Selenium Intakes and Health Outcomes

Selenium and good health. How much do we need? How do we get it? Generally speaking, our family and friends do not know just how important selenium is to good health. Our bodies cannot synthesize selenium. We are dependent upon food for an adequate daily intake of this essential trace element.

Salmon rich in selenium
Depending upon where we live, the selenium content of our food may be too low. Wang et al [2023] estimate that approximately one billion people worldwide lack sufficient selenium in their diet.
In many regions of the world, the soil and the foodstuffs have a poor selenium content. Accordingly, the daily intake of selenium varies considerably. Many people have an inadequate supply and thus risk poor health outcomes as a result. For example, in much of Europe, the UK, and the Middle East, there are widespread reports of suboptimal selenium status. Supplementation is necessary in selenium-poor regions [Stoffaneller & Morse 2015]. read more

Selenium Status and Mortality Risk

Mortality and morbidity. As we get older, we start to think about ways to reduce the risk of an early death. We want to reduce the risk of living out our lives in ill health.

Zion National Park in the USA
Pictured here: A creek in the Zion National Park in Utah.

We think about diet, exercise, 10,000 steps a day, hobbies, social contact. But, do we think about our selenium intake and status? Now, some large survey studies conducted in the US have shown that higher selenium status is significantly associated with lower mortality.

Each year, the National Health and Nutrition Examination Survey (NHANES) in the United States conducts surveys that focus on different population groups or health topics. This week, we present data from studies of selenium status and mortality.

Selenium Status and Type 2 Diabetes

Qiu et al examined the data from 3199 adults with type 2 diabetes. Their analysis showed that higher serum selenium concentrations are associated with lower all-cause mortality and lower heart disease mortality among individuals with type 2 diabetes [Qiu 2022]. read more

ChatGPT Answers About Different Forms of Selenium Supplements

In our last article, we asked ChatGPT about the health benefits of selenium supplements in Europe. This time, we asked what is the best form of selenium supplement?

ChatGPT about selenium
We asked ChatGPT for information about the various forms of selenium supplements.

ChatGPT answered that the best form of selenium supplement depends on various factors. These factors include individual health needs, dietary habits, and preferences. Each different form of selenium supplement has its own set of advantages and considerations.

  • Selenomethionine: This form of selenium is found in foods like Brazil nuts, grains, and legumes. The body absorbs selenomethionine well.
  • Sodium selenite: This is an inorganic form of selenium. It is generally considered to have lower bioavailability compared to organic forms like selenomethionine and selenium yeast.
  • Selenium yeast: Selenium yeast is produced by fermenting the yeast Saccharomyces cerevisiae in the presence of selenium. It contains various species of selenium including selenomethionine. The yeast is inactivated in the supplements.

Editor’s note: The presence of various other species of selenium in the selenium yeast may be important for cancer prevention. By other species, we mean the selenium species other than the selenomethionine that is in the selenium yeast supplements.

  • In the Nutritional Prevention of Cancer study, researchers administered 200 mcg/day of selenium-enriched yeast for an average of 5.4 years. The study results showed a significant reduction of colorectal, lung, prostate, and total cancer incidence [Clark 1996].
  • In the SELECT study, researchers administered selenium in the form of selenomethionine, 200 mcg/day. The supplementation with selenomethionine alone and also together with vitamin E did not show any reduction of the risk of colorectal, lung, or prostate cancer after 5.5 years of follow-up [Lippman 2009].

Thus, it seems that the protective effect against cancer may have come from one or more of the other selenium species in the selenium yeast preparation, not from the selenomethionine in the preparation [Bjørnstedt 2010]. read more

ChatGPT Answers Selenium Health Benefits Question

How does ChatGPT answer the question: what are the health benefits of selenium supplementation in Europe? Earlier this month, we posed that question to the free version of ChatGPT. We focused on Europe because the selenium intakes in the United States are generally much higher than the selenium intakes in many parts of Europe [Alehagen 2022].

ChatGPT and selenium supplementation
ChatGPT links selenium supplementation to antioxidant protection, cancer prevention, heart health, immune function, and thyroid function. Important to talk with a health professional about selenium intakes and the need for selenium supplementation.

First, ChatGPT explained that selenium is an essential trace element. It plays an important role in physiological processes in the body. It is a necessary component in selenoproteins. These selenoproteins have antioxidant properties. They help regulate immune system function, thyroid function, and DNA synthesis.

Next, ChatGPT reminded that excessive intake of selenium can lead to toxicity. Selenium supplementation should be undertaken under the guidance of a healthcare professional. Note that the Nordic Nutrition Recommendations 2023 and the European Food Safety Authority both set the tolerable upper intake level at 255 mcg/day [Blomhoff 2023; EFSA 2023]. read more

Selenium and Selenoproteins and Viral Infections

Selenium is an essential micronutrient. Humans cannot synthesize it. Therefore, we must get it from our diets. The selenium content of our diets depends on the richness or poorness of the selenium in the soil and the food. In fact, there are surprisingly large differences in selenium content in various regions of the world [Zhang 2020a].

Woman sneezing
Selenium deficiency and reduced selenoprotein expression have been associated with the pathogenicity of several viruses.

Selenium through its incorporation into 25 known selenoproteins is necessary for a range of biological functions. Zhang et al [2020a] list the following biological functions of selenium and selenium-derived selenoproteins:

  • Antioxidant function
  • Anti-inflammatory function
  • Anti-viral function
  • Cellular redox function
  • Immune cell function
  • Protection of the cardiovascular system
Selenoprotein Functions Relevant to Viral Infections

Selenium and selenium-derived selenoproteins such as the glutathione peroxidases (GPXs), the thioredoxin reductases (TXNRDs), and the endoplasmic-reticulum-associated selenoproteins influence viral pathogenicity. Among other things, these antioxidant selenoenzymes reduce the extent of oxidative stress generated by viral pathogens. Failure to counteract oxidative stress can result in mutations in the viral genome from benign to highly virulent strains [Zhang 2020a]. read more

Selenium and Anti-Aging Effects

Maintaining adequate selenium status is an acknowledged anti-aging strategy. We need selenium to live longer and to be healthier as we age. Adequate intakes of selenium and adequate bio-synthesis of selenoproteins contribute to healthy aging and to reduced vulnerability to various disorders. Selenium and selenoproteins are important for the following biological activity [Bjorklund 2022]:

  • antioxidant protection
  • enhancement of immune system function
  • metabolic homeostasis
Crowds of people
Bjorklund et al estimate that selenium deficiency affects about one billion people in the world and may have a significant adverse effect on human health.

One characteristic of aging is oxidative stress.

Oxidative stress is defined as an imbalance between the damage caused by harmful free radicals and the protection offered by antioxidants. Inadequate selenium status can reduce the longevity and the health of senior citizens by accelerating the aging process and/or increasing vulnerability to immune system dysfunction, cardiovascular disease, and cancer [Bjorklund 2022]. read more

Blood Sugar Control and Selenium Supplementation

Blood sugar levels. Insulin sensitivity. Risk of diabetes. What, if anything, is the likely effect of selenium supplementation on glycemic control?

Blood sugar monitor
To maintain blood sugar levels within the normal range, the CDC recommends eating at regular times, not skipping meals, eating foods lower in calories, saturated fat, trans fat, sugar, and salt, drinking water instead of juice or soda, limiting alcohol intake, and exercising. Adequate intakes of selenium are also important.

Glycemic control is the maintenance of blood sugar levels within an acceptable range to prevent the adverse effects of low blood sugar and high blood sugar.

The best measure of glycemic control is the HbA1c test. This blood test HbA1C gauges the average glucose level in the blood over a period of approximately three months. It is considered a good predictor of diabetic complications.

Checking Blood Sugar

The US Center for Disease Control and Prevention suggests that logical times for testing blood sugar levels are as follows [CDC 2022]:

  • When first awake and before eating or drinking anything
  • Before a meal
  • Two hours after a meal
  • At bedtime
Target Blood Sugar Levels

The CDC suggests the following desirable blood sugar levels [CDC 2022]: read more

Selenium and the Thyroid Gland

The thyroid gland is the organ in the body that contains the most selenium per gram of tissue [Wang 2023].

Illustration of thyroid gland from Wikimedia Commons
The thyroid gland makes and releases hormones that control our metabolism, i.e., regulate how we use energy. Source:

In a 2023 review article, Wang et al summarize the reasons why adequate selenium intake and status are necessary for good thyroid health.

Humans cannot synthesize selenium: the daily intake of selenium depends on the contents of the individual’s diet.

  • The selenium content of food depends on the selenium content of the soil, which varies extensively from region to region of the world. Much of Europe has selenium-poor soil; much of the United States has soil considerably richer in selenium.
  • Selenium is a micronutrient that makes possible the body’s synthesis of some 25 identified selenoproteins containing the amino acid selenocysteine.
  • The best known selenoproteins – such as the glutathione peroxidases, the thioredoxin reductases, and the iodothyronine deiodinases – are expressed in the thyroid gland, where they contribute to thyroid hormone metabolism and to antioxidant defense.
  • A selenium deficiency will increase the risk of several kinds of thyroid diseases.

Selenium Supplementation and Thyroid Diseases

Wang et al [2023] report the following outcomes from clinical trials of selenium supplementation. They advise that we need more clinical evidence for the efficacy of selenium treatment of thyroid disorders.

  • Selenium supplementation slows the progression of Graves’ orbitopathy and improves the quality of the patients’ lives.
  • Selenium supplementation is associated with the decreased levels of anti-thyroid peroxidase antibodies and with improved thyroid ultrasound structure in patients with Hashimoto’s thyroiditis.
  • Selenium supplementation has shown variable anticancer activity in patients with thyroid cancer.

Strong Association Between Selenium and Thyroid Disease

Selenium and Graves’ disease

Wang et al [2023] reviewed the data from 11 clinical trials. Nine clinical trials showed that selenium supplementation results in faster achievement of normal thyroid function in patients with hyperthyroidism. Two clinical trials did not show the beneficial effect of selenium supplementation. The difference in outcomes may be related to differences in the form of the selenium supplementation, the dose, the duration of supplementation, and the nutritional status of the study participants. read more

Heart Failure Risk and Selenium Deficiency

Low plasma selenoprotein P levels are associated with a higher risk of heart failure in a Swedish population [Jujic 2023].

Heart rate
Selenium deficiency in heart failure patients is significantly associated with increased risk of cardiovascular mortality, impaired exercise capacity, and poorer quality of life [Bomer 2020].
Selenoprotein P is the primary protein transporter of selenium in the blood.

Plasma and serum selenoprotein P concentrations are useful biomarkers of selenium status in individuals with relatively low selenium intakes because selenoprotein P responds to different intake forms of selenium [Hurst 2010].

Selenium deficiency – defined as serum selenium concentrations below 70 mcg/L – has been associated with more severe symptoms of heart failure, poorer exercise capacity, and poorer quality of life. Sub-optimal serum selenium concentrations of 70–100 mcg/L have similar adverse associations, suggesting that values less than 100 mcg/L, might be considered abnormal [Bomer 2020]. read more

Selenium-Enriched Yeast Supplementation Studies

The rationale for taking a selenium-enriched yeast preparation: one or more of the selenium compounds in the preparation other than selenomethionine may be the selenium species that has specific effects against cancer. This is an area for further research.

Glass of beer made using brewer's yeast
Selenium-enriched yeast preparations use Saccharomyces cerevisiae, commonly known as as brewer’s yeast. The yeast is grown in a selenium-enriched medium in which the yeast absorbs the selenium. The finished preparation is pasteurized, causing the yeast cells to die. Selenium-enriched yeast preparations contain many organic selenium compounds in addition to selenomethionine.

This week, we focus on studies conducted with a selenium-enriched yeast preparation containing at least 20 different species of selenium in addition to selenomethionine [Bendahl & Gammelgaard 2004].

Randomized, double-blind, controlled clinical trials are the gold standard method for testing the safety, absorption, and efficacy of nutritional supplements and medical drugs. Below, we summarize some of the important clinical trials of nutritional interventions using selenium-enriched yeast. read more