A thyroid storm is a rare and life-threatening complication of hyperthyroidism. It occurs when overactive thyroid activity leads to hypermetabolism, which can result in death from cardiac arrest or multiple organ failure. The transition from hyperthyroidism to thyroid storm is typically triggered by a non-thyroidal insult, including fever, sepsis, dehydration, myocardial infarction, and psychiatric diseases. Individuals are at higher risk of thyroid storm if their hyperthyroidism is incompletely treated or if their anti-thyroid drugs are discontinued.

Symptoms of thyroid storm include an acute onset of symptoms of hyperthyroidism, such as a fast heart rate, restlessness, and agitation, accompanied by other features such as fever (temperatures often above 40 °C/104 °F), hypertension, mental status changes, diarrhea, and vomiting. The clinical presentation may also include respiratory distress, fatigue, poor feeding and weight loss, abdominal pain, jaundice, anxiety, altered behavior, seizures, and coma.

Thyroid storm is a medical emergency and needs to be treated in a hospital. The mortality associated with thyroid storm is estimated to be 8 to 25% despite modern advancements in its treatment and supportive measures. Thus, it is very important to recognize it early and start aggressive treatment to reduce mortality. Treatment may include medications to reduce thyroid hormone production, beta-blockers to control heart rate and blood pressure, and supportive care to manage symptoms and prevent complications.

People with conditions that cause hyperthyroidism, such as Graves’ disease or a toxic thyroid adenoma, are more likely to get thyroid storm. Women and people assigned female at birth are more likely to experience thyroid storms than men or people assigned male at birth, and the average age of a person who gets thyroid storm is 42 to 43 years.