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Thyroid Lab Tests to check and Medication to take

diagnose thyroid storm: usually HYPERthyroidism or Graves Disease or multinodular goiter but can alsoHappen after surgery,infection etc.

Thyroid storm happens when your thyroid gland suddenly releases large amounts of thyroid hormone in ashort period of time

hypotheses include a rapid rate of increase in serum thyroid hormone levels, increased responsiveness tocatecholamines, or enhanced cellular responses to thyroid hormone [1]. The degree of thyroid hormoneexcess (elevation of T4 and T3, suppression of TSH) typically is not more profound than that seen inpatients with uncomplicated thyrotoxicosis. However, one study found that while the total T4 and T3levels were similar to those seen in uncomplicated patients, the free T4 and free T3 concentrations werehigher in patients with thyroid storm

http://www.uptodate.com/contents/initial-and-reoperative-thyroidectomy?source=see_link

http://emedicine.medscape.com/article/850924-workup

Presently, no specific diagnostic criteria to establish the diagnosis of thyroid storm exist. Burch and Wartofsky have constructed an excellent clinical diagnostic point scale to facilitate a

semiquantitative distinction between uncomplicated thyrotoxicosis, impending storm, andestablished thyroid storm .[3] Laboratory findings in thyroid storm are consistent with those of thyrotoxicosis and include the following:

o Elevated T 3 and T 4 levelso Elevated T 3 uptakeo Suppressed TSH levelso Elevated 24-hour radioiodine uptake

Elevated T 4 and decreased TSH are the only abnormal findings needed for conformation of thyrotoxicosis. Treatment should not be withheld for any laboratory confirmation of hyperthyroidism when thyroid storm is suspected clinically. A 2-hour radioiodine uptake isadvisable if thyroid storm is suspected and no past history of hyperthyroidism exists.

Other abnormal laboratory values that point toward decompensation of homeostasis includethe following:

o Increased BUN and creatinine kinaseo Electrolyte imbalance from dehydration, anemia, thrombocytopenia, and leukocytosiso Hepatocellular dysfunction as shown by elevated levels of transaminases, lactate

dehydrogenase, alkaline phosphatase, and bilirubino

Elevated calcium levelso Hyperglycemia

blood cell count , electrolyte levels ,

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blood sugar level,liver function , andthyroid hormone levels. Circulating Free T3, T4 and TSHCalcium Levels

Treatment and supportive measures can include:

A complete evaluation to determine the cause of thyroid stormIntravenous fluids and electrolytes Oxygen if neededFever control with antipyretics (fever-reducing medications) and if needed cooling blanketsIntravenous corticosteroids such as hydrocortisone Medications to block the production of thyroid hormones, such as propylthiouracil (PTU) or

methimazole (Northyx, Tapazole)Iodide to block thyroid hormone releaseDrugs called beta-blockers, such as propranolol (Inderal) to block the action of thyroid hormones onthe bodyTreatment of heart failure if present

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