Clinical Review and Update on the Management of Thyroid Storm

Mo Med. 2022 Jul-Aug;119(4):366-371.


Thyroid storm is a severe manifestation of thyrotoxicosis. Thyroid storm is diagnosed as a combination of thyroid function studies showing low to undetectable thyroid stimulating hormone (TSH) (<0.01mU/L) with elevated free thyroxine (T4) and/or triiodothyronine (T3), positive thyroid receptor antibody (TRab) (if Graves' disease is the underlying etiology), and with clinical signs and symptoms of end organ damage. Treatment involves bridging to a euthyroid state prior to total thyroidectomy or radioactive iodine ablation to limit surgical complications such as excessive bleeding from highly vascular hyperthyroid tissue or exacerbation of thyrotoxicosis. The purpose of this article is a clinical review of the various treatments and methodologies to achieve a euthyroid state in patients with thyroid storm prior to definitive therapy.

Publication types

  • Review

MeSH terms

  • Graves Disease* / complications
  • Graves Disease* / drug therapy
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Iodine* / therapeutic use
  • Thyroid Crisis* / diagnosis
  • Thyroid Crisis* / etiology
  • Thyroid Crisis* / therapy
  • Thyroid Neoplasms*
  • Thyrotoxicosis* / complications
  • Thyrotropin / therapeutic use
  • Thyroxine / therapeutic use
  • Triiodothyronine / therapeutic use


  • Iodine Radioisotopes
  • Triiodothyronine
  • Thyrotropin
  • Iodine
  • Thyroxine