Thyroid Emergencies

Understanding the function of the thyroid gland and its hormones is key to treating patients suffering from thyroid emergencies. This includes both hyperthyroidism and hypothyroidism. In this episode of the Back to Basics podcast, we discuss the signs and symptoms of the most common thyroid disorders as well as how to identify emergency thyroid conditions that require immediate intervention.

What is the thyroid?

The thyroid is an exocrine gland that helps regulate our metabolism. By secreting thyroid hormone, the body is signaled to metabolize faster, resulting in faster cellular work. Thyroid issues can be fairly common. Emergencies involving the thyroid are pretty rare, and emergency treatment is standard stabilization, but as we always say, if you don’t know what you’re looking for, you’ll never find it.

It’s important to be familiar with how the thyroid gland works and what it looks like when it’s not working properly so you can prepare appropriately in the rare cases that it gets out of hand and results in an emergency.

How does the thyroid gland work?

The thyroid gland is located up in the neck and is butterfly-shaped. It works closely with the pituitary gland and the parathyroid gland. The pituitary gland secretes a hormone called thyroid stimulating hormone, or TSH. This does exactly what it sounds like, stimulates the thyroid to secrete. The parathyroid gland involves calcium production.

The thyroid gland secretes T4, a chemical made up of 4 types of iodine. This is worth remembering because when we have iodine issues, it can greatly affect this entire process. T4 will convert to T3, which is the active form of thyroid hormone. T3 acts on cells of the body to increase their metabolism or speed of action. When the thyroid gets out of whack, it produces too much T3 (aka hyperthyroidism) or too little (aka hypothyroidism).

What is Hyperthyroidism?

Hyperthyroidism results in the metabolism being so fast that the patient exhibits symptoms like tachycardia, excessive sweating and heat intolerance, hair loss, weight loss, and other overworked symptoms. In extreme cases, an emergency condition called a Thyroid storm (also called thyroid crisis and thyrotoxic crisis) develops.

The opposite is true of hypothyroidism, where the slow metabolism causes the patient to gain weight, become bradycardic, have dry, coarse skin, be sluggish and weak, and in extreme cases, go into a coma, called myxedema coma. Management of the thyroid for hypothyroidism involves supplemental thyroid hormone, often in the form of a med called levothyroxine. On the other hand, treatment for Hyperthyroidism involves medication, radiation, and even surgical removal of the thyroid.