The Basics of Thyroid Storm

Thyrotoxicosis is a condition in the endocrine system characterized by having an excess of thyroid hormones circulating in the body. This is often loosely used as a synonym of hyperthyroidism as both conditions are characterized by having an overactive thyroid gland. Thyrotoxicosis is quite common and treatments are already available in hospitals. However, it is its more serious form that is not only rare, but also quite difficult to treat once the peak of its severity is reached. This more serious form of thyrotoxicosis is called Thyroid Storm.

What is Thyroid Storm?

Thyroid Storm is an extremely life-threatening form of Thyrotoxicosis, although already considered as a rare condition in the modern era. The term itself was first used in scientific and medical journals in the 1920s, but information about the condition was hugely lacking back in the day. In an interview with EndocrineWeb[1], Takashi Akamizu, MD, PhD, professor of medicine at Japan’s Wakayama Medical University advised that patients with overactive thyroid should be made aware of research developments regarding Thyroid Storm, especially since the disease is extremely rare.

Causes of Thyroid Storm

According to a 2010 research[2] shared by the US National Library of Medicine, thyroid storm (also known as thyroid or thyrotoxic crisis) is characterized by a compromised organ function. Mortality rate remains high at 10 to 20 per cent in the few that are affected.

Thyroid Storm is commonly associated with an underlying Graves’ disease – which is the most common cause of hyperthyroidism. Clinical studies also show decomposition of organs accompanied by fever. It was traditionally seen as a condition experienced following thyroidectomy, but modern medications have since eliminated this risk.

Thyroid storm is also caused and aggravated by infection, as well as myocardial infraction, diabetic ketoacidosis, and trauma.

Symptoms of Thyroid Storm

According to a 2018 study by Pokhrel and Bhusal[3], Thyroid storm only accounts for about 1 to 2 per cent of hyperthyroidism cases and it occurs thrice as commonly in women than in men.

In addition since this is a form of thyrotoxicosis, any and all symptoms of a thyrotoxic state may also be seen in a patient suffering from thyroid storm. The criteria listed in the research by Burch and Wartofsky in 1993 details the levels of organic dysfunction seen when thyrotoxicosis in patients are severe enough to be labeled as thyroid storm.

Some of these are:

Possible Treatment for Thyroid Storm

Patients suffering from Thyroid Storm must immediately be admitted to intensive care and be monitored for heart rate and blood pressure while ventilatory support should also be on standby if needed.

Thyroid storm develops quickly and affects all systems of the body so it is important to be admitted to a hospital even with just a suspicion. Kristeen Moore of Healthline[4] has shared that anti-thyroid medication may be the first line of defense as these can reduce the production of thyroid hormones. Radioactive Iodine therapy also works as an ongoing care for people with hyperthyroidism.

 

[1] Thyroid Storm: What to Know. Doheny K. (2018 January 16). https://www.endocrineweb.com/conditions/thyroid/thyroid-storm-what-know

[2] Endocrine and metabolic emergencies: thyroid storm.  Caroll R., Matfin G. (2010 June). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475282/

[3] Thyroid Storm. Pokhrel B., Bhusal K. (Updated: 2018 September 8). https://www.ncbi.nlm.nih.gov/books/NBK448095/

[4] Thyroid Storm. Moore K., Reviewed by Biggers, A. https://www.healthline.com/health/thyroid-storm#prevention

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