Thyroid storm
Life-threatening thyrotoxicosis with organ dysfunction. Diagnose clinically, then give a beta-blocker, a thionamide, iodine an hour later, and glucocorticoid, while treating the trigger.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Thyroid storm is thyrotoxicosis plus decompensation: fever, delirium, tachyarrhythmia, heart failure, GI upset or jaundice. Mortality is still around 10% or more with treatment.
- The diagnosis is clinical. Hormone levels look like ordinary thyrotoxicosis.
- Treat in this order: beta-blocker, thionamide, then iodine at least 1 hour later, glucocorticoid, supportive care, and the precipitant. Then plan definitive treatment.
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Sources
- 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosisAmerican Thyroid Association (Ross et al., Thyroid 2016;26:1343-421), 2016 (current ATA hyperthyroidism guideline, checked November 2026)
- Guidelines for the management of thyroid storm from the Japan Thyroid Association and Japan Endocrine Society (first edition)Japan Thyroid Association and Japan Endocrine Society (Satoh et al., Endocr J 2016;63:1025-64), 2016
- American Thyroid Association 2026 guidelines for thyroid disease in preconception, pregnancy, and postpartumAmerican Thyroid Association (Korevaar, Leung, Alexander et al., Thyroid 2026;36(5):481-544), 2026 (replaces the 2017 ATA pregnancy guideline; full text paywalled, PTU recommendation read via a 2026 editorial summary, November 2026)
- Endocrinology (Therapeutic Guidelines)AU/NZTherapeutic Guidelines Ltd
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy