Thyroid Storm Management

Severe and life-threatening decompensation of thyrotoxicosis.

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 10, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Thyroid Storm Management?

Thyroid storm is the severe and life-threatening form of thyrotoxicosis. It manifests with tachyarrhythmia, high fever, altered mental status, heart failure and gastrointestinal symptoms. Infection, trauma, surgery, radioactive iodine therapy, delivery or diabetic ketoacidosis can trigger it.

The Burch-Wartofsky score is used to support clinical suspicion. Mortality is reported as 10-30%. Intensive care management is required.

Treatment includes propylthiouracil (PTU) preferred, high-dose beta blockers, iodine preparations (Lugol), glucocorticoids, supportive care and management of the underlying trigger. Long-term definitive therapy (surgery, RAI) is planned.

Symptoms

High fever (40 °C and above)

Atrial fibrillation and tachyarrhythmia

Agitation, confusion, coma

Nausea, vomiting, diarrhea

Signs of heart failure

Sweating and hypotension

Goiter and ophthalmopathy

Risk Factors

Uncontrolled Graves disease

Toxic multinodular goiter

Thyroid surgery or RAI

Infection and trauma

Childbirth

DKA

Antithyroid drug nonadherence

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

High fever in known hyperthyroid patient
New-onset tachyarrhythmia
Altered consciousness with thyrotoxicosis
Heart failure with thyrotoxicosis
High Burch-Wartofsky score
Emergency department referral

Treatment Methods

Propylthiouracil (PTU) first line

Beta blocker (propranolol)

Lugol solution

Glucocorticoid

Fever and volume management

Treatment of trigger

Intensive care monitoring

Long-term definitive therapy plan

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.