life-threatening medical condition that needs emergency attention. Common symptoms are persistent sweating, heart failure, confusion, and high fever. The patient feels better after the immediate treatment in the hospital's emergency room.
What is a thyroid storm?
A Thyroid storm is life-threatening and a rare complication of Hyperthyroidism. It’s also called a thyroid crisis or thyrotoxic crisis. This medical condition happens when the thyroid gland secretes a huge amount of thyroid hormone in a short time period. A thyroid storm is a health emergency, and without insistent and quick treatment, it may cause death.
What does thyroid do?
A
thyroid is a butterfly-shaped gland situated in the middle of the neck. The
thyroid gland produces two types of significant hormones T3 (Triiodothyronine)
and T4 (Thyroxine), that help the growth and body functions. The thyroid gland
plays a significant role in several main body functions.
A
thyroid is a butterfly-shaped gland situated in the middle of the neck.
The
thyroid gland produces two types of significant hormones T3 (Triiodothyronine)
and T4 (Thyroxine), that help the growth and body functions. The thyroid gland
plays a significant role in several main body functions.
T3 and
T4 together are called thyroid hormones, and these hormones regulate the body
temperature and control the metabolism and heart rate.
The
person, who has a thyroid storm, the huge amount of thyroid hormones in the
body releases the metabolism at a high speed that is dangerous and fatal.
When a
person has hyperthyroidism, the thyroid produces a very high amount of thyroid
hormone (T3 and T4), which turns out cells to work too quickly. For example,
heart rate and respiration rate will be elevated than normal would be. A person
may speak more quickly than usual.
When there is forceful metabolism activity, the body needs additional oxygen, the heartbeat gets fast called tachycardia which may cause heart failure.
How common is the thyroid storm?
A
Thyroid storm is not a common but rare medical emergency, in the United States,
around five to seven individuals per 1 million people get a thyroid storm.
Does thyroid storm come suddenly?
As
thyroid storm is a rare complication of hyperthyroidism, which may fatal, in
this condition thyroid suddenly produces a large amount of thyroid hormones in
a short period of time. The thyroid storm needs quick medical attention.
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Causes
What causes a thyroid storm?
Health
experts are not so far sure about the definite factors that turn out in a
thyroid storm. Even though, a thyroid storm may develop if anyone is not
treated or undertreated for hyperthyroidism for a long time. It’s repeatedly
caused by a sudden and acute condition. But not all hyperthyroidism cases
experience thyroid storm.
These
sudden conditions are
- Thyroidectomy
(Thyroid surgery)
- Suddenly
stop taking antithyroid medication
- Trauma
- Nonthyroid
surgery
- Infection
associated with hyperthyroidism
- Acute
diseases, such as heart failure, diabetic ketoacidosis (KDA), and drug
reaction.
- Stroke
- Pregnancy
- A
rapidly large amount of iodine enters the body, for example, in certain
imaging procedures that are used, iodinated contrast agents.
Who gets a thyroid storm?
As thyroid storm is complicated hyperthyroidism, an individual who has a condition that turns out hyperthyroidism, for example, toxic thyroid adenoma, or Grave’s disease, is more on the verge of getting thyroid storm. Like with all thyroid disorders, women and individuals allocated female at birth are more prone to get thyroid storm than men allocated male at birth. The usual age of an individual who experiences thyroid storm is in between 42-43 years.
What does thyroid storm feel like?
While
thyroid hormones participate in many body functions, if anyone gets thyroid
storm in general he will feel pretty bad all over, and he may experience
- Very
anxious or agitated
- Very
sweaty and hot
- Sick
to stomach
- Shaky
- Feel
like he does not have control over his body
- Confusion
- Unconsciousness
If anybody is experiencing one of these symptoms, an immediate appointment and checkup is necessary to get back to the normal life.
Symptoms
What are the signs and symptoms of thyroid storm?
Signs
and symptoms of thyroid storm are as similar to hyperthyroidism patient
experiences but, they are more intense, abrupt, and rigorous, that’s why
patients with thyroid storm can’t seek care on their own.
Common
signs and symptoms are
- Persistent
sweating
- Rapid
heart rate called tachycardia that can go above 140 beats /minute.
- High
fever. A temperature may between 104 to 106 degrees Fahrenheit
- Congestive
heart failure
- Restlessness
- Confusion
- Unconsciousness
- Shaking
- Abdominal
pain
- Severe
nausea and/or vomiting
- Jaundice
(Yellowish eyes and skin)
- Diarrhea
What is the first thing to do during a thyroid storm?
If you
expect you have a thyroid storm by experiencing the symptoms of a thyroid storm
for example elevated heart rate, or high blood pressure, immediately make a
call to 911. Your healthcare providers will measure your thyroid hormone levels
with a thyroid blood test.
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Diagnosis
How thyroid storm is diagnosed?
A
person who shows any symptom of thyroid storm is usually admitted to the
emergency room after the healthcare provider’s recommendations. A patient with
a thyroid storm usually exhibits high blood pressure as well as an elevated
heart rate.
Healthcare
providers also practice the physical examination to observe the sign of thyroid
storms such as
- Ophthalmopathy,
which is a complicated condition of Grave’s disease, is associated with
eye problems, for example, bulging and swollen eyes.
- Moist
and warm skin
- Tachycardia
or atrial fibrillation
- Hand
tremors
- Lid
lag, in which the patient’s upper eyelid is higher than it should be when
looking down.
- Management and Treatment
Treatment
How thyroid storm is treated?
If an
individual experiences symptoms of a thyroid storm like tachycardia, hand
tremors, lid lag or confusion, or other symptom mentioned above, it is
significant to get to the nearest hospital as soon as possible because this is
a life-threatening medical emergency.
The
treatment strategies suggested by healthcare providers are divided into 4
common groups, which include
- Treatment
for the patient’s body system and tissues for example heart is affected by
the high amounts of thyroid hormones.
- Embattled
treatment, works in opposition to the making and production of thyroid
hormones. Antithyroid medications such as methimazole also called
Tapazole, and propylthiouracil also known as PTU, are usually given to
decrease the making of thyroid hormones.
- Treatment
of the condition or disease that turned out thyroid storm
- Other
supportive treatment strategies to assist with side effects and symptoms.
Treatment
and medication therapies for thyroid storm may comprise
- Beta-blockers
to deal with symptoms
- Antithyroid
medicines like thioamides stop the thyroid from producing new thyroid
hormones.
- Use
iodine solution, to prevent the thyroid from producing hormones.
- Use
Bile acid sequestrants to stop the gut from reabsorbing thyroid hormones.
- Respiratory
treatment, for example, supplemental oxygen
- Cooling
blankets and acetaminophen to lower the patient’s temperature
- An individual having a thyroid storm is probably in ICU (Intensive care Unit) in the hospital so the healthcare provider's team can supervise the treatment and symptoms repeatedly.
How soon will I better after treatment for thyroid storm?
If you get accurate medical treatment, you will probably feel well again within 24 hours. It will take up to about 7 days to treat your thyroid storm.
Prevention
Can I prevent thyroid storm?
The
most efficient way to prevent the commencement of a thyroid storm is to
maintain your thyroid health plan. Take your medication strictly prescribed by
your healthcare providers. Keep all the appointments with healthcare providers
and follow throughout with blood work orders as required.
Most
cases of thyroid storm are preventable, but if you have hyperthyroidism,
healthcare providers suggested some things you can do to try to stop or prevent
thyroid storm, including
- Visiting
your healthcare providers on a regular basis to make sure your treatment
is going well.
- Constantly
taking your medicines prescribed by healthcare providers.
- Due to the body’s stress response to anesthesia or surgery thyroid stress may develop. That’s why healthcare providers prescribed antithyroid medicines before surgery in order to prevent thyroid storm.
Long term outlook
As a
thyroid storm is a life-threatening medical emergency, it requires urgent,
aggressive medical attention. It can cause congestive heart failure or
fluid-filled lungs if left untreated. However, within 24 hours of treatment,
most people experience improvement.
The
possibility of surviving a thyroid storm elevates if quick medical care is
provided. When thyroid hormone levels returned back to the normal range,
related complications may be decreased.
The
death rate for individuals with untreated thyroid storm is approximately to be
75%.
Risks
issues for a bad prognosis are
- If
an individual, has neurological problems on admission to a hospital, for
example, lessened mental function and sensation problems.
- If
an individual of old age
- If
an individual needs mechanical ventilation (breathing through the machine)
or/and dialysis to treat thyroid storm.
- Due to some health conditions, healthcare providers are unable to use antithyroid and beta-blockers medicines to treat thyroid storm.
Can thyroid storm be fetal?
A
thyroid storm is an emergency condition that can be fatal, if it’s not treated
on time. Even it can be fatal with treatment. About 10-30% of cases of thyroid
storm result in death.
It is necessary to reach the hospital as soon as possible if someone exhibits symptoms of thyroid storm, don’t wait for symptoms to get worse.
Complications
What are the complications of thyroid storm?
As
discussed above thyroid storm may result in serious complications if treatment
is interrupted or it’s untreated, including:
- Seizures
- Blood
clots
- Cardiac
failure (Heart attack)
- Delirium
- Coma
FAQ
Q1: What triggers thyroid storm?
- Most
of the time thyroid storm happens in individuals with uncontrolled
hyperthyroidism due to stress, for example, infections, heart attack,
trauma, etc.
Q2: What is the first line treatment for thyroid storm?
- Tachycardia is the major and serious symptom of Thyroid
Storm, so bisoprolol (given orally) or Beta-1-selective adrenergic
antagonists such as esmolol, and, landiolol (given intravenously) will be
the first choice of treatment of Thyroid Storm.
Q3: What medication is administrated for thyroid
storm?
- Generally,
in medical practice, 100 mg of hydrocortisone after every 6-hour gap
intramuscular (IM) or intravenous (IV) is given until the resolution of
the thyroid storm. Treatment would be tapered properly depending on the
required time period of steroid therapy.
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