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Hyperthyroidism and Thyroid Storm: What You Need to Know

August 23, 2016

thyroid_diagramThe thyroid is a small gland located at the front of the neck that is responsible for making thyroid hormones. These hormones enter the blood and are carried to tissues located throughout the body.

Thyroid hormones help the body use energy and control a number of activities. They control breathing, how fast the body burns calories, and even how fast the heart beats.

These hormones are also involved in processes such as helping the body stay warm and keeping the brain, heart muscles, and other organs working properly.

Thyroid hormone levels are controlled by a small gland in the brain called the pituitary. This gland makes the thyroid stimulating hormone (TSH), which stimulates the thyroid to produce thyroid hormones.

 

TSH levels in the bloodstream rise or fall depending on whether enough hormones are made to meet the body’s needs. As thyroid hormone levels go up or down, the pituitary gland drops or raises TSH production in response.

When the gland releases too many or too few hormones, thyroid disorders can occur.

According to the British Thryoid Foundation Thyroid disorders affect one in twenty people in the UK. Both overactive and underactive thyroid glands can lead to a variety of serious health problems

What is hyperthyroidism?

Hyperthyroidism is a thyroid disorder that occurs when the thyroid makes too much of the hormone thyroxine. An overactive thyroid can cause many body functions to speed up. There are many conditions that can cause hyperthyroidism, including:

The thyroid gland is located at the front of the neck.
  • Graves’ disease
  • Viral infections, autoimmune conditions, or having a period following childbirth – these can enflame the thyroid
  • Overactive thyroid nodules
  • Tests that use iodine
  • Eating too many foods containing iodine
  • Consuming large amounts of thyroid hormone
  • Tumors of the ovaries or testes

Hyperthyroidism can mimic other health problems. This can make it difficult for doctors to diagnose. They often look for a wide variety of signs and symptoms. These symptoms include:

  • Sudden weight loss, even when appetite and diet remain the same
  • Rapid or irregular heartbeat
  • Increased appetite
  • Anxiety
  • Trembling in hands and fingers
  • Sweating
  • Changes in menstruation
  • Increased sensitivity to heat
  • Changes in bowel patterns
  • An enlarged thyroid gland
  • Tiredness and weakness
  • Difficulty sleeping
  • Thinner skin or brittle hair

Some people may not have any symptoms at all, which makes the disorder even more difficult to pinpoint.

What is thyroid storm?

Without treatment for overactive thyroid problems, people can develop serious health problems. These can include heart problems, weak and brittle bones, and even death.

Thyroid storm is a rare but life-threatening condition that can occur if hyperthyroidism is not treated. Thyroid storm can occur in any patient with untreated hyperthyroidism.

It is generally brought on by stressful situations such as trauma, surgery, or a severe infection. Thyroid storm is a severe form of having too much thyroid hormone in the body. It can lead to heart failure and a buildup of fluid in the lungs.

Symptoms of thyroid storm may result in a number of complications. They include:

Symptoms of thyroid storm include fever, nausea, and heart failure.
  • Fever
  • Dehydration
  • Rapid or irregular heart rate
  • Nausea or vomiting
  • Diarrhea
  • Weakness
  • Heart failure
  • Confusion
  • Shaking
  • Sweating

A high fever is often one of the most common signs of thyroid storm. It may reach as high as 105-106°F.

Diagnosis of thyroid storm

There are no specific lab tests that can diagnose thyroid storm. The diagnosis is primarily up to the doctor. To diagnose thyroid storm, the doctor will look to see if the patient has any common symptoms of hyperthyroidism, high temperature, fast heart rate, or confusion.

Blood tests can help signal high levels of thyroid hormones in the blood. The thyroid-stimulating hormone (TSH) test is also used.

Thyroid storm is a very dangerous condition. In many cases, there is no time for blood tests. Instead, medical treatment is started immediately. Even with medical care, The University of California, San Diego Health Center state that the mortality rate of thyroid storm is between 20-30 percent. The disorder is particularly dangerous in older adults.

Treatment for thyroid storm

Treatment for thyroid storm depends on age, the cause, the severity of the illness, and any other medical conditions the patient may have.

In many cases, the right treatment regime produces improvement within 24 hours. With continued treatment, thyroid storm is generally resolved within a week. Treatment options include:

  • Beta-blockers to control symptoms like altered heart rate
  • Iodine
  • Glucocorticoids
  • Propylthiouracil or methimazole

Undiagnosed thyroid disease can increase the risk of osteoporosis, infertility, and heart disease.

People with an overactive thyroid can help control their disorder by eating well, exercising, and keeping their stress levels down.

Anyone that experiences any of the symptoms discussed should see a health professional immediately. Other disorders can mimic hyperthyroidism, so testing is often needed for a correct diagnosis.

Quick treatment is vital to making sure that the body functions normally, but also prevents the onset of thyroid storm. Thyroid storm can be prevented by treating an overactive thyroid and following doctor’s orders.

What is Graves’ disease?

Graves’ disease is the leading cause of hyperthyroidism. It is an autoimmune condition where the immune system attacks the thyroid gland. In response, the thyroid makes too much thyroid hormone.

The pituitary gland releases the hormone that helps control thyroid function. The thyrotropin receptor antibody (TRAb) is linked with Graves’ disease, and it works like the regulatory pituitary hormone. As a result, the TRAb overrides the normal regulation of the thyroid and causes hyperthyroidism.

Anyone can develop Graves’ disease, but there are a number of factors that increase the risk, including:

Women are more likely than men to develop Graves’ disease.
  • A family history of Graves’ disease or other thyroid or autoimmune disorders
  • Other autoimmune disorders: People inflicted with other immune disorders such as type 1 diabetes or rheumatoid arthritis have an increased risk
  • Emotional or physical stress: Stressful life events or illnesses can trigger an onset of Graves’ disease
  • Pregnancy: Pregnancy or a recent childbirth can increase the risk of the disorder in some women
  • Smoking: Cigarette smoking can affect the immune system and increase the risk of Graves’ disease

Women are also more likely to develop the disorder than men.

Graves’ disease treatment

Most people who have Graves’ disease have some symptoms of hyperthyroidism. A doctor will likely perform a physical exam as well as additional tests to help make a final diagnosis. These can include:

  • Thyroid function tests
  • Radioactive iodine uptake (RAIU)
  • Antibody tests

There are three main treatment options. Beta-blockers, which block the action of the thyroid hormone, are given.

Two antithyroid medicine drugs are used in the U.S: methimazole and propylthiouracil. They help to keep the thyroid from making too much thyroid hormone.

Radioactive iodine (RAI) treatment requires patients to swallow a pill that contains a form of iodine that damages the thyroid with radiation. By damaging thyroid cells, less thyroid hormones are made.

In some cases, surgery is recommended where most of the thyroid is removed.

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