When should I consider referring a patient with thyroid storm to secondary care for further management?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

The provided UK guideline excerpts do not specifically detail referral criteria for "thyroid storm" . However, they do provide guidance on the management and referral of hyperthyroidism, of which thyroid storm is a severe manifestation.

You should consider referring adults with hyperthyroidism for specialist assessment and further treatment in secondary care . While awaiting specialist assessment, initial management in primary or non-specialist care may include antithyroid drugs along with supportive treatment .

Additionally, if a patient develops agranulocytosis while on antithyroid drugs, these drugs should be stopped immediately and not restarted, and referral to a specialist for further management options should be considered .

Educational content only. Always verify information and use clinical judgement.