Thyroid Storm

A Thyroid Storm is sudden extreme over activity of the thyroid gland. Anyone experiencing the symptoms should know that this is a life-threatening emergency. All body functions are accelerated to dangerously high levels. Severe strain on the heart can lead to a life-threatening irregular heartbeat, extremely fast pulse, and shock. Thyroid storm may also cause fever, extreme weakness, restlessness, mood swings, confusion, altered consciousness, or an enlarged liver.

Thyroid Storm is generally caused by untreated or inadequately treated hyperthyroidism and can be triggered by infection, injury, surgery, poorly controlled diabetes, pregnancy or labor, or other medical stresses. A Thyroid Storm can occur when drugs being used to treat thyroid problems are stopped. Thyroid Storms are rare in children.

What can cause a Thyroid Storm?

• Infections, especially of the lung.
• Thyroid surgery in patients with an overactive thyroid gland.
• Termination of medications given for hyperthyroidism.
• Treatment with radioactive iodine.
• Pregnancy or labor.
• Severe medical stresses such as heart attack or heart emergencies.
• Over-replacement of thyroid hormone

What are the symptoms of a Thyroid Storm?

• Rapid heart beats / irregular heart beat
• High body temperature
• Palpitations / Chest pain / Shortness of breath
• Anxiety and irritability / confusion / disorientation
• Increased sweating / dehydration
• Rapid Weight Loss
• Weakness or fatigue
• Rapid heart rate
• Nausea/vomiting
• Diarrhea
• Heart failure
• Exaggerated reflexes
• Stupor or Coma

What treatment is available?

People experiencing symptoms of a Thyroid Storm should seek medical help immediately. This is a life threatening condition.

Earlier in the 19th century, the mortality rate of a thyroid storm approached 100%. However, today, with the use of aggressive therapy, the death rate from thyroid storm is less than 20%. The key to surviving is seeking help as soon as any of the symptoms appear.

Other Thyroid Illness

THYROID AND PREGNANCY

During pregnancy, thyroid hormone is very important for the baby to develop normally. While it is rare, fetal and neonatal

death is often due to hypothyroidism in their mothers. Further, it appears that the rate of miscarriage is higher in mothers

that are hypothyroid during their pregnancy.

 

HYPOTHYROIDISM

A condition where the thyroid gland is underactive and doesn’t produce enough thyroid hormone. Treatment requires taking

thyroid hormone pills. The diagnosis of hypothyroidism is made most often by increased levels of Thyroid Stimulating

Hormone (TSH). The upper normal limit of TSH is the subject of considerable controversy. As a result, the TSH normal

range limits, as determined from national databases, have not yet been uniformly applied to clinical practice. This study

looked at whether the levels of TSH changed according to age groups and ethnic groups.

 

GOITER

A thyroid gland that is enlarged for any reason is called a goiter. A goiter can be seen when the thyroid is overactive, underactive

or functioning normally. If there are nodules in the goiter it is called a nodular goiter; if there is more than one

nodule it is called a multinodular goiter. Multinodular goiters are very common as we get older. Most function normally

and do not require any treatment. Occasionally, multinodular goiters can enlarge and put pressure on structures in the

neck, causing choking and difficulty swallowing. When that occurs, the usual treatment is surgery. Recently, some studies

have suggested that large multinodular goiters can shrink if treated with radioactive iodine (RAI). Further, some studies

have shown that the RAI can be more effective if the thyroid is turned on first by treatment with recombinant human

TSH (rhTSH), a compound used in patients with thyroid cancer.

 

HYPERTHYROIDISM

A condition where the thyroid gland is overactive and produces too much thyroid hormone. Hyperthyroidism may be

treated with antithyroid meds (Methimazole, Ptopylthiouracil), radioactive iodine or surgery.

 

GRAVES’ DISEASE

Graves’ disease is the most common form of hyperthyroidism in the United States. A mild anemia, with low hemoglobin

levels, can sometimes develop in patients with Graves’ disease. A major symptom of anemia is fatigue, so this may play

a role in the tiredness that some patients have when the Graves’ disease is active. The cause of this anemia is uncertain.

The aim of this study was to determine how common it occurs and what might be the cause of anemia associated with

Graves’ disease.

 

THYROID CANCER

After surgery, most thyroid cancer patients are treated with radioactive iodine (RAI) to destroy any remaining thyroid

cells, both normal and cancerous. In order for the RAI to be effective, the patient’s TSH levels need to be increased to

stimulate the thyroid cells to take up the RAI and be destroyed. There are two ways to increase TSH: 1) withdraw the patient

from thyroid hormone (THW), making the patient hypothyroid for a short period of time or 2) use recombinant human

TSH (rhTSH) to allow patients to stay on their thyroid hormone and avoid the short term hypothyroidism. Recently,

smaller doses of I-131 have been used effectively with THW to destroy remaining thyroid cells in low-risk-patients with

thyroid cancer.

 

Other Thyroid Illness reprinted with permission from the American Thyroid Association.

 

For more information please visit:

Graves Disease Foundation

American Thyroid Association