Selenium
Specifically for Hashimoto's Thyroiditis
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Why it works for Hashimoto's Thyroiditis:
Mechanistic rationale: The thyroid packs high amounts of selenium-dependent enzymes (selenoproteins) involved in thyroid hormone activation (deiodinases) and antioxidant defense (e.g., glutathione peroxidases). In theory, correcting low selenium could dampen oxidative stress and autoimmune activity (TPO/Tg antibodies). Frontiers
What the overall evidence shows: Multiple systematic reviews/meta-analyses (including a 2024 network meta-analysis and a 2024 meta-analysis) find that selenium reduces thyroid autoantibodies (especially TPOAb) and in some studies slightly lowers TSH, but has little to no consistent effect on FT4/FT3, thyroid volume, levothyroxine dose, or hard clinical outcomes (symptoms/progression). In short: biochemical signals may improve; clear clinical benefits remain uncertain. Frontiers
How to use for Hashimoto's Thyroiditis:
Form & dose used most often in trials:
- Selenomethionine 200 µg/day (sometimes selenium-yeast ≈ selenomethionine) for 3–6 months is the most common regimen linked with antibody reduction and small TSH falls in RCTs. Smaller doses (e.g., 83–100 µg/day) have also been studied with mixed results. thyroid.org
Who may benefit most: People with low baseline selenium status (common in some regions) appear to show larger antibody or TSH responses in subgroup analyses. thyroid.org
Monitoring plan often used clinically (mirrors trial timelines):
- Baseline TSH, FT4/FT3, TPOAb/TgAb and, if available, a selenium status marker.
- Start selenomethionine (e.g., 200 µg/day).
- Recheck at ~3 months; continue to 6 months if antibodies/TSH are trending favorable and no adverse effects.
- Stop if no biochemical response by ~6 months or if side-effects emerge. (There’s no strong evidence that “more/longer” is better.) thyroid.org
Dietary angle: Consider improving dietary selenium first (seafood, meats, eggs; Brazil nuts vary wildly in selenium and can easily overshoot intakes). Supplement only if intake/status is likely low or you’re targeting an RCT-like trial. Office of Dietary Supplements
Timing with thyroid meds: Selenium doesn’t share the well-known absorption interaction that calcium/iron have with levothyroxine, but many clinicians still separate supplements from LT4 by 3–4 hours to keep routines simple and consistent. (Evidence for a specific selenium-LT4 interaction is limited.)
Scientific Evidence for Hashimoto's Thyroiditis:
2024 ATA summary of a meta-analysis (Huwiler et al., 2024, Thyroid): Across RCTs, selenium was associated with slightly lower TSH (in those not on LT4) and lower TPOAb; no consistent change in FT4/FT3/TgAb or thyroid volume; the most prominent effect signal came from 200 µg/day for 6 months. Authors call for more data on whether it truly prevents progression. thyroid.org
2024 network meta-analysis (Frontiers in Endocrinology): Among supplements for Hashimoto’s (vitamin D, myo-inositol, selenium), selenium showed significant reductions in TPOAb and TgAb versus placebo; clinical endpoints remain less certain. Frontiers
Cochrane review (summary): Earlier RCT pool (heterogeneous, higher risk of bias) concluded insufficient evidence to recommend selenium for Hashimoto’s. Useful as a conservative counterpoint to newer analyses. Cochrane
Selected RCTs / mechanistic RCT:
- Hu et al., 2021 (Clin Transl Sci): RCT showed antibody reductions and effects on regulatory T-cells with selenium; clinical impacts remain inconsistent. ascpt.onlinelibrary.wiley.com
- Duntas et al., 2003 (Eur J Endocrinol): 200 µg/day selenomethionine for 6 months reduced anti-TPO in autoimmune thyroiditis (older but frequently cited). OUP Academic
- Pregnancy (Negro et al., 2007; mixed follow-ups): 200 µg/day during pregnancy/postpartum reduced antibody titers and postpartum thyroid dysfunction in one RCT; other trials were neutral—overall ATA (2017) gave a weak recommendation against selenium supplementation in TPOAb+ pregnancy based on the totality of evidence.
Specific Warnings for Hashimoto's Thyroiditis:
Do not exceed safe upper limits.
- NIH (U.S.) tolerable upper intake level (UL): 400 µg/day for adults. EFSA (Europe, 2023) updated UL: 255 µg/day for adults. Given this discrepancy, it’s prudent to stay ≤200 µg/day unless a specialist is monitoring you. Signs of toxicity (selenosis) include hair/nail brittleness/loss, GI upset, metallic taste/“garlic breath,” rash, fatigue, neuropathy. Office of Dietary Supplements
Pregnancy/postpartum: Despite some positive RCT signals, ATA guidance (2017) recommended against routine selenium supplementation in pregnant TPOAb+ patients (weak recommendation; moderate-quality evidence). If pregnant or trying to conceive, do not start selenium on your own. Office of Dietary Supplements
Unknown clinical benefit: Even with antibody reductions, hard outcomes (progression to hypothyroidism, symptom improvement, LT4 dose changes) are not consistently improved. If you’re already euthyroid on adequate dietary selenium, adding a supplement may offer little and adds toxicity risk. thyroid.org
Drug interactions & comorbidities: Selenium can interact with some medications (e.g., cisplatin) and is primarily excreted renally—use caution in chronic kidney disease and coordinate with your clinician if on complex regimens. Office of Dietary Supplements
Brazil nuts caution: Selenium content varies enormously; 1–2 nuts can exceed daily needs, and habitual intake can inadvertently push you over the UL. Supplements provide steadier dosing. Office of Dietary Supplements
General Information (All Ailments)
What It Is
Selenium is an essential trace mineral required by the human body in small amounts for various physiological functions. It is naturally found in foods such as Brazil nuts, seafood, eggs, whole grains, and organ meats. Selenium is also available as a dietary supplement, either alone or in combination with vitamins and other minerals.
In the body, selenium is a critical component of several enzymes and proteins known as selenoproteins, which play key roles in metabolism, DNA synthesis, reproduction, and protection against oxidative damage.
How It Works
Selenium exerts its effects primarily through its incorporation into selenoproteins, which have antioxidant and regulatory functions. The most notable of these include glutathione peroxidases, thioredoxin reductases, and iodothyronine deiodinases.
- Antioxidant Defense: Selenium-containing enzymes help neutralize free radicals and reactive oxygen species that can damage cells and tissues. This antioxidant effect helps reduce oxidative stress, which contributes to aging and various chronic diseases.
- Thyroid Function: Selenium is necessary for the conversion of the thyroid hormone thyroxine (T4) into its active form triiodothyronine (T3). It supports thyroid gland function and protects it from oxidative damage.
- Immune Support: Selenium enhances immune response by promoting the proliferation of immune cells and helping regulate inflammation. It also influences how the body responds to infections.
- DNA Synthesis and Repair: Through its role in certain enzymes, selenium contributes to maintaining the integrity of genetic material and assists in repairing damaged DNA.
Why It’s Important
- Protection Against Disease: Adequate selenium intake is linked to a lower risk of certain chronic conditions such as cardiovascular disease, some cancers, and cognitive decline. Its antioxidant role helps prevent cell damage associated with these diseases.
- Immune System Health: Selenium supports the immune system’s ability to fight infections. Deficiency has been associated with increased susceptibility to viral infections and inflammatory disorders.
- Thyroid Health: The thyroid gland contains more selenium per gram of tissue than any other organ in the body. Selenium deficiency can contribute to thyroid dysfunction, such as hypothyroidism or autoimmune thyroid diseases like Hashimoto’s thyroiditis.
- Reproductive Health: Selenium plays a role in sperm motility and overall male fertility. In women, adequate selenium levels contribute to proper ovarian function and pregnancy outcomes.
Considerations
- Deficiency Risks: Selenium deficiency can occur in areas where soil selenium content is low, leading to reduced levels in locally grown foods. Deficiency symptoms may include fatigue, muscle weakness, compromised immunity, and in severe cases, conditions such as Keshan disease (a heart disorder) or Kashin-Beck disease (a bone and joint disorder).
- Toxicity and Overconsumption: While selenium is essential, too much can be harmful. Chronic overconsumption can cause selenosis, characterized by hair and nail brittleness, gastrointestinal disturbances, a garlic-like odor on the breath, and in severe cases, nervous system abnormalities. The upper safe intake limit for adults is around 400 micrograms per day.
- Interactions: Selenium interacts with other nutrients, such as vitamin E, in enhancing antioxidant defenses. However, supplementation should be approached cautiously, especially for those already receiving adequate amounts from their diet.
- Individual Variability: The need for selenium may vary depending on age, health status, and specific conditions (e.g., thyroid disorders, chronic infections, or inflammatory diseases). Consultation with a healthcare provider before supplementation is recommended.
Helps with these conditions
Selenium is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Hypothyroidism
The thyroid is rich in selenoproteins (e.g., deiodinases that activate/inactivate thyroid hormone; glutathione peroxidases that limit oxidative stress...
Hashimoto's Thyroiditis
Mechanistic rationale: The thyroid packs high amounts of selenium-dependent enzymes (selenoproteins) involved in thyroid hormone activation (deiodinas...
Hyperthyroidism
Antioxidant & immune effects: Selenium is built into “selenoproteins” (e.g., glutathione peroxidases, thioredoxin reductases, selenoprotein P) tha...
Heavy Metal Toxicity
Biologic rationale (what it does):Selenium is required to make selenoproteins (e.g., glutathione peroxidases, thioredoxin reductases, selenoprotein P)...
Chronic Pancreatitis
Oxidative stress is implicated in CP pain and progression. CP tissue shows markers of oxidative damage; antioxidant depletion has been described in pa...
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Helps With These Conditions
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