Thyroid crisis is a complication that arises due to high levels of thyroid hormone in the blood (hyperthyroidism) that is not treated. Thyroid crisis is very rare, but can be serious, even fatal. This condition is most often experienced by women, especially during adolescence.
The thyroid is a gland located in the lower neck. The thyroid produces thyroid hormone which functions to regulate the work of cells in the body, including processing nutrients and turning them into energy.
When a person has hyperthyroidism , the thyroid produces too much thyroid hormone. This condition causes cells to work too fast, and can even trigger the malfunction of a number of organs.
Causes of Thyroid Crisis
Thyroid crisis occurs due to excessive thyroid hormone production (hyperthyroidism) that is not treated properly. Thyroid diseases that can trigger hyperthyroidism are toxic adenoma , Graves' disease, thyroiditis, or hypothyroid drug overdose.
However, not all people with hyperthyroidism experience thyroid crisis.
Thyroid crisis risk factors
There are a number of factors that can increase the risk of developing a thyroid crisis, namely:
- Female gender
- 10–15 years old or teenager
- Have had surgery or trauma to the thyroid gland
- Is pregnant
- Experiencing thyroid gland damage
- Have a severe infection that causes elevated thyroid hormone levels, such as pneumonia
- Do not take hyperthyroidism drugs as directed by the doctor
- Have thyroid nodules
- Suffer from certain diseases, such as stroke, heart failure, diabetic ketoacidosis , and pulmonary embolism
- Experiencing severe emotional stress
Thyroid Crisis Symptoms
Thyroid crisis has the same symptoms as hyperthyroidism , but it progresses rapidly within a few hours and is more severe. The following are symptoms of a thyroid crisis:
- Fever over 38.5 ° C
- Nausea and vomiting
- Nervousness, restlessness, and daze
- Loss of consciousness
- Excessive sweating
- Shaking ( tremors )
- Tachycardia or fast heart rate
- Protruding eyeballs
- Muscle weakness, especially in the upper arms and thighs
- Hard to breathe
- Abdominal pain
- Jaundice ( jaundice )
When to see a doctor
Check with your doctor if you experience symptoms of hyperthyroidism. If treated quickly, the risk of thyroid crisis can be prevented.
Immediately go to the doctor or contact the hospital emergency room if people around you experience the complaints mentioned above. Thyroid crisis is an emergency and requires prompt diagnosis and treatment to prevent multiple organ failure.
Diagnosis of Thyroid Crisis
Thyroid crisis requires prompt diagnosis and treatment. To diagnose this condition, the doctor will ask about the symptoms experienced, as well as examine clinical signs, such as the patient's body temperature and heart rate.
If the patient's condition matches the signs of a thyroid crisis, the doctor will immediately start treatment while waiting for the results of laboratory tests.
The most important laboratory tests are blood tests, including:
- Examination of thyroid hormone levels and hormones that stimulate the work of the thyroid gland (TSH)
- Complete blood count , to detect the presence of infection in the body
- Measurement of gas and electrolyte levels in the blood
- Measurement of calcium levels, to indicate the patient is experiencing thyroid crisis, because usually will experience hypercalcemia
If the laboratory test results come out later, the examination must be continued, especially in patients who were not previously aware that they had hyperthyroidism.
Apart from blood tests, other supporting tests that may be recommended by the doctor are:
- Urine test (urinalysis), to detect the presence of certain substances in the urine
- Chest X-ray, to see an enlarged heart and accumulation of fluid in the lungs due to heart failure
- Electrocardiography , to detect heart rhythm disturbances
- Head CT scan, to see the condition of the nerves in thyroid crisis patients with decreased consciousness
Thyroid Crisis Treatment
Thyroid crisis sufferers must be treated and treated intensively in the hospital. The aim of this treatment is to deal with the excessive production and release of thyroid hormone, as well as overcome the decline in organ function experienced by the patient.
Generally, the doctor will give some medicines, such as:
- Antithyroid drugs, such as methimazole , to inhibit the work of the thyroid gland in producing thyroid hormone
- Potassium iodide medication, to suppress the release of thyroid hormone by the thyroid gland
- Corticosteroids, such as hydrocortisone, to inhibit changes in thyroid hormones
- Beta blocker drugs , to lower blood pressure and regulate heart rhythm
- Pain relievers, such as paracetamol, to reduce fever
Apart from the drugs above, people with hyperthyroidism can also undergo radioactive iodine therapy. This therapy can shrink the thyroid gland so that thyroid hormone production can be reduced. However, this therapy is not recommended for pregnant women, because it can be harmful to the fetus.
If all of the treatment methods above are ineffective, the doctor may recommend the patient to undergo thyroid gland removal surgery .
The patient's condition generally begins to improve within 1–3 days after being treated. Once the thyroid crisis is passed, the patient's condition needs to be re-evaluated by the doctor to determine the continuation of treatment. Through regular medication and therapy, recurrence of thyroid crisis can be prevented.
Thyroid Crisis Complications
If left untreated, a thyroid crisis can cause several complications, such as:
- Pulmonary oedema
- Heart failure
- Heart rhythm disturbances (arrhythmias)
- Liver disfunction
Thyroid Crisis Prevention
Thyroid crisis can be prevented by taking regular treatment for hyperthyroidism. In other words, people with hyperthyroidism can live a normal life if their condition is controlled regularly. Therefore, discuss with your doctor about the right method to treat hyperthyroidism.