Dr Leonard Wartofsky is a professor of medicine at Georgetown University Hospital, chairman emeritus of the Department of Medicine at the Washington Hospital Center, and past president of the American Thyroid Association and the Endocrine Society.
How to treat thyroid storm?
Leonard Wartofsky, MD, MPH: We treat thyroid storm with a multipronged approach to therapy, starting with inhibiting new synthesis of thyroid hormone with propylthiouracil (PTU) or Tapazole (methimazole/thiamazole). Secondly, inhibiting the release of hormone with iodine or lithium carbonate. Treating the thyroid hormone levels that are elevated in the peripheral blood, which can be done by dialysis, plasmapheresis, or charcoal hemadsorption columns—percolating blood through a column. And treating whatever the underlying illness: infection, sometimes it was surgery, or labor and delivery. So, [we use] the customary therapy for whatever was going on to restore normal homeostasis and compensation.