Category: Thyroid Function

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Thyroid Disorders and Selenium Supplementation

Thyroid disorders.

Many clinicians treating autoimmune thyroid diseases are using selenium supplementation as one treatment modality even though, in the official guidelines, selenium supplementation is recommended only in the treatment of mild Graves orbitopathy [Winther 2020].

Thyroid gland
The thyroid gland is the butterfly-shaped organ in the front part of the neck. Thyroid hormones regulate body temperature, heart rate, and weight gain or loss. Autoimmune thyroid disorders occur when immune system cells attack thyroid gland cells. Autoimmune thyroid disorders cause overproduction of thyroid hormones (hyperthyroidism) and underproduction of thyroid hormones (hypothyroidism). Graves’ disease is the most common autoimmune hyperthyroidism. Hashimoto’s thyroiditis is the most common autoimmune hypothyroidism.

Some clinicians consider supplementation with selenium to be a pharmaceutical action that should be taken only with thyroid disorder patients with well-defined symptoms in order to alleviate the symptoms, to improve the course of the disease, or to provide a cure. Typically, in such cases, the selenium treatment is conducted for short periods, and the health benefits and side effects are evaluated and weighed [Schomburg 2020].

Other clinicians consider supplementation with selenium in a more holistic way and use selenium supplementation as a way to correct a nutritional deficiency of selenium, which is associated with thyroid disorders [Schomburg 2020]. read more

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Selenium Deficiency and Thyroid Disorders

Selenium plays an important role in optimal immune and endocrine system function. The role that selenium plays with respect to thyroid function is complex [Chmura 2022]:

Thyroid system
Good thyroid system function promotes improved metabolism, better growth and development, and increased effect of catecholamines. Note: Catecholamines are hormones released in response to emotional or physical stress. (Attribution: Mikael Häggström, Public domain, via Wikimedia Commons.)

The thyroid gland is the organ with the greatest amount of selenium per gram of tissue.

  • An adequate supply of selenium is necessary for synthesizing the enzymes – the iodothyronine deiodinases – that are involved in the metabolism of thyroid hormones.
  • Selenium supplementation may give beneficial effects to patients with autoimmune diseases of the thyroid gland.
  • There is a significant correlation between selenium deficiency and thyroid gland dysfunction. Selenium deficiency is defined as serum or plasma selenium levels below 70 mcg/L. Optimal serum/plasma selenium levels are approximately 125 mcg/L [Winter 2020].
    • Selenium Deficiency and Thyroid Dysfunction

    A 2022 review highlights the following relationships between selenium deficiency and thyroid gland dysfunction [Chmura 2022]: read more

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    Adjuvant Treatment of Graves’ Hyperthyroidism with Selenium Yeast

    Thyroid disease. Hyperthyroidism. Adjuvant treatment of thyroid disease with selenium yeast supplementation. All topics of interest. At this writing (August 2022), we await the publication of the outcomes of the GRASS clinical trial. GRASS is the acronym for the selenium supplementation for patients with Graves’ hyperthyroidism study [study protocol described by Watt 2013].

    What is Graves’ Hyperthyroidism?

    Thyroid gland
    The thyroid gland is a butterfly-shaped endocrine gland in the neck below the Adam’s apple that makes and stores hormones that help regulate blood pressure, body temperature, heart rate, and the rate at which food is converted into energy. [This image is licensed under the Creative Commons Attribution-Share Alike 4.0 International license.]
    Hyperthyroidism is an autoimmune disease. It causes overactivity of the thyroid gland, resulting in too much production of the hormone thyroxine. Hyperthyroidism can cause an acceleration of the body’s metabolism; it can cause weight loss and rapid or irregular heartbeat.

    Hyperthyroidism is caused by a number of conditions, including Graves’ disease, which is a common cause. Graves’ disease is the result of immune system disorder. It can affect anyone, but it is more common in women and in individuals under the age of 40. read more

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    Hashimoto’s Disease Patients Benefit from Selenium Supplementation

    Hypothyroidism is the medical condition caused by an underactive thyroid gland that is not producing sufficient quantities of thyroid hormones. It is the failure of the thyroid gland to function normally.

    Jan Olav Aaseth
    Endocrinologist Jan Aaseth, M.D., Ph. D., ERT, explains that, in Norway, the diagnosis of Hashimoto’s disease is made after a clinical examination that involves determination of the patient’s circulating levels of the thyroid hormone thyroxine (T4), thyroid stimulating hormone, and thyroperoxidase antibodies [Aaseth 2022].
    The most common form of hypothyroidism is related to Hashimoto’s disease. Hashimoto’s disease is an autoimmune disorder most common among middle-aged women. Symptoms include anxiety, dry skin, fatigue and lethargy, muscle aches and muscle stiffness, negative mood, sensitivity to cold, slow thinking and poor memory.

    The standard treatment for Hashimoto’s disease is twofold:

    1) treatment with a synthetic hormone called levothyroxine, which works like the T4 hormone that is naturally produced by the thyroid gland read more

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    Selenium Supplementation and Autoimmune Thyroiditis

    Autoimmune thyroiditis is the umbrella term for various types of thyroiditis in which the immune system mistakenly attacks the thyroid gland.

    Endocrine glands placement
    The thyroid gland is the butterfly-shaped endocrine gland in the lower part of the neck. It plays an essential role in the regulation of our basic metabolism.

    The result is often hypothyroidism, the insufficient functioning of the thyroid gland.

    The two major types of hypothyroidism are Hashimoto’s disease and atrophic thyroiditis.

    Thyroiditis is the medical term for inflammation of the thyroid gland.

    Immune system disorder can also cause an overactive thyroid, called hyperthyroidism; Graves’ disease is the most common form.

    Selenium Supplementation to Prevent Hypothyroidism

    In a 2021 review article, Filipowicz et al assert that many European endocrinologists prescribe selenium supplements to autoimmune thyroiditis patients.

    For example, a 2016 survey of 815 doctors (91% endocrinologists) has shown that almost 80% of the surveyed doctors prescribe selenium supplementation to autoimmune thyroiditis patients. The rationale for the selenium supplementation is the delay of the hypothyroidism or a decrease in thyroid antibodies [Filipowicz 2021]. read more

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    Selenium and Patients with Autoimmune Thyroid Disease

    Sufficient selenium status is necessary for good thyroid health.

    A woman's neck
    Selenium-containing drugs are effective for treating patients with autoimmune thyroid disorders [Zuo 2021].
    Zuo et al [2021] have investigated selenium status and the effects of selenium supplementation in patients with autoimmune thyroid disease.

    They analyzed the data from 17 journal articles based on studies of 1,911 subjects. Their meta-analysis results showed the following statistically significant associations:

    • Serum free triiodothyronine (FT3) levels in patients were reduced after selenium supplementation compared to placebo treatment.
    • Serum free thyroxine (FT4) levels and anti-thyroid peroxidase antibody (TPOAb) levels were reduced after selenium supplementation compared to placebo treatment.
    • Anti-thyroid peroxidase antibody (TPOAb) levels were decreased after selenium supplementation compared to placebo treatment.

    However, the thyroid stimulating hormone (TSH) levels
    and the anti-thyroglobulin antibody (TGAb) levels were not significantly different between the selenium treatment group and the control group.

    The researchers concluded that selenium-containing drugs were effective in treating patients with autoimmune thyroid disease and greatly reduced
    the levels of free triiodothyronine, free thyroxine, and anti-thyroid peroxidase antibody in these patients. read more

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    Selenium in the Prevention and Treatment of Thyroid Disorders

    Throid gland in the neck
    The thyroid gland is an endocrine gland in the front of the neck just below the Adam’s apple. It consists of two lobes connected by the thyroid isthmus. Selenium deficiency and less than optimal activity of the selenoproteins may be a factor in autoimmune thyroid diseases.  https://commons.wikimedia.org.

    A 2017 summary of the research literature supports the idea that optimal selenium levels are needed for antioxidant protection against harmful free radicals in the thyroid gland and for the normal metabolism of thyroid hormones [Ventura 2017].

    A 2018 research literature review shows that selenium supplementation can reduce anti-thyroperoxidase antibody levels and can improve thyroid ultrasound features. In addition, selenium supplementation is associated with improved symptoms and improved quality of life in patients with Graves orbitopathy [Santos 2018].

    Note: Anti-thyroperoxidase antibody levels that are too high (>500 IU/ml) are associated with an increased risk of hypothyroidism in autoimmune thyroiditis, which is the most common form of thyroid disorder [Ehlers 2016]. read more

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    Selenium Supplementation and Graves’ Disease

    Low selenium status is associated with increased risk of Graves’ Disease. Graves’ Disease is an autoimmune disease of the thyroid. It is the most common cause of hyperthyroidism. It often results in an enlarged thyroid.

    A 2018 meta-analysis of randomized controlled trials shows that adjuvant selenium supplementation may enhance the restoration of normal thyroid function in patients with Graves’ Disease [Zheng].

    Graves’ Disease is the most common cause of hyperthyroidism in adults. It is characterized by below-normal serum TSH levels and increased serum levels of free thyroxine (FT4) and/or triiodothyronine (T3). The basal metabolic status of Graves’ Disease patients is accelerated; the result is an increase in the production of harmful free radicals and reactive oxygen species [Zheng].

    Intra-cellular antioxidant enzymes such as superoxide dismutase (SOD), glutathione reductase, and glutathione peroxidase (GPx) protect against the cellular damage caused by oxidative stress. read more

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    Selenium supplementation in the Su.Vi.Max. study

    Depicted above (A): apoptosis in normal cell division with a damaged cell (2) and programmed cell death (1). Depicted below (B): cancer cell division with uninhibited cell production and increasingly more dangerous cell mutations. Selenium supplementation can help normal healthy adults who have low selenium status with cancer chemo-prevention benefits, thyroid function benefits, and cognitive function benefits.

    The Su.Vi.Max. study —  SUpplementation en VItamines et Minéraux AntioXydants — was a big randomized, double-blind, placebo-controlled study carried out with typical French efficiency.  Even though I have written the name of the study in French, there are so many English cognates that I am sure you can read the full name of the study.

    The study was designed to test the health benefits of daily supplementation with a number of vitamins and minerals at nutritional dosages (roughly, one to three times the daily recommended dietary intakes) [Hercberg 1998]:

    • selenium, 100 micrograms
    • vitamin C, 120 mg
    • vitamin E, 30 mg
    • beta-carotene, 6 mg
    • zinc, 20 mg

    In particular, the French researchers wanted to see the effect of the daily supplementation over a long period, approximately 7.5 years, from 1994 to 2002, on the prevention of cancer and cardiovascular disease, both of which have been linked to oxidative stress and oxidative damage and might, therefore, be affected by supplementation with antioxidants. read more

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    Selenium and thyroid function

    The thyroid system regulates and maintains many vital functions in the body.  To ensure its optimal functioning, the thyroid gland requires adequate levels of selenium and iodine.

    Selenium is an essential micronutrient.  We need only small quantities of it, but we do need selenium as a component of the amino acid selenocysteine.  We need the selenocysteine, in turn, for the body’s synthesis of 25 identified selenoproteins that have a variety of biological functions [Bellinger].

    The following outcomes are some of the health benefits associated with adequate selenium intake and status [Ventura]:

    • Reduction of the risk of cancer
    • Enhancement of thyroid function
    • Protection against oxidative damage
    • Enhancement of immune system function
    • Detoxification and elimination of mercury
    • Slower progression of HIV infections to AIDS and death
    • More resistance to opportunistic infections

    Selenium and thyroid function

    The thyroid is the small butterfly-shaped gland at the base of our necks, just above our breastbones.  For such a small gland, the thyroid gland is very important.  When it is healthy, it produces the hormones that regulate many bodily functions:

    • the body’s metabolism rate
    • the body’s heart function
    • the functioning of the digestive system
    • the body’s muscle control
    • the brain’s development
    • the maintenance of good bone health

    Diseases inhibiting thyroid gland function

    The most prevalent diseases of the thyroid gland are the following [Iddah]: read more