From Mary Shomon,
Your Guide to Thyroid Disease.
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Some people with Graves' disease or hyperthyroidism -- an overactive thyroid that is producing too much thyroid hormone -- develop a condition known as thyroid storm. It's not common however; only 1-2% of patients with hyperthyroidism develop thyroid storm. During thyroid storm, the heart rate, blood pressure and body temperature can become uncontrollable high. Whenever thyroid storm is suspected, the patient must go immediately on an emergency basis to the hospital, as this is a life-threatening condition that can develop and worsen quickly, and requires treatment within hours to avoid fatal complications such as stroke or heart attack. Thyroid storm is more common in the elderly.

Risks for Thyroid Storm

Untreated Graves' disease and/or hyperthyroidism is a particular risk factor, as is being female. Even when the Graves' disease is identified and being treated, however, certain other factors raise the risk of thyroid storm:

• Infection: lung infection, throat infection or pneumonia
• Blood sugar changes: Diabetic ketoacidosis, insulin-induced hypoglycemia
• Recent surgery to the thyroid
• Abrupt withdrawal of antithyroid medications
• Radioactive iodine (RAI) treatment of the thyroid
• Excessive palpation (handling/manipulation) of the thyroid
• Severe emotional stress
• An overdose of thyroid hormone
• Toxemia of pregnancy and labor

Symptoms

What are the symptoms of thyroid storm?

• High fever of 100 to as high as 106
• A high heart rate that can be as high as 200 beats per minute
• Palpitations, chest pain, shortness of breath
• High blood pressure
• Confusion, delirium and even psychosis
• Extreme weakness and fatigue
• Extreme restlessness, nervousness, mood swings
• Exaggerated reflexes
• Difficulty breathing
• Nausea, vomiting, diarrhea
• Recent dramatic weight loss may have taken place recently
• Profuse sweating, dehydration
• Stupor or coma

Thyroid storm is treated with a combination of antithyroid drugs, blockade iodine drug, beta-blockers, and treatment for any underlying non-thyroidal illness or infection that may becontributing to the thyroid storm.

NOTE: If thyroid storm is suspected, go to an emergency room immediately!

Mary Shomon, About.com's Thyroid Guide since 1997, is a nationally-known patient advocate and best-selling author of 10 books on health, including "Living Well With Graves' Disease and Hyperthyroidism," "The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss," "Living Well With Hypothyroidism: What Your Doctor Doesn't Tell You...That You Need to Know," "Living Well With Autoimmune Disease," "Living Well With Chronic Fatigue Syndrome and Fibromyalgia," and the "Thyroid Guide to Fertility, Pregnancy and Breastfeeding Success." Click here for more information on Mary Shomon.