Thyroid UK
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hashimotos storm

at the moment iam in a debate on another forum. i believe you can have a thyroid storm with hashimotos/under-active yet others think this only happens with over-active/ graves. i have hashimotos and believe i once had a storm as all the symptoms were the same as some-one i know who had graves. i would be interested what others think on this subject?

4 Replies

A thyroid storm is a life threatening medical emergency, its not really the same thing as going hyper with hashimotos. I have been hyper with hashimotos, i felt pretty rotten and it was the hyper phase which alerted my doctor to the fact that my two years of complaining were probably linked to the thyroid, but i wouldnt have described my hyperactivity as a life threatening emergency.

Is this any help....



Agree with galathea.

Below is just the start of the Thyroid Storm part of a chapter of Thyroid Manager.


Thyroid (or thyrotoxic) storm is an acute, life-threatening syndrome due to an exacerbation of thyrotoxicosis. It is now an infrequent condition, because of earlier diagnosis and treatment of thyrotoxicosis, better pre- and postoperative medical management. However, acute exacerbation of thyrotoxicosis caused by intercurrent illness, especially infections, may still occur. Thyroid storm in the past most frequently occurred after surgery, but now it is usually a complication of untreated or partially treated thyrotoxicosis, rather than a postoperative complication.

Clinical pattern

Classic features of thyroid storm are indicative of a sudden and severe exacerbation of thyrotoxicosis, with fever, marked tachycardia, tremor, nausea and vomiting, diarrhea, dehydration, restlessness, extreme agitation, delirium or coma. Fever is typical and may be higher than 105.8 F (41 C). Patients may present with a true psychosis or a marked deterioration of previously abnormal behavior. Sometimes thyroid storm takes a strikingly different form, called apathetic storm, with extreme weakness, emotional apathy, confusion, absent or low fever

Signs and symptoms of multiorgan decompensation may be present. Delirium is one example. Congestive heart failure may also occur, with peripheral edema, congestive hepatomegaly, and respiratory distress. Marked sinus tachycardia or tachyarrhythmias, such as atrial fibrillation, are common. Liver damage and jaundice may derive from congestive heart failure or a direct action of thyroid hormone on the liver coupled with malnutrition (Chapter 10). Fever and vomiting may produce dehydration and prerenal azotemia. Abdominal pain may be a prominent feature. The clinical picture may be masked by a secondary infection such as pneumonia, a viral infection, or infection of the upper respiratory tract. Death may be caused by cardiac arrhythmia, congestive heart failure, hyperthermia, or other unidentified factors.

Storm is typically associated with Graves’ disease, but it may occur in patients with toxic nodular goiter (1, 2) . At present, although still life-threatening, death from thyroid storm is rarer if it is promptly recognized and aggressively treated in an intensive care unit. In a recent, nationwide study from Japan mortality rate was calculated to range between 9.5% and 11% (3).

Follow this link to read more:


Joyce59, Thyroid Storm is a life threatening medical emergency experienced by untreated, or undertreated hyperthyroid patients.

Hashitoxicosis is a transient hyperthyroidism caused by dying thyroid cells dumping excess thyroid hormone into the blood.


While the symptoms may be similar, I think it's the degree, or severity or symptoms, that differentiates the two. I believe someone can die from untreated Graves' within a couple of weeks. People don't typically die from untreated Hashi's, they just suffer.

The other possibility is that you really weren't hyper at all, but severely hypo when you had hyper symptoms. Severe hypo can cause a fast heart rate, high BP, insomnia, etc. Have you seen this post?


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