A thyroid storm, also known as a thyrotoxic crisis, is a sudden and potentially serious condition that occurs when your thyroid gland releases a large amount of hormone all at once. It can cause symptoms such as a rapid heart rate, fever, sweating, and shakiness.
Excess thyroid hormones speed up your metabolism to dangerous levels, which makes your body work much harder than usual and can lead to certain symptoms. Recognizing early signs and seeking medical care is crucial, as a thyroid storm can rapidly worsen if untreated. This proactive approach can help you prevent it from escalating.
Early signs include:
- Feeling very hot and sweaty: A thyroid storm can suddenly make you feel very hot, with a body temperature greater than or equal to 100.4 degrees Fahrenheit (38 degrees Celsius). It can also make you red and sweaty, even in a cool room or without strenuous activity.
- Anxiety: Anxiety may come on suddenly without a clear cause due to overstimulation of the nervous system, putting your body in a constant state of alert. This can make you feel nervous, restless, or irritable.
- Tachycardia (racing heart): Excess thyroid hormones can cause your heart to race, even at rest, leading to tachycardia (rapid heartbeat, typically over 130 beats per minute). It may feel like your heart is racing or pounding, or make you feel dizzy.
- Tremors and hyperreflexia: Tremors or shakiness occur due to overstimulation of your muscles and nerves. It can make simple tasks difficult. For example, you might notice your hands trembling when holding a cup or writing. You may also find that your reflexes (like when a healthcare provider taps your knee and your leg kicks out) are much stronger or faster.
As a thyroid storm advances, the body’s response to excess thyroid hormones worsens, leading to severe symptoms that require immediate and urgent medical attention. These include:
- High fever and intense sweating: Your body temperature can rise above 104 degrees Fahrenheit (40 degrees Celsius). With a high fever, you may feel extremely hot, flushed, and uncomfortable, even in cool environments. You might also experience chills or intense sweating.
- Heart palpitations or irregular heartbeats: You may notice heart palpitations or irregular heartbeats as your heart begins to work harder. Palpitations may make you feel like your heart is skipping beats, fluttering, or pounding in your chest.
- Hypertension: As your heart starts to work harder, it can put excess pressure on your blood vessels, causing hypertension (high blood pressure). High blood pressure can cause dizziness, headaches, or blurred vision.
- Abdominal pain: Excess thyroid hormones can disrupt digestion. You may experience abdominal pain that feels crampy or sharp, stomach upset, nausea, vomiting, or diarrhea.
- Chest pain: A rapid heartbeat and high blood pressure can strain your heart, causing chest pain. This discomfort might feel like a sharp, stabbing pain or a dull, aching pressure. You may also experience shortness of breath, sweating, or tightness in your chest.
- Shortness of breath: Shortness of breath can happen because your heart and lungs are working harder to meet your increased oxygen demand. You may breathe too fast, feel short of breath, struggle to take deep breaths, or feel like you’re suffocating.
- Agitation: Worsening anxiety may cause severe agitation. You may feel easily annoyed and have sudden mood swings, causing you to react more strongly to things that generally wouldn’t bother you. Some people also feel a sense of impending doom.
These severe, life-threatening symptoms indicate the thyroid storm has reached a critical stage and requires emergency medical intervention:
- High fever: Your body temperature may rise to 104-106 degrees Fahrenheit (40-41.1 degrees Celsius). If not treated promptly, this can lead to organ damage or failure.
- Cachexia: Cachexia is rapid weight and muscle loss. It often occurs later in a thyroid storm because the body burns calories and muscle faster, even with enough food. Fever, anxiety, and stomach issues can also reduce appetite and nutrient absorption, worsening cachexia.
- Delirium: Severe confusion or delirium may cause disorientation, difficulty recognizing familiar people or places, or hallucinations. This mental state can be highly distressing and is a sign that the brain is under severe stress.
- Seizures or coma: Seizures occur when excessive electrical activity in the brain causes sudden, uncontrolled movements or changes in behavior. In severe cases, a thyroid storm can also lead to a coma, a deep state of unconsciousness where you can’t wake up or respond to anything.
Multi-System Organ Failure
If the thyroid storm progresses, multiple organs, including the heart, kidneys, and liver, can stop working as they should. Multi-system organ failure is critical and requires immediate emergency medical attention. Failure of the heart, kidneys, and liver can cause:
- Altered mental status
- Cold, clammy skin due to poor circulation
- Difficulty breathing
- Jaundice (yellowing of the skin and eyes)
- Low blood pressure
- Reduced urine output
- Swelling in the feet, hands, or belly
Thyroid storms aren’t contagious, but infections like influenza (the flu) or pneumonia, which can trigger thyroid storms, are contagious. Symptoms of these infections include fever, sore throat, congestion, coughing, body aches, and fatigue.
Thyroid storms typically occur in people who already have hyperthyroidism (an overactive thyroid), especially if they stop taking their thyroid medication or don’t take it as prescribed. Other possible triggers include trauma, surgery, childbirth, infection, diabetic ketoacidosis, heart failure, and some medications.
Because this crisis can quickly become life-threatening, recognizing thyroid storm symptoms is essential for getting timely medical help.
It’s important to contact a healthcare provider if you or a loved one shows any signs of a thyroid storm, especially if you have hyperthyroidism. Watch for these early symptoms, especially if they appear without an apparent cause or happen together:
- Anxiety
- Feeling hot and sweaty
- Rapid heartbeat
- Shakiness
If you or someone you know experiences any of the following severe symptoms, it’s crucial to call emergency services or go to the nearest emergency room immediately:
- Chest pain
- Extreme confusion
- High fever
- Loss of consciousness
- Severe shortness of breath
A thyroid storm is a severe, life-threatening condition caused by a sudden surge of thyroid hormones. This excess of hormones overstimulates your metabolism, leading to early symptoms like fever, sweating, rapid heartbeat, anxiety, and shakiness.
As the condition worsens—which can happen quickly—symptoms can escalate to include a high fever, severe confusion, chest pain, shortness of breath, and loss of consciousness.
If you or someone you know shows signs of a thyroid storm, seek medical help immediately. Prompt treatment can significantly reduce the risk of complications and improve outcomes.
