Thyroid storm management includes which combination of therapies?

• A. Antithyroid drug only
• B. Antithyroid drug, beta-blocker for sympathetic symptoms, and iodine after antithyroid therapy; supportive care
• C. Beta-blocker alone
• D. Iodine alone

Answer: (B)

Thyroid storm requires rapid, coordinated therapy to reduce hormone production, prevent release, and control the body’s exaggerated sympathetic response while providing supportive care. The best approach combines an antithyroid drug to shut down new thyroid hormone synthesis, a beta-blocker to blunt tachycardia, tremors, and other adrenergic symptoms (and it also helps reduce peripheral conversion of T4 to T3), and iodine given after the antithyroid agent to block the release of already formed thyroid hormone. This sequence—block production first, then block release—minimizes circulating hormone quickly. Supportive care addresses fever, dehydration, electrolyte imbalances, and potential organ dysfunction, and corticosteroids are often used to reduce peripheral conversion of T4 to T3 and to treat possible adrenal insufficiency. When you see thyroid storm, this multi-pronged regimen is necessary because no single therapy fully mitigates the dangerous surge in thyroid hormones. Using only one component misses other critical steps, and giving iodine alone would not stop ongoing synthesis, while a beta-blocker or iodine alone fails to control both production and release.