IV Selenium Supplementation for Critically Ill Patients

Critically ill patient
Increased generation of harmful free radicals and increased systemic inflammation seem to play a direct role in cell death, increased morbidity, and higher mortality in critically ill patients. Selenium is a trace element that has cell regulatory, immunologic, and antioxidant and anti-inflammatory functions. Early selenium supplementation is a promising adjunctive therapy for critically ill patients.

Selenium supplementation – especially intravenous selenium supplementation – seems to be a promising adjuvant treatment for critically ill patients.

The aggregated results of a meta-analysis of the clinical outcomes of selenium supplementation on critically ill patients shows that intravenous selenium supplements as a single therapy can decrease the total mortality and can shorten the length of stay in hospital [Zhao 2019].

Furthermore, the results from the meta-analysis showed that the selenium supplementation did not increase the incidence of drug-induced side effects compared with the control group [Zhao 2019].

Selenium Supplementation for Critically Ill Patients – The Evidence

The researchers reviewed 19 randomized controlled trials enrolling 3341 critically ill patients. There were 1694 critically ill patients in the selenium supplementation group and 1647 critically ill patients in the control group. read more

Selenium Supplementation and HIV Infections: A Review

Symptoms of AIDS
The six selenium and HIV infection studies show a beneficial effect of daily supplementation with 200 micrograms of selenium on immune function, in particular on CD4 white blood cell counts. The same beneficial effect on the immune system may be protective against other forms of infection, including against Covid-19 infections.

Six randomized controlled studies show that providing daily selenium supplementation to HIV-infected adults increases CD4 cell counts, reduces the risk of diarrhea morbidity, and lowers hospital admission rates for HIV-related conditions and opportunistic infection in HIV-infected adults [Kayode 2020].

Alexander et al [2020] have recognized the importance of selenium to immune system function and have recommended the initiation of adequate selenium supplementation in high-risk Covid-19 areas and as soon as possible after a suspected Covid-19 infection.

Richie et al [2014] have shown that selenium supplementation in the form of selenium-enriched yeast provides significantly greater protection against oxidative stress than supplementation with exclusively selenomethionine does. read more

Selenium Supplementation and Blood Sugar Levels

Testing blood sugar
The results of randomized controlled trials of selenium supplementation show beneficial effects or no effect on blood sugar levels and insulin sensitivity values. In this review, we summarize the study results.

The effect of selenium supplementation on blood sugar levels and on the risk of diabetes is still an open question. However, the data from randomized controlled studies show that selenium supplementation is associated with either a beneficial effect or no effect at all on blood sugar levels, insulin sensitivity, and glucose tolerance [Jablonska 2016].

Study Participants with Type-2 Diabetes

Beneficial effect. In a 2019 study, the participants were 72 male and 22 female patients aged 48 to 64 years old with diabetes mellitus type 2. They were smokers, all of them, and they all followed a Mediterranean diet.

The researchers administered selenium 200 microg/day once daily on an empty stomach. The study data showed a statistically significant reduction in the blood levels of glucose and in HbA1c values at both three months and six months after the beginning of the treatment. The administration of selenium to type-2 diabetic patients seemed to improve the patients’ glycemic profile [Karalis 2019]. read more

Selenium Supplementation and Prostate Cancer

New Zeland landscape
The New Zealand study results suggest that each of us needs to take personalized selenium supplement dosages based on our individual characteristics rather than have all of us take the same 200 microg/day tablet for prostate health benefits [Karunasinghe 2019].
Demographic, dietary, genetic, and life style factors influence the prostate health effects of selenium supplementation according to New Zealand researchers.

An inverse association between serum selenium concentrations and prostate-specific antigen levels was especially strong in the following sub-groups of study participants [Karunasinghe 2019]:

  • men below the age of 55 years
  • men who never smoked
  • men carrying the GPX1 rs1050450 T allele
  • men with dietary intakes above the recommended daily intake for zinc (11 mg)
  • men with dietary intakes below the recommended daily intake for vitamin B12 (15 mcg)

Moreover, the increase in serum selenium status and the resulting post-supplementation serum selenium status were significantly dependent upon baseline serum status [Karunasinghe 2019].

The overall gain in serum selenium levels from supplementation declined at a rate of 0.828 microg/L with each one microg/L increase in baseline serum selenium level [Karunasinghe 2019]. read more

Selenium Status and Viral Infections

Selenium and viral infections, what do we know?

  • Selenium is a micronutrient that is essential for good health.
  • Low serum selenium status (below 85 microg/mL) and marginal serum selenium status (between 85 and 100 microg/mL) are common in many regions of the world, especially in many parts of Europe, the Middle East, China, and East Asia.
  • Selenium status is a key factor regulating the immune response to viral infections [Hiffler 2020].
  • Selenium status influences the immune system response to the severe acute respiratory syndrome corona virus infections [Bermano 2020].
  •  Selenium status is a risk factor that could well influence the outcome of a Covid-19 infection, particularly if the infected individuals have a sub-optimal or low selenium intake [Bermano 2020].
  • Selenium supplementation may limit the severity of Covid-19 infections, particularly in regions in which the selenium intake is low [Bermano 2020, Hiffler 2020].

Evidence for a Link Between Selenium Status and Viral Infection Severity

The early evidence came from study of the Keshan Disease in China – caused by the combination of the coxsackie B3 virus and low selenium status. By adding selenium to the soil fertilizer and by encouraging the use of selenium supplements, Chinese authorities have been able to reduce significantly the incidence of the disease [Bermano 2020].

Then came evidence from mouse studies that showed that there is increased virulence to coxsackie and influenza viruses in hosts with low selenium status [Bermano 2020].

Next came evidence that low selenium status, commonly seen in HIV-infected patients, is associated with reduced numbers of CD4 T cells and with increased disease progression and death rates [Bermano 2020]. read more

Selenium, Selenoproteins, and Antioxidant Systems

Disinfection materials
Low selenium status is associated with increased virulence of virus infections, with worse symptoms of heart failure, and with greater risk of some forms of cancer.

Oxidative stress is the bio-medical term for a lack of balance between 1) the production of harmful reactive oxygen and reactive nitrogen species and 2) the protective action of antioxidant systems. According to the news network of the Mayo Clinic, oxidative damage has been linked to several conditions such as Alzheimer’s, cancer, cataracts, diabetes, heart disease, macular degeneration, and Parkinson’s.

Free Radicals and Oxidative Damage

The reactive oxygen and reactive nitrogen species are popularly referred to as free radicals. They are molecules produced as natural by-products of metabolic processes and as a consequence of exposure to pollutants, to heavy metals, to industrial chemicals, to some drugs, to some forms of radiation including x-rays, and to cigarette smoking. read more

Selenium Intakes and the Risk of Cancer: Two Meta-Analyses

Blue ribbon for prostate cancer
Despite the billions of dollars spent in the war on cancer, cancer in its various forms continues to be a leading cause of death worldwide. Treatment is expensive. The prognosis is often poor. Even so, the World Health Organization estimates that perhaps one third of all cancer cases could be prevented with changes in behavioral and dietary patterns. An inverse linear association has been found between increased selenium intake and reduced risk of all cancers. As the selenium intake increased, the overall risk of cancer incidence decreased [Kuria 2020].
A 2020 meta-analysis of population-based prospective studies shows that selenium supplementation is protective against cancer; however, the beneficial effects of the selenium supplementation vary with the different types of cancer. The differences in the effect of selenium intakes on the risk of various cancer forms has been attributed to differences in the pathophysiology of cancer [Kuria 2020].

Briefly, the data from the meta-analysis show that selenium decreases the risk of cancer at the highest daily intake levels of the included studies.

This outcome is consistent with the outcomes of a previous study showing a protective effect of selenium at high doses compared to low doses [Cai 2016]. A 2018 meta-analysis used different methods to assess selenium exposure and showed a null association between selenium at high doses compared to low doses [Vinceti 2018]. read more

Selenium to Raise Anti-Viral Resistance Against COVID-19

COVID-19 Virus Infection
COVID-19 virus infections are accompanied by excessive activation of the innate immune system, by progressive inflammation, and by cytokine storms. A review of the medical journal literature shows that an adequate supply of the micronutrients selenium, zinc, and vitamin D is necessary to strengthen immune function and to reduce inflammation.

Adequate intakes of selenium, zinc, and vitamin D are essential to ensure resistance to viral infections, to promote strong immune function, and to reduce levels of inflammation. A team of Norwegian, Swedish, and Russian researchers recommends the initiation of adequate supplementation with these micronutrients in high-risk areas and in cases of suspected exposure to SARS-CoV-2 [Alexander 2020].

Selenium Supplementation to Protect Against the Hyper-Inflammation Associated with COVID-19

The team of researchers concluded from its review of the available medical literature that an adequate selenium intake/status can protect against the hyper-inflammation associated with corona viral infections.

Consequently, individuals at high risk who have a selenium status below 100 micrograms per liter should consider daily supplementation at a dose of 100–200 micrograms of selenium per day [Alexander 2020]. read more

Effect of Selenium Supplementation on Heart Health

Chambers of the heart
The American Heart Association defines heart failure as a condition in which the heart muscle cannot pump enough blood out to the body to keep the tissues and organs sufficiently supplied with oxygen. Heart failure is a condition for which there is no known cure. Selenium deficiency is associated with worsening heart failure.

Selenium is an essential antioxidant trace element that is necessary for key activities in human metabolism [Djalalinia 2019]. Meta-analyses of randomized controlled trials of selenium supplementation reveal that selenium supplementation is a cost-effective and simple-to-use intervention that can play an important role in the prevention of heart disease risk factors [Hasani 2018; Hasani 2019; Mahdavi 2019; Tabrizi 2017].

These results from meta-analyses of randomized controlled trials reaffirm the outcomes in the Bomer multinational observational cohort study. In that study, heart failure patients with serum selenium concentrations below 70 micrograms per liter were more likely to have the following characteristics [Bomer 2019]: read more

Selenium Vital for Good Health

Gerhard N. Schrauzer
Dr. Gerhard N. Schrauzer (1933-2014) was the Director of the Biological Trace Element Research Institute in San Diego and the founder and editor-in-chief of the Biological Trace Element Research journal. He was a pioneer in the study of selenium’s biological functions. He was one of the first researchers to realize that selenium has positive effects on human and animal health.

Quote: “Pluck almost any cell from your body, and it will have a million or more selenium atoms in it, yet until recently nobody had any idea what they were there for. We now know that selenium makes two vital enzymes, deficiency in which has been linked to hypertension, arthritis, anaemia, some cancers, and, even, possibly reduced sperm counts. So, clearly, it is a good idea to get some selenium inside you (it is found particularly in nuts, whole meal bread, and fish), but at the same time, if you take too much, you can irremediably poison your liver. As with much of life, getting the balances right is a delicate business.” End Quote.

The above lines are quoted from Bill Bryson’s book The Body: A Guide for Occupants. ISBN-13: 978-0385539302. I can recommend the book highly. Bryson writes an English that is a pleasure to read, and the book is full of facts and relationships. You may already know him from his earlier book about science and technology, The Short History of Almost Everything. read more