Thyroid Storm Can Disrupt Life

It is known that many diseases occur when vital thyroid hormones work more or less. Pointing out that sometimes the increase in hormone secretions is given to the blood very quickly and in large quantities, the picture of “thyroid storm” may occur, Endocrine Surgery Specialist from Yeditepe University Hospitals Parathyroid Transplantation Clinic. Dr. Erhan Ayşan said, "Here is the storm inside us, from now on."

Thyroid hormones play a decisive role in all kinds of functions from walking, speaking, digestion, heart rate, blood pressure, pulse, even thinking and perception. If T3 and T4 hormones, which play an important role in our daily life, work less or more, hypothyroidism and hyperthyroidism can occur. Warning that these problems affecting a large part of the society can be confused with different diseases, Prof. Dr. Erhan Ayşan warned to be careful about the symptoms. Underlining that the picture, which occurs when thyroid hormones are suddenly and excessively injected into the blood and defined as thyroid storm, is of particular importance in terms of serious consequences, Prof. Dr. Erhan Ayşan continued his words as follows: “While this storm sometimes gives findings that can be seen from the outside, sometimes it moves forward by damaging the internal organs without any findings. Heart and brain will take the first place among these damages. Rhythm disturbances and sudden cardiac arrest may develop due to rapid heartbeat. Cerebral hemorrhage may be seen due to fractures in the cerebral vessels. Organ damage that will occur will vary depending on the age of the patient and the existing comorbidities. Internal organ damage is seen earlier in elderly patients. The effects of thyroid storm on the heart may be experienced much earlier and more severe in people with additional disease, for example a person with heart failure.


Reminding that there is a thyroid disease that the patient is not aware of in case of thyroid storm, but this is not a rule, Prof. Dr. Erhan Ayşan said that thyroid storm may be the first finding of a newly started thyroid disease. Prof. Dr. Ayşan continued his words as follows: “The overfunctioning of the thyroid gland and the production of excess T3 and T4 hormones is called hyperthyroidism. Graves disease is the most common cause of hyperthyroidism. In fact, thyroid storm is a type of hyperthyroidism, but the production of T3 and T4 hormones is much higher in this picture, and the picture develops much more suddenly. However, the thyroid is an endocrine organ and, like every endocrine organ, it is affected very quickly by stress. Pregnancy is also a stress and can trigger thyroid storm along with thyroid disease. Asymptomatic thyroid storm can be confused with many diseases. For this reason, we frequently encounter unnecessary tomographs, MRIs, angiographies, endoscopies. "


Prof. Dr. According to the information given by Erhan Ayşan, the sooner and most prominent symptom of the thyroid storm picture is “palpitations”. The patient, who feels an obvious increase in heart rate in the left chest, explains this situation as "my heart is going to come out". Meanwhile, the pulse rate increases and the pulse is not rhythmic; Sometimes it is seen that the interval between the pulse beats is opened and sometimes these intervals are shortened. The constant increase in heart rate causes sleep disturbances, especially at night, along with palpitations. Especially in physical activities that increase the pulse rate, this number increases even more and makes the patient very comfortable. People immediately notice palpitations and think that it is a heart disease and can go to a cardiologist. "


Another symptom of thyroid storm is high blood pressure and related headache. Drawing attention to the fact that this situation may pose a life-threatening risk, especially in elderly patients with high blood pressure (hypertension), Prof. Dr. Erhan Ayşan said, “Since these people also have arteriosclerosis, the vessels may crack and cerebral hemorrhage may be seen, not withstanding the rising blood pressure. This situation is also a life-threatening emergency, ”he said.

Prof. Dr. Erhan Ayşan explained the following about other symptoms that may be experienced: “Sleep disturbance, frequent waking at night, and being uncomfortable with heat are among the common symptoms we encounter in patients. Therefore, people who walk around in cold weather in thin clothes and express that they do not feel cold should consult an endocrinologist. However, rapid weight loss without dieting is another finding. The expression "I eat but not gain weight" may make many people happy, but these people may experience a thyroid storm and the internal organs may be seriously tired due to the acceleration of metabolism. These people may have to deal with serious organ failure in the future. Changes in toilet habits, frequent urination, and diarrhea attacks are other findings related to the digestive system. "


Underlining that the picture of thyroid storm affects the psychological state of people as well as their physiological structure, Prof. Dr. Erhan Ayşan said, “Emotional disorders, depression (withdrawal) or irritability (anxiety) can also be seen in these patients. Changes in the behavior of someone you know for years, whose personal characteristics and habits you know, reducing their sharing with you, or on the contrary, getting angry with unnecessary things are among the factors that make you think of thyroid storm.


Stating that the diagnosis of thyroid storm can be made with laboratory tests, Prof. Dr. Erhan Ayşan explained the following about what can be done in diagnosis: “First of all, when complaints arise, it is absolutely necessary to consult a physician by suspecting the existence of a problem. The diagnosis is made when T3 and T4 hormones are found to be very high in the laboratory examinations and the TSH hormone is low. However, the patient should definitely have thyroid ultrasound. The whole thyroid gland may be working fast or there is a working nodule in the thyroid gland and this nodule is the cause of the disease. With the ultrasound, all information is available. Therefore, ultrasound is a diagnostic method that must be done as it will provide information about both the cause of the disease and the treatment method. "


Stating that medications constitute the first step of treatment in thyroid storm, and that different options can be applied in the following processes, Prof. Dr. Erhan Ayşan explained the following about the treatment of the disease: “We have reliable drugs that will block the hormones secreted by the thyroid. Starting these in the right doses will relieve the patient within a few days and protect the internal organs from the effects of the storm. In the later period, the treatment can be continued with medication, radioactive iodine (atom therapy) or surgery. The endocrinologist should decide which of these options will be applied. Thyroid storm may recur, therefore, a correct treatment should be started at the initial diagnosis stage and follow-up should not be interrupted. "

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