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What is thyroid storm? Demystifying this potentially deadly condition!
Thyroid storm is a rare but potentially fatal state of extreme or decompensated hypothyroidism. This condition usually develops in older adults, particularly after a stressful event such as an infection, myocardial infarction, or stroke. The most common symptoms include altered consciousness and hypothermia, but hypoglycemia, hypotension, and hyponatremia may also occur.
The thyroid gland plays an important role in regulating metabolism throughout the body. The two main hormones it produces—thyroxine (T4) and triiodothyronine (T3)—have a profound impact on body functions.
Although the symptoms of thyroid storm are serious, sometimes there is no obvious swelling of the thyroid gland, and the patient's consciousness may become blurred rather than completely comatose. According to recent theories, thyroid storm may be caused by a syndrome of nonthyroidal disease leading to total ostasis overload, which exacerbates the effects of hypothyroidism.
Causes
Thyroid storm usually occurs in patients who have already been diagnosed with hypothyroidism, but in some cases, the patient's hypothyroidism may have gone undetected. Common predisposing factors include:
- Hypothermia caused by winter cold
- Metabolic disorders, such as hypoglycemia and hyponatremia
- Respiratory failure with hypoxia and hypercapnia
- Infections, such as pneumonia and urinary tract infections
- Heart failure and stroke
- Trauma, such as a car accident or broken bones
- Use of certain medications, including narcotics, sedatives, and antidepressants
The most common cause of hypothyroidism is insufficient dietary iodine, while in iodine-sufficient areas, Hashimoto's thyroiditis is the leading cause of hypothyroidism.
Pathophysiology
The main function of the thyroid gland is to regulate the metabolism of the whole body by producing thyroid hormones. However, when the thyroid gland cannot secrete enough T3 and T4, hypothyroidism will occur. With the loss of thyroid hormone, the body may experience a series of serious effects at the genetic and cellular levels, including a variety of symptoms and high mortality. In the absence of these hormones, normal metabolic processes are hampered.
The physiological changes caused by a lack of thyroid hormone can lead to impaired heart function, a weakened immune system, and even affect concentration and cognitive function.
Diagnosis
When diagnosing thyroid storm, clinical features are the focus of the doctor's judgment. These characteristics may cover cardiovascular, respiratory, neurological, and other aspects of the body, including:
- Cardiac, such as irregular heartbeats and low cardiac output
- Respiratory issues, such as hypoxia and carbon dioxide poisoning
- Neurological aspects, such as impaired cognitive function and coma
- Digestive system issues, such as gastrointestinal distension and constipation
The diversity of these symptoms makes diagnosis complicated, but doctors usually use the patient's medical history and laboratory tests to assist in the diagnosis.
EpidemiologyStudies have shown that hypothyroidism is four times more common in women than in men, while the incidence of thyroid storm has been reported at 0.22 cases per million people per year, with relatively limited data, especially in countries located along the equator. and countries outside the West. This condition mostly occurs in people over 60 years old, and the risk of occurrence is higher in winter, so people are called upon to pay attention to their health and receive timely diagnosis and treatment.
As patients age, changes in their health status may cause them to unconsciously underestimate the potential risk of hypothyroidism. Do you understand your health history and have you considered thyroid problems that run in your family?
