{"id":3415,"date":"2024-05-15T09:16:01","date_gmt":"2024-05-15T09:16:01","guid":{"rendered":"https:\/\/seleniumfacts.com\/?p=3415"},"modified":"2024-04-28T09:39:31","modified_gmt":"2024-04-28T09:39:31","slug":"selenium-and-graves-hyperthyroidism","status":"publish","type":"post","link":"https:\/\/seleniumfacts.com\/index.php\/selenium-and-graves-hyperthyroidism","title":{"rendered":"Selenium and Graves\u2019 Hyperthyroidism"},"content":{"rendered":"

Thyroid disease. What is the role of the micronutrient trace element selenium in thyroid disease? The thyroid gland is the organ in the body that contains the greatest amount of selenium per gram of tissue [Wang 2023]. Even in times of low dietary selenium intakes, the thyroid gland has high priority for the supply of selenium in the body [Schomburg 2020].<\/strong><\/p>\n

\"Endocrine
The thyroid gland is part of the endocrine system. It plays an important role in the body’s metabolism. It has high priority for the supply of selenium in the body. <\/strong><\/figcaption><\/figure>\n

Dietary selenium intakes vary considerably from region to region in the world. There are large differences in the soil content of selenium and in the factors that influence the bioavailability of selenium to plants. As a consequence, individuals\u2019 plasma\/serum selenium status varies<\/a> accordingly [Winther 2020]. Thus, widespread sub-optimal selenium status has been reported throughout Europe<\/a>, the United Kingdom, and the Middle East [Stoffaneller & Morse 2015].<\/strong><\/p>\n

Human studies show a strong association between selenium intake and selenium status, on the one hand, and thyroid disease on the other hand. However, the evidence for the clinical significance of selenium in thyroid disease<\/a> remains unclear; more clinical studies are needed [Wang 2023].<\/p>\n

Prioritized Supply of Selenium to the Thyroid Gland<\/h5>\n

There is prioritized supply<\/a> of selenium to the thyroid gland, even in times of low selenium intakes. With this in mind, Schomburg [2020] points out that small differences in dietary selenium intake are not likely to affect selenoprotein expression in thyroid gland cells and tissues significantly. Schomburg hypothesizes that the benefit of selenium supplementation is not directly to the thyroid gland.<\/p>\n

Instead, the benefit is to the immune system, which does not receive priority supply of selenium. In times of selenium deficiency, the immune system is not able to express the selenoproteins needed for adequate immune response to challenges, e.g., by infection, shock, trauma, iodine deficiency, pregnancy, and other strong threats. In selenium deficiency, Schomburg says, the thyrocyte-lymphocyte interaction becomes disturbed and suboptimal [Schomburg 2020].<\/p>\n

Selenium and Graves\u2019 Hyperthyroidism \u2013 the GRASS Study<\/h5>\n

On March 30, 2024, we reported on the clinical research related to selenium supplementation and hypothyroidism<\/a>. Here, we review the status of research into selenium supplementation and Graves\u2019 hyperthyroidism.<\/p>\n

In 2013, Watt et al announced the study protocol for the GRASS randomized controlled trial of the efficacy of selenium supplementation for patients with Graves’ hyperthyroidism<\/a>.<\/p>\n

At that time, the researchers\u2019 aim was to enroll 492 Graves\u2019 disease patients. The researchers would randomly assign the study participants to an active treatment group (two tablets of 100 mcg selenium once daily) or to a placebo group (two identical placebo tablets once daily) for 24 to 30 months [Watt 2013].<\/p>\n

As the primary study outcome, the researchers looked for a decrease in anti-thyroid drug treatment failure after 24-30 months of selenium supplementation. They wanted to know if the selenium supplementation, as compared to placebo treatment, could keep the Graves\u2019 disease patients\u2019 thyroid values normal one year after the cessation of anti-thyroid drug therapy treatment without any need for further anti-thyroid drug treatment. They wanted to see if the selenium supplementation would lead to faster and longer lasting remission and to improved quality of life in patients with Graves’ hyperthyroidism. The trial results would, thus, be relevant to daily clinical practice [Watt 2013].<\/p>\n

At the present time, we expect publication of the outcomes of the GRASS clinical study sometime in 2025. Note that the very long study period is necessary. Typically, the Graves\u2019 disease patients are treated for 12 to 18 months with anti-thyroid drugs. Then, the patients must be in remission for one year after stopping anti-thyroid drugs [Watt 2013].<\/p>\n

Selenium and Hyperthyroidism \u2013 Meta-analysis of Studies<\/h5>\n

Song et al analyzed the pooled data from seven studies enrolling 209 patients with Graves\u2019 disease. In the analysis, selenium supplementation significantly increased serum selenium and selenoprotein concentrations. [Song 2023].<\/p>\n

The researchers found that selenium supplementation combined with antithyroid drugs<\/a> was significantly more effective than placebo combined with antithyroid drugs [Song 2023]:<\/p>\n