A Pilot Study on the Beneficial Effects of the Additional Selenium Supplementation to Methimazole for Treating Patients with Graves? disease

Xu, Bin; Wu, Di; Hong, Ying; Zhang, Ying

doi:10.3906/sag-1808-67

Cited by 8 publications

(13 citation statements)

References 32 publications

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“…In fact, there is a 2018 systematic review [16], which included 10 studies, that concluded that GD patients using Se-Su as part of their treatment, were more likely to show improved thyroid function (with significantly decreased TSH-receptor antibody (TRAb), free T4 and free T3 levels and elevated TSH), when compared to GD patients without Se-Su. A recent clinical trial came to similar conclusions [28]. The improvement in hyperthyroidism analytical markers and GD's autoantibodies, reported by latest studies, is consistent with the two most voted purposes of Se-Su in GD by our respondents, which were "inducing the remission of the disease" and "reducing antibody titres".…”

Section: Discussionsupporting

confidence: 88%

“…Almost 40% of the responses stated that Se-Su is recommended "in all forms" of GO. This shows that our respondents' Se-Su prescription in GO might go beyond those specified in the guideline, possibly due to its proven efficacy across all GD patients [16,28].…”

Section: Discussionmentioning

confidence: 88%

“…This relatively high rate of prescription may result from the acquaintance of several studies that advocate Se benefits in Hashimoto's treatment (Table 1). Some of the latest [27,28,31,34], have consistently shown that Se-Su treated HT patients have reduced thyroid autoantibodies and TSH levels. A 2016 systematic review and meta-analysis of 16 studies [17] also concluded that Se-Su significantly reduces serum antibodies levels.…”

Section: Discussionmentioning

confidence: 99%

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Survey on selenium clinical supplementation in autoimmune thyroid disease

Santos

Bessa

Rocha

et al. 2023

European Thyroid Journal

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Objective: Previous trials show that selenium could be a very useful tool in control and treatment of autoimmune thyroid diseases. In this cross-sectional study, through a survey, we aim to evaluate Portuguese endocrinologists' perception and pattern of prescription of selenium supplements in these diseases and verify its agreement with current guidelines. Methods: The endocrinologists registered in the Portuguese Medical Association were sent an email with a web-based questionnaire, regarding their knowledge and use of selenium supplements in thyroid autoimmune pathology. Results: A total of 105 physicians (33% of the total) submitted the survey. The selenium serum concentration in the general population was unknown to 80% of respondents. Over a third of respondents have never prescribed selenium in Autoimmune Thyroid Disease. However, 89% are not afraid of recommending it, and 61% indicate Graves’ Orbitopathy as the pathology they would supplement. In Hashimoto’s Thyroiditis, 36% of respondents use selenium occasionally or frequently, and this percentage rises to 60% in Graves’ Disease. Conclusions: Although recommendations only encompass mild Graves’ Orbitopathy, selenium is prescribed across the spectrum of autoimmune thyroid diseases, probably due to recent studies that consistently show improvement of biochemical hallmarks in these patients. Further investigation is required on the impact of selenium supplements on primarily clinical outcomes and to identify disorders and/or patients who will benefit the most. Also, there is still insufficient knowledge on this field in the medical community, and evidence-based practice should continue to be promoted by endocrinology societies.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Survey on selenium clinical supplementation in autoimmune thyroid disease

Santos

Bessa

Rocha

et al. 2023

European Thyroid Journal

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“…Plant-based foods are rich sources of vitamins, oligoelements and metabolites (such as phenols, polyphenols, phytoestrogens, flavonoids, flavones, in fact, even if one study investigating the effects of selenium added to methimazole (MMi) treatment for gd reported a good biochemical control of hyperthyroidism, two randomized clinical trials (rcTs) did not demonstrated a short-term improvement of hyperthyroidism or an amelioration of response/recurrence rates. [100][101][102][103] However, new evidences could emerge from more recent studies thoroughly analyzing clinical parameters, like the work by Xu et al, 104 in which the comparison between MMi alone and MMi plus selenium groups revealed significantly lower levels of FT3, FT4, TPo-ab, Tg-ab and Trab, and a marked increase in TSH after 6 months of treatment.…”

Section: Dietary Intake Of Plant-derived Antioxidantsmentioning

confidence: 99%

Oxidative stress as a key feature of autoimmune thyroiditis: an update

et al. 2021

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iNTrodUcTioN: oxidative stress has been proposed as one of the factors concurring in the pathophysiology of autoimmune thyroid diseases. reactive oxygen species are the main expression of oxidative stress in biological systems, and their production can overcome antioxidant defenses ultimately leading to cell damage, apoptosis, and death. The present review was aimed at describing the state of the art of the relationships between oxidative stress and autoimmune thyroiditis. The most used biomarkers of oxidative stress and their correlation with thyroid function are reported. eVideNce acQUiSiTioN: We conducted a search of the literature in the english language starting from 2000, using the following search terms: "Hashimoto thyroiditis," "autoimmune thyroiditis," "hypothyroidism," "hyperthyroidism," "oxidative stress," "oxidants," "antioxidant," "advanced glycation end products." Both clinical studies and animal models were evaluated. eVideNce SYNTHeSiS: data form clinical studies clearly indicate that the balance between oxidants and antioxidants is shifted towards the oxidative side in patients with autoimmune thyroiditis, suggesting that oxidative stress may be a key event in the pathophysiology of the disease, irrespective of thyroid function. Studies in animal models, such as the NOD.H2h4 mouse, confirm that thyroidal accumulation of ROS plays a role in the initiation and progression of autoimmune thyroiditis. coNclUSioNS: oxidant/antioxidant imbalance represent a key feature of thyroid autoimmunity. oxidative stress parameters could be used as biochemical markers of chronic inflammation, to better predict the disease evolution along its natural history. dietary habits and antioxidant supplements may provide protection from autoimmunity, opening new perspectives in the development of more tailored therapies.

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“…Selenium deficiency inhibits the expression of CD8+ T cells, enhances the function of helper T cells, causes B lymphocytes to synthesize a large number of antithyroid antibodies, promotes the activation of thyroid peroxidase, and ultimately damages thyroid tissue. Selenium supplementation can effectively improve these pathological and physiological changes[ 17 , 18 ]. In addition, selenium supplementation can effectively enhance the antioxidant capacity of the thyroid gland, reduce thyroid cell damage, inhibit the expression of thyroglobulin and thyroid peroxidase, and improve the immune status of children.…”

Section: Discussionmentioning

confidence: 99%

Clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter in children

Zhang¹,

Yuan²,

Chen³

2022

WJCC

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BACKGROUND The incidence of toxic diffuse goiter (Graves’ disease) is higher in adolescents and preschool-aged children, with an upward trend. The incidence at 6–13 years of age is approximately 11.0%, and the incidences in men and women are 7.8% and 14.3%, respectively. AIM To explore the clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter (Graves’ disease) in children and its effect on serum anti-thyroglobulin antibody (TRAb) and anti-thyroid peroxidase antibody (TPOAb). METHODS A total of 103 children with Graves’ disease treated in our hospital from January 2018 to June 2021 were divided into a traditional group and a combined group (15-20 mg methimazole orally given to children) and a combined group (50 µg selenium added on the basis of traditional treatment) according to different treatment methods to explore the therapeutic effects of the two methods and to observe the changes in thyroid volume and serum TRAb, TPOAb, free thyroxine (FT4) and inflammatory factor levels before and after treatment. The time taken for FT4 to return to normal was compared between the two groups. RESULTS Treatment was significantly more effective in the combined group than in the traditional group ( P < 0.05). The thyroid volumes of the children in the two groups was measured before and after treatment. Thyroid volume decreased significantly after treatment in both groups, and the thyroid volume was significantly lower in the combined group than in the traditional group ( P < 0.05). The serum levels of interleukin-6 (IL-6), IL-8, TRAb, TPOAb and FT4 in the two groups were detected before and after treatment. The levels of IL-6, IL-8, TRAb, TPOAb and FT4 were significantly lower in the combined group than in the traditional group ( P < 0.05). Follow-up of the children in the two groups showed that compared with the traditional group, it took less time for children in the combined group to return to the normal level ( P < 0.05). CONCLUSION Methimazole combined with selenium can effectively treat Graves’ disease in children, reduce the expression of TRAb, TPOAb, FT4 and inflammatory factors, and improve the curative effect. Thus, the combined treatment warrants further clinical research.

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A Pilot Study on the Beneficial Effects of the Additional Selenium Supplementation to Methimazole for Treating Patients with Graves? disease

Cited by 8 publications

References 32 publications

Survey on selenium clinical supplementation in autoimmune thyroid disease

Survey on selenium clinical supplementation in autoimmune thyroid disease

Oxidative stress as a key feature of autoimmune thyroiditis: an update

Clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter in children

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