Two systematic review s have evaluated controlled trials among patients with autoimmune thyroiditis and report that selenium supplementation decreases circulating thyroid autoantibodies .
The immunomodulatory effects of selenium might involve reducing proinflammatory cytokine release .
In Graves ’ disease , some , but not all , trials indicate that adjuvant selenium supplementation enhances the restoration of biochemical euthyroidism , and might benefit patients with mild Graves ’ orbitopathy .
The available evidence from trials does not support routine selenium supplementation in the st and ard treatment of patients with autoimmune thyroiditis or Graves ’ disease .
However , correction of moderate to severe selenium deficiency may offer benefits in preventing , as well as treating , these disorders .
Purpose of review This review provides an appraisal of recent evidence for or against selenium supplementation in patients with autoimmune thyroid diseases , and discusses possible effect mechanisms .
Recent findings Epidemiological data suggest an increased prevalence of autoimmune thyroid diseases under conditions of low dietary selenium intake .
However , clinical ly relevant effects of selenium supplementation , including improvement in quality of life , are more elusive .
A Prospective Investigation of Graves' Disease and Selenium: Thyroid Hormones, Auto-Antibodies and Self-Rated Symptoms
Background : In Graves ' thyrotoxicosis tachycardia , weight loss and mental symptoms are common . Recovery takes time and varies between patients . Treatment with methimazole reduces thyroid hormone levels . According to previous research , this reduction has been faster if selenium ( Se ) is added . Objective : The objective was to investigate whether supplementing the pharmacologic treatment with Se could change the immune mechanisms , hormone levels and /or depression and anxiety . Methods : We prospect ively investigated 38 patients with initially untreated thyrotoxicosis by measuring the thyroid-stimulating hormone ( TSH ) , free thyroxine ( FT4 ) , free triiodothyronine ( FT3 ) , thyroid receptor antibodies and thyroid peroxidase auto-antibodies before medication and at 6 , 18 and 36 weeks after commencing treatment with methimazole and levo-thyroxine , with a r and omized blinded oral administration of 200 µg Se/day or placebo . The selenoprotein P concentration was determined in plasma at inclusion and after 36 weeks . The patients were also assessed with question naires about depression , anxiety and self-rated symptoms before medication was started and after 36 weeks . Results : FT4 decreased more in the Se group at 18 weeks ( 14 vs. 17 pmol/l compared to the placebo group , p = 0.01 ) and also at 36 weeks ( 15 vs. 18 pmol/l , p = 0.01 ) . The TSH increased more in the Se group at 18 weeks ( 0.05 vs. 0.02 mIU/l , p = 0.04 ) . The depression and anxiety scores were similar in both groups . In the Se group , the depression rates correlated negatively with FT3 and positively with TSH . This was not seen in the placebo group . Conclusions : Se supplementation can enhance biochemical restoration of hyperthyroidism , but whether this could shorten clinical symptoms of thyrotoxicosis and reduce mental symptoms must be investigated further
Two systematic review s have evaluated controlled trials among patients with autoimmune thyroiditis and report that selenium supplementation decreases circulating thyroid autoantibodies .
The immunomodulatory effects of selenium might involve reducing proinflammatory cytokine release .
In Graves ’ disease , some , but not all , trials indicate that adjuvant selenium supplementation enhances the restoration of biochemical euthyroidism , and might benefit patients with mild Graves ’ orbitopathy .
The available evidence from trials does not support routine selenium supplementation in the st and ard treatment of patients with autoimmune thyroiditis or Graves ’ disease .
However , correction of moderate to severe selenium deficiency may offer benefits in preventing , as well as treating , these disorders .
Purpose of review This review provides an appraisal of recent evidence for or against selenium supplementation in patients with autoimmune thyroid diseases , and discusses possible effect mechanisms .
Recent findings Epidemiological data suggest an increased prevalence of autoimmune thyroid diseases under conditions of low dietary selenium intake .
However , clinical ly relevant effects of selenium supplementation , including improvement in quality of life , are more elusive .