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Selenium Supplementation in Patients with Autoimmune Thyroiditis Decreases Thyroid Peroxidase Antibodies Concentrations
Abstract
In areas with severe selenium deficiency there is a higher incidence of thyroiditis due to a decreased activity of selenium-dependent glutathione peroxidase activity within thyroid cells. Selenium-dependent enzymes also have several modifying effects on the immune system. Therefore, even mild selenium deficiency may contribute to the development and maintenance of autoimmune thyroid diseases. We performed a blinded, placebo-controlled, prospective study in female patients (n = 70; mean age, 47.5 +/- 0.7 yr) with autoimmune thyroiditis and thyroid peroxidase antibodies (TPOAb) and/or Tg antibodies (TgAb) above 350 IU/ml. The primary end point of the study was the change in TPOAb concentrations. Secondary end points were changes in TgAb, TSH, and free thyroid hormone levels as well as ultrasound pattern of the thyroid and quality of life estimation. Patients were randomized into 2 age- and antibody (TPOAb)-matched groups; 36 patients received 200 microg (2.53 micromol) sodium selenite/d, orally, for 3 months, and 34 patients received placebo. All patients were substituted with L-T(4) to maintain TSH within the normal range. TPOAb, TgAb, TSH, and free thyroid hormones were determined by commercial assays. The echogenicity of the thyroid was monitored with high resolution ultrasound. The mean TPOAb concentration decreased significantly to 63.6% (P = 0.013) in the selenium group vs. 88% (P = 0.95) in the placebo group. A subgroup analysis of those patients with TPOAb greater than 1200 IU/ml revealed a mean 40% reduction in the selenium-treated patients compared with a 10% increase in TPOAb in the placebo group. TgAb concentrations were lower in the placebo group at the beginning of the study and significantly further decreased (P = 0.018), but were unchanged in the selenium group. Nine patients in the selenium-treated group had completely normalized antibody concentrations, in contrast to two patients in the placebo group (by chi(2) test, P = 0.01). Ultrasound of the thyroid showed normalized echogenicity in these patients. The mean TSH, free T(4), and free T(3) levels were unchanged in both groups. We conclude that selenium substitution may improve the inflammatory activity in patients with autoimmune thyroiditis, especially in those with high activity. Whether this effect is specific for autoimmune thyroiditis or may also be effective in other endocrine autoimmune diseases has yet to be investigated.
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“Selenium might have a role in reducing TPO-Ab concentrations, 168,169 although results and potential benefits from selenium supplementation studies have been inconsistent.170”
From Hypothyroidism (2024) · cites this paper as [169]
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Metadata
- Authors
- Gärtner, R., Gasnier, B. C. H., Dietrich, J. W., Krebs, B., & Angstwurm, M. W. A.
- Affiliations
- Department of Endocrinology, Medizinische Klinik Innenstadt, University of Munich, D-80336 Munich, Germany
- Ludwig-Maximilians-Universität München (DE)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2002-04-01
- Volume
- 87
- Issue
- 4
- Pages
- 1687-1691
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2135834945
- Cited by
- 389
- References
- 43
- Citations by year
- 2026: 11 · 2025: 18 · 2024: 16 · 2023: 13 · 2022: 18 · 2021: 16 · 2020: 15 · 2019: 20 · 2018: 21 · 2017: 23 · 2016: 17 · 2015: 15 · 2014: 18 · 2013: 24 · 2012: 22
- FWCI
- 6.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Selenium in Biological Systems
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Physical Sciences › Chemistry › Organic Chemistry › Organoselenium and organotellurium chemistry
- Keywords
- selenium supplementation, autoimmune thyroiditis, thyroid peroxidase antibodies, thyroglobulin antibodies, sodium selenite, selenium deficiency, glutathione peroxidase, thyroid echogenicity, thyroid autoimmunity, thyroid hormone levels, quality of life
- MeSH terms
- Adult, Antibodies, Antioxidants, Autoantibodies, Chronic Disease, Double-Blind Method, Female, Humans, Iodide Peroxidase, Middle Aged, Osmolar Concentration, Prospective Studies, Reference Values, Selenium, Thyroglobulin, Thyroid Gland, Thyroiditis, Autoimmune, Ultrasonography
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