Selenium Status and HIV Infections

HIV (human immunodeficiency virus) is still very much a public health concern. Deficiencies of certain micronutrients are known to play a role in the progression of HIV infections to AIDS (acquired immunodeficiency syndrome). In particular, adequate intakes of selenium are important because of selenium’s antioxidant and anti-inflammatory activities in HIV infection [Pourmoradian 2023].

Umbrella Study of Systematic Reviews of Selenium and HIV Studies

Symptoms of AIDS Poster
Selenium levels are often low in individuals infected with HIV virus. Selenium supplementation can slow the decline in CD4 cell counts, can reduce the risk of hospitalization, can prevent increases in the HIV-1 viral load, and can slow the progression of the infection to AIDS.

In a 2023 umbrella study of systematic reviews of studies of selenium in HIV patients, Pourmoradian et al found the following evidence:

  • Four reviews showed that selenium supplementation at the level of 200 mcg/day was effective in delaying CD4 decline in HIV-infected patients.
  • Three reviews showed that selenium supplementation at the level of 200 mcg/day significantly reduced HIV viral load.
  • The researchers suggested that the underlying mechanism of the selenium effect on HIV progression is the improvement of the immune response and the antioxidant defense system.
  • In particular, the selenium-dependent glutathione peroxidase (GSH-Px) enzyme system reduces the extent of oxidative stress, indirectly strengthens the immune system, and slows the progression of the disease.

Note: CD4 cells are lymphocytes that help to coordinate the immune response to infections. If an HIV patient’s CD4 cell count falls below 200 cells per cubic millimeter of blood, then the HIV infection is considered to have progressed to the AIDS stage. In healthy individuals, the CD4 count will be between 500 and 1,600 cells/cubic millimeter of blood. read more

Selenoprotein P – Selenium Transport Protein and Biomarker of Selenium Status

Selenium and selenoproteins are essential to human health [Rayman 2012]. However, selenium intakes from food vary considerably from region to region in the world, depending on how rich or poor the soil and the foodstuffs are.

Selenium researcher Professor Urban Alehagen
Professor Urban Alehagen realized that the low selenium content of the soil in Sweden and in much of Europe results in wide-spread low dietary selenium intake and selenium deficiency. In the Swedish KiSel-10 Study, the average serum selenium concentration was a quite low 67 mcg/L.

For example, widespread suboptimal selenium status has been reported throughout Europe, the UK, and the Middle East [Stoffaneller & Morse 2015]. In contrast, the soil and the foodstuffs in much of the United States and Canada have a much higher selenium content than is the case in Europe. Serum selenium levels of US citizens are generally above 120 mcg/L. In many European countries, the corresponding serum selenium levels are 90 mcg/L on average [Alehagen 2016].

  • The best estimate for serum selenium status that is sufficient for good health is around 125 mcg/L [Winther 2020, fig. 3].
  • Serum selenium levels below 70 mcg/L are indicative of selenium deficiency [Bomer 2020].
  • Serum selenium levels below 100 mcg/L are indicative of sub-optimal selenium status [Al-Mubarak 2021].
Selenoprotein P as the Major Selenium Transport Protein

Dietary selenium is incorporated into the amino acid selenocysteine, which becomes an integral component of 25 selenoproteins. The best known selenoproteins are the glutathione peroxidases, thioredoxin reductases, and
iodothyronine deiodinases [Schomburg 2019]. read more

Selenium Supplementation Increases Serum Sirtuin1 Concentrations

Daily supplementation with 200 mcg of selenium and 200 mg of Coenzyme Q10 for four years has resulted in significant increases in serum SIRT1 concentrations. In the parallel placebo group, the serum SIRT1 concentrations decreased significantly [Opstad, Alehagen 2023].

Selenium Researcher Professor Jan Aaseth
Professor Jan Olav Aaseth, Inland Norway University of Applied Sciences, is the guest author on this review article. Dr. Aaseth has written extensively about selenium in health and disease. He is one of the co-authors on the Sirtuin1 study summarized here.

This is the latest evidence from the KiSel-10 Study in which researchers randomly assigned elderly community-living Swedish men and women, average age: 76 years, 49% female, to a combined selenium and Coenzyme Q10 treatment group or to a placebo group [Alehagen 2013].

In earlier papers, the KiSel-10 Study researchers have reported beneficial effects of the combined supplementation of the elderly Swedish citizens with low baseline selenium levels [Alehagen 2022; Opstad 2022]: read more

Selenium Supplementation and Chemotherapy in Cervical Cancer Patients

Selenium yeast supplementation administered concurrently with chemotherapy and radiation therapy effectively increased blood selenium levels in cervical cancer patients with inadequate selenium status. The selenium yeast supplementation was used as an adjuvant treatment to the standard chemotherapy and radiation therapy. It significantly decreased the hematologic toxicity of the chemoradiotherapy [Yang 2023].

Cancer and selenium
Each year, worldwide, half a million women are diagnosed with cervical cancer, and 300 000 die from the disease. In most cases, the human papilloma virus is the cause of the disease [Cohen 2019]. The trace element selenium has antiviral properties. Cell studies and mouse studies of cervical cancer have shown that different selenium species have anticancer effects in cervical cancer induced by human papilloma virus or by chemical carcinogens [Jablonska 2021].
In a randomized controlled trial, researchers randomly assigned 104 patients diagnosed with stage IIB cervical cancer receive 100 mcg selenium yeast tablets (n=50) or matching placebos twice daily (n=54) for five weeks [Yang 2023].

All patients in both groups received the standard treatment including pelvic external irradiation, concurrent five cycles of chemotherapy, and brachytherapy [Yang 2023]. read more

Selenium and a Longer Healthier Life

The micronutrient selenium has antioxidant and anti-aging properties. Specifically, numerous selenoproteins, in which selenium is an essential component, have antioxidant, anti-inflammatory, and immunostimulating effects [Bjørklund 2022].

Why is this important?

Old people
Biological aging involves the gradual worsening of the composition of our cells and organelles. It involves the slowing down of our body functions. Aging is typically accompanied by wrinkled skin and thinner skin, by a loss of body mass and bone density, and by poorer eyesight. The older we get, the more vulnerable we are to loss of cognitive function and dementia, heart trouble, osteoporosis, renal failure, viral infections, etc. Eventually death comes.

The aging process is characterized by the following inevitable physiological developments [Alehagen 2021]:

Selenium and selenoproteins and antioxidant protection

One theory of biological aging is that oxidative stress and chronic low-grade inflammation play an important role in aging-related physical and mental decline. Harmful reactive oxygen species – popularly known as free radicals – overwhelm the ability of the available antioxidants to neutralize them. The harmful free radicals cause oxidative damage to the cells and to the DNA, lipids, and proteins in the cells [Bjørklund 2022]. read more

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

Selenium Supplementation and Alzheimer’s Disease

Clinical studies show a clear correlation between Alzheimer’s Disease and low selenium status.  Lower selenium status is associated with worse cognitive decline [Aaseth 2016].

In many regions of Europe and the Middle East, there is poor selenium content in the soil and, accordingly, lower intake of selenium from food sources [Stoffaneller & Morse 2015; Winther 2020].

Woman with Alzheimer's
Adequate levels of selenium are essential for brain function; in fact, the brain is one of the organs that is supplied with selenium at the expense of other organs and tissues in times of low selenium intake. Selenoprotein P plays a special role in delivering selenium to the brain and the neurons. Some of the glutathione peroxidase and thioredoxin reductase selenoenzymes are important intracellular antioxidants in neurons and glia cells of the central nervous system.

The daily intake of selenium from food in many European countries is well below the amount needed for optimal function of important selenoproteins. The needed intake of selenium from food is  estimated to be at least 105 mcg per day [Winther 2020, fig. 2].

Using evidence from human studies in various countries, Prof. Jan Aaseth and colleagues have documented the association between lower selenium  status and Alzheimer’s Disease and/or cognitive impairment [Aaseth 2016]. read more

Selenium and Coenzyme Q10 Supplementation To Prevent Heart Disease

Heart disease prevention. In the KiSel-10 Study, combined supplementation of community living senior citizens for four years with an organic high selenium yeast (200 mcg selenium/day) and Coenzyme Q10 in the ubiquinone form (2 x 100 mg/day) prevented an increase in fibroblast growth factor 23 and reduced the risk of cardiovascular disease [Alehagen Feb 2022].

what is fibroblast growth Factor 23?
Prof. Urban Alehagen
Prof. Urban Alehagen was among the first cardiologists to suspect that low selenium intakes might increase the risk of death from heart disease. He designed and conducted the KiSel-10 Study to test the hypothesis that combined selenium and Coenzyme Q10 supplementation might reduce the risk of cardiovascular disease.

Professor Urban Alehagen explains that fibroblast growth factor 23 is a hormone that is secreted primarily from the osteocytes (i.e., mature bone cells) into the blood. From the blood circulation, the hormone acts on fibroblast growth factor receptors in the heart, intestine, kidney, and parathyroid gland [Alehagen Feb 2022].

Fibroblast growth factor 23 is mainly active in the metabolism of vitamin D and phosphorus. However, there have been reports that indicate an association between increased fibroblast growth factor 23 levels and cardiovascular mortality even in the patients with no sign of kidney disease [Alehagen Feb 2022]. read more

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

Impact of Selenium Status on Ageing

Selenium is an essential trace element. Essential means that sufficient selenium is necessary for normal cell functioning and that our bodies cannot synthesize selenium for us. We must get it from our diets. Trace element means selenium is a micronutrient that is needed in very small quantities, in microgram quantities. It may be an important element to slow the ageing process.

Elderly couple
Selenium as a component in protective enzymes helps to keep us healthier longer in life. It helps to suppress oxidative stress and to decrease inflammation, to remove misfolded proteins, to decrease DNA damage, and to promote telomere length.

Sufficient selenium status plays an important role in the prevention of cardiovascular diseases, inflammation, and infections. Prof. Margaret P. Rayman, University of Surrey, estimates that serum/plasma selenium status of around 125 mcg/L is optimal for human health [Rayman 2020].

The beneficial work of selenium in the cells and tissues is done by selenoproteins that contain the amino acid selenocysteine in the active center. Among the selenoproteins known to have an antioxidant effect in the body are the glutathione peroxidases (GPX1-4 and GPX6) and the thioredoxin reductases (TXNRD1-3) [Alehagen 2021]. read more