–Dr Subhash Kumar Wangnoo, Senior Consultant Endocrinologist and Diabetologist, Indraprastha Apollo Hospital
Thyroid storm also referred to as thyrotoxic crisis, is an acute, life-threatening condition. It is caused due to the excessive release of thyroid hormones (THs) in individuals with thyrotoxicosis. During a thyroid storm, an individual’s heart rate, blood pressure, and body temperature can rise to dangerously high levels. Without immediate and aggressive treatment, thyroid storm can often be fatal.
The thyroid gland is a butterfly-shaped gland that is located in the front of our neck and is an endocrine gland. Hormones are stored and are produced in the thyroid gland and it affects the functioning of the various organs in the body. The hormones regulate the body’s metabolic rate; its heart rate as well as digestive function, brain development, muscle control, bone maintenance, and moods.
Causes of Thyroid Storm
Thyroid storm is rare. It develops in people who have hyperthyroidism but aren’t receiving appropriate treatment. This condition is marked by the extreme overproduction of the two hormones produced by the thyroid gland. Not all people with hyperthyroidism develop thyroid storm.
Causes of this condition include:
- severe undertreated hyperthyroidism
- the untreated overactive thyroid gland
- infection associated with hyperthyroidism
People with the condition of hyperthyroidism may develop thyroid storm after experiencing one of the following:
- severe emotional distress
- diabetic ketoacidosis (A serious diabetes complication where the body produces excess blood acids)
- congestive heart failure
- pulmonary embolism
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Symptoms of Thyroid Storm
Symptoms of thyroid storm are quite similar to those of hyperthyroidism, but they are more sudden, severe, and extreme. Common symptoms include:
- a racing heart rate that exceeds 140 beats per minute
- high fever
- persistent sweating
The primary treatment of thyroid storm is with inorganic iodine, lithium, steroids, and ant-thyroid drugs to reduce synthesis and release of thyroid hormone. Temperature control and intravenous fluids are also mainstays of management. Beta-blockers are often used to reduce the effects of thyroid hormone. Patients often require admission to the intensive care unit.
Preventing Thyroid Storm
The most effective way to prevent the thyroid storm is to keep up with a thyroid health plan. Take medications as instructed. Regularly consult your doctor and follow through with blood tests as and when required. You can prevent thyroid storm by:
- Keeping a close watch on your condition and monitoring your symptoms.
- Going to your doctor for regular follow-up.
- Educating yourself about thyroid storm.
- Get early treatment if you have any warning symptoms of thyroid storm.
- Avoiding excessive caffeine/nicotine.
- Withdrawing yourself from situations, which can cause stress and precipitate anxiety.
- Avoiding long strenuous exercise.
- Following a well-balanced diet provides for increased metabolism.
- Not having foods or drinks containing artificial preservatives, which can make you irritable.
- Getting yourself treated earlier for any infection.
- Not discontinuing medicines prescribed for your hyperthyroidism.
A thyroid storm requires immediate, aggressive emergency medical attention. When left untreated, it can cause congestive heart failure or fluid-filled lungs. The mortality rate for a patient with untreated thyroid storm is estimated to be 75 per cent.
The chances of surviving thyroid storm increase if you quickly seek medical care. Related complications may be lessened once your thyroid hormone levels have returned to the normal range.