Thyroid storm is also known as thyrotoxic crisis-a condition that can occur in patients with an over-active thyroid. Thyroid storm is not common, but when it does occur, a thyroid storm is a medical emergency. To understand thyroid storm, it is best to understand a little about hyperthyroidism, in general. Hyperthyroidism is characterized by the overproduction of thyroid hormones. The symptoms of hyperthyroidism are: feeling hot, sweating, rapid heart rate, weight loss, and sometimes the patient has eye problems that make the patient appear as if the eyes are bulging-exophthalmos.
Thyroid storm is a life and death emergency. 90 percent of patients with thyroid storm die unless diagnosis is made early. The symptoms of thyroid storm are: elevated temperature-as high as 105 degrees and higher; rapid heart rate; chest pain; anxiety; shortness of breath; disorientation; confusion; profuse sweating; nausea and vomiting; jaundice-indicative of liver failure; seizures; hypertension; hypotension-secondary to shock, coma, cardiac arrhythmias, and heart failure.
If you-or a family member or friend-have hyperthyroidism and have the symptoms of a thyroid storm listed above, call 911 and get help immediately. You can very quickly lose control of your mental and physical capacities. Once the EMT’s (emergency medical technicians) arrive they will take care of you. Once in the ambulance, protocol is to start you on oxygen and to start an IV line on you. The IV line is to keep a vein open for any emergency drugs that will have to be administered to you.
Once you arrive in the ED (emergency department) your doctor will prioritize your care according to the severity of your symptoms. You may be hooked up to a cardiac monitor so your heart rhythm can be monitored and recorded. Blood work will be done to check your complete blood count (CBC), blood sugar, thyroid hormone levels, electrolytes and tests may be done to measure your liver function. Your doctor will try to determine what brought on your thyroid storm. The doctor will know by examining you that you are in a crisis situation, he/she will not have to wait for lab results to make the diagnosis. The labs will tell the doctor specific things, that he/she needs to know to better treat you.
You may be give special anti-inflammatory drugs-corticosteroids-through your IV line. The medications may be hung as a piggy-back, or they may be directly administered via a syringe IV push, by the nurse. After the emergency is over you may be admitted into the hospital in an ICU ward until stable and then to a regular room until you are stable enough to go home. When you do go home you may be put on medications to block your thyroid from producing thyroid hormone, and then you may be given a prescription of a Synthroid, or some other form of thyroid hormone. You may be prescribed a medication known as a beta-blocker called Inderal to block your thyroid hormones from influencing you at the cellular level.
It isn’t entirely understood just what causes a thyroid storm; however, people who have storms have toxic levels of thyroid hormones released into their blood stream by an over-active thyroid gland-which may be caused by some other disease process. Thyroid storm can occur in patients that have to take thyroid hormone as a medication. There are some heart medications that can cause the thyroid gland to go into over-drive. It is thought that some infections could also play a role in the impairment of thyroid function.
You are at risk of having a thyroid storm if you have had an infection, such as pneumonia; if you are diabetic and go into diabetic ketoacidosis; if you had recent thyroid surgery; if you have abruptly stopped taking your thyroid medication; if your have Graves disease (hyperthyroidism); if you have taken an overdose of thyroid medication; if you are pregnant and have pre-eclampsia (toxemia) through labor and delivery.
When medical treatment doesn’t work to control the disease, the doctor may suggest surgery to remove part of the thyroid or all of it. Removing part of the gland can be all that is needed to put the thyroid hormone production back in balance. In some cases, the whole gland is removed and the patient is put on a daily dose of thyroid hormone. Some doctors suggest the patient ingest radioactive iodine (Iodine-131); it comes in pill or liquid form. The radioactive iodine is taken only once, it stays in the body for a period of time, and the thyroid gland picks it up-Iodine-131 will destroy the thyroid cells.
When taking care of yourself at home, follow your doctor’s regimen. Keep your doctor appointments; take your medication as prescribed. If you start having symptoms of a thyroid storm call 911; don’t try to drive yourself to the doctor. It is a good idea to wear a medic-alert bracelet or have a card to carry in your wallet to speak for you, in case you cannot speak for yourself.
Source:
Medicine Net information page
Mayo Clinic information page
