{"id":4157,"date":"2026-11-15T06:33:38","date_gmt":"2026-11-15T06:33:38","guid":{"rendered":"https:\/\/seleniumfacts.com\/?p=4157"},"modified":"2026-10-14T09:53:34","modified_gmt":"2026-10-14T09:53:34","slug":"selenium-and-graves-hyperthyroidism-2","status":"publish","type":"post","link":"https:\/\/seleniumfacts.com\/index.php\/selenium-and-graves-hyperthyroidism-2","title":{"rendered":"Selenium and Graves\u2019 Hyperthyroidism"},"content":{"rendered":"<h5>What was the GRASS trial of selenium supplementation and Graves\u2019 hyperthyroidism?<\/h5>\n<figure id=\"attachment_3258\" aria-describedby=\"caption-attachment-3258\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3258 size-medium\" src=\"https:\/\/seleniumfacts.com\/wp-content\/uploads\/2023\/09\/Thyroid-gland-300x197.png\" alt=\"Thyroid gland\" width=\"300\" height=\"197\" srcset=\"https:\/\/seleniumfacts.com\/wp-content\/uploads\/2023\/09\/Thyroid-gland-300x197.png 300w, https:\/\/seleniumfacts.com\/wp-content\/uploads\/2023\/09\/Thyroid-gland.png 368w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-3258\" class=\"wp-caption-text\"><strong>The thyroid gland needs optimal selenium for thyroid hormone functions and protection.<\/strong><\/figcaption><\/figure>\n<p><strong>The GRASS trial was a multi-centre randomized controlled trial. The researchers enrolled 430 individuals with newly diagnosed Graves\u2019 hyperthyroidism. In addition to standard hyperthyroidism medication, the study participants received daily supplementation with 2 x 100 mcg selenium or placebo tablets during 24\u201330 months, depending on the timing of antithyroid drug withdrawal. The primary outcomes that they measured were 1) rate of remission and 2) quality of life [Cramon 2026].<\/strong><\/p>\n<h5>What selenium preparation did the GRASS trial test?<\/h5>\n<p><strong>The researchers used organic selenium in the form of selenium-enriched yeast, consisting mainly of selenomethionine, at a dose of 200 mcg of selenium per day (two 100 mcg tablets).<\/strong><\/p>\n<ul>\n<li>Product: Organic selenium (100 mcg tablets).<\/li>\n<li>Manufacturer: Jemo-Pharm A\/S, Stege, Denmark.<\/li>\n<li>Placebo: Matching tablets made with non-selenium-enriched yeast.<\/li>\n<\/ul>\n<h5>What effects did the GRASS trial show?<\/h5>\n<p>As an adjuvant treatment to standard <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC13156667\/\" target=\"_blank\" rel=\"noopener\">Graves\u2019 hyperthyroidism therapy<\/a>, the selenium adjuvant treatment did not show any significant effect, compared with placebo, on remission rate and quality of life [Cramon 2026].<\/p>\n<h6>Quality of life<\/h6>\n<p>Quality of life improved substantially over time in both groups. Because the improvement occurred in both the selenium and placebo groups, the improvement cannot be attributed specifically to the selenium supplementation.<\/p>\n<p>At the beginning of the study, the participants had worse thyroid-related quality of life than the general population. However, their quality of life continued improving during the first 6\u201312 months after entering the trial. By the end of the trial, the participants\u2019 quality of life generally approached population-level quality of life. This shows a positive outcome for the standard therapy for Graves\u2019 hyperthyroidism.<\/p>\n<h6>No adverse effects of the selenium supplementation<\/h6>\n<p>The researchers reported no serious adverse reactions and no difference in adverse reactions between selenium and placebo.<\/p>\n<h6>No difference in remission rates<\/h6>\n<p>The researchers reported that participants who achieved remission had a higher mean baseline serum selenium concentration than those who did not: 83.7 mcg\/L for those who achieved remission and 76.7 mcg\/L for those who did not achieve remission.<\/p>\n<p>However, when the researchers did a sub-analysis of only those participants whose baseline serum selenium was below 80 mcg\/L, the results did not show significant benefit of supplementation with respect to remission rate.<\/p>\n<h5>Why did selenium fail to improve remission?<\/h5>\n<p>The actual non-remission rates were 53.3% with placebo and 54.6% with selenium.<\/p>\n<p>Graves\u2019 hyperthyroidism is driven by an autoimmune process. Using selenium supplementation to provide more defense against oxidative stress and\/or to increase selenium-dependent enzyme activity does not necessarily suppress the underlying autoimmunity sufficiently to induce remission.<\/p>\n<p>That is to say, the selenium supplementation did not measurably change the autoimmune disease process. The study results showed no meaningful difference between the groups in thyroid-stimulating hormone receptor antibody (TRAb) concentrations at 18 months or at the end of the trial. Moreover, the time to antithyroid drug withdrawal did not differ significantly between the two study groups.<\/p>\n<h6>Study limitations<\/h6>\n<p>Beyond this, the authors could not establish a definitive molecular reason for the null result. The clinical and antibody findings provided no evidence that selenium, at the tested dose, substantially altered the disease course.<\/p>\n<p>One possible limitation of the study was that it was slightly smaller than planned. However, the researchers did not consider a missed benefit as likely. The planned number of participants was 492. The actual number recruited was 430. The researchers stopped recruiting before reaching their target because of funding constraints. The study\u2019s estimated statistical power fell from 80% to 74.5% [Cramon 2026].<\/p>\n<h5>What improved the participants\u2019 quality of life?<\/h5>\n<p>The standard hyperthyroidism treatment itself improved quality of life in both the selenium supplementation group and the placebo group. The standard antithyroid drug treatment helped to control the hyperthyroidism, thus improving symptoms and day-to-day functioning [Cramon 2026].<\/p>\n<p>Accordingly, with the standard treatment so effective, there was seemingly little additional room for improvement with the selenium supplementation.<\/p>\n<p>By the end of the study, the standard hyperthyroidism therapy had improved the participants&#8217; quality of life to the point that it was broadly comparable to the general-population reference sample.<\/p>\n<h5>What other evidence is there for selenium supplementation and quality of life?<\/h5>\n<h6>KiSel-10 trial<\/h6>\n<p>Combined supplementation with selenium-enriched yeast and Coenzyme Q10 had a significant beneficial effect on thyroid hormones with respect to cardiovascular mortality and health-related quality of life. The <a href=\"https:\/\/www.q10facts.com\/the-kisel-10-study-a-new-pillar-in-coq10-heart-health-research-old\/\" target=\"_blank\" rel=\"noopener\">KiSel-10 study<\/a> participants\u2019 initial deficient selenium status corresponded to an impaired thyroid function. Increased activity of the selenium-dependent deiodinase enzymes explains the changes in the thyroid hormone levels of the supplemented study participants. Professor Alehagen et al concluded that a substantial number of the elderly citizens living in selenium-poor regions may suffer from suboptimal thyroidal function with adverse clinical implications [Alehagen 2024].<\/p>\n<h6>Marcocci trial<\/h6>\n<p>Selenium administration (sodium selenite 200 mcg\/day) for six months and with another six months of follow-up significantly improved quality of life, reduced ocular involvement, and slowed progression of the disease in patients with <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/21591944\/\" target=\"_blank\" rel=\"noopener\">mild Graves&#8217; orbitopathy<\/a> [Marcocci 2011].<\/p>\n<h5>Conclusion: Selenium and hyperthyroidism in the GRASS trial<\/h5>\n<p>The GRASS trial was a relatively large, well-designed, randomized controlled trial.<\/p>\n<p>The encouraging findings are two-fold:<\/p>\n<ol>\n<li>The standard hyperthyroidism therapy leads to improvement in patients&#8217; overall health-related quality of life.<\/li>\n<li>The supplementation with selenium-enriched yeast at 200 mcg\/day for two years did not show any evidence of serious adverse reactions.<\/li>\n<\/ol>\n<h5>Sources<\/h5>\n<p>Alehagen U et al. Supplementation with selenium and coenzyme Q10\u00a0in an elderly Swedish population low in selenium &#8211; positive effects on thyroid hormones, cardiovascular mortality, and quality of life. BMC Med. 2024 May 7;22(1):191.<\/p>\n<p>Cramon PK et al. Selenium supplementation in individuals with newly diagnosed Graves&#8217; hyperthyroidism: a double-blind, multi-centre RCT. Eur Thyroid J. 2026 Jan 6;15(1):ETJ250264.<\/p>\n<p>Marcocci C et al. Selenium and the course of mild Graves&#8217; orbitopathy. N Engl J Med. 2011 May 19;364(20):1920-31.<\/p>\n<p>Marcocci C et al. Selenium and the course of mild Graves&#8217; orbitopathy. N Engl J Med. 2011 May 19;364(20):1920-31.<\/p>\n<p><em>The information presented in this review article is not medical advice. Readers should not use the information as medical advice.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>What was the GRASS trial of selenium supplementation and Graves\u2019 hyperthyroidism? The GRASS trial was a multi-centre randomized controlled trial. The researchers enrolled 430 individuals with newly diagnosed Graves\u2019 hyperthyroidism. In addition to standard hyperthyroidism medication, the study participants received daily supplementation with 2 x 100 mcg selenium or placebo tablets during 24\u201330 months, depending &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/seleniumfacts.com\/index.php\/selenium-and-graves-hyperthyroidism-2\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;Selenium and Graves\u2019 Hyperthyroidism&#8221;<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[118,117,35,272,197],"class_list":["post-4157","post","type-post","status-publish","format-standard","hentry","category-thyroid-function","tag-graves-disease","tag-graves-hyperthyroidism","tag-selenium","tag-thyroid-disease","tag-thyroid-function"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - 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