Clinical Observation of Levothyroxine Sodium Combined with Selenium in the Treatment of Patients with Chronic Lymphocytic Thyroiditis and Hypothyroidism and the Effects on Thyroid Function, Mood, and Inflammatory Factors

Sun, Chunping; Zhu, Min; Li, Li; Fan, Hua; Lv, Fang; Zhu, Dawei

doi:10.1155/2021/5471281

Cited by 9 publications

(39 citation statements)

References 25 publications

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“…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%

“…Se-Su, however, is not considered in the guidelines from the American Thyroid Association (ATA), probably because Se levels tend to be considerably higher in North America and lower in many European countries. Nevertheless, several trials and studies have continued the investigation of Se-Su effects in different AITDs ( Table 1 ) ( 15 , 16 , 17 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ). Overall, in patients with HT, Se-Su has resulted in higher antioxidant activity ( 27 ), reduced thyroid autoantibody titre ( 34 ), lower levels of thyroid-stimulating hormone (TSH) ( 32 ), higher Tregs ( 32 ), and reduced expression of proinflammatory cytokines ( 34 ).…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, several trials and studies have continued the investigation of Se-Su effects in different AITDs ( Table 1 ) ( 15 , 16 , 17 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ). Overall, in patients with HT, Se-Su has resulted in higher antioxidant activity ( 27 ), reduced thyroid autoantibody titre ( 34 ), lower levels of thyroid-stimulating hormone (TSH) ( 32 ), higher Tregs ( 32 ), and reduced expression of proinflammatory cytokines ( 34 ). Se-treated AITD patients might have improvement in the echoic thyroid pattern ( 29 ), and anxiety and depression scales were significantly better in supplemented patients, which suggests that Se-Su could improve patients’ mood more effectively ( 34 ).…”

Section: Introductionmentioning

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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

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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show abstract

“…Interestingly, a recent animal study found that when mice were placed on a low selenium diet (0.02 mg/kg), selenium levels in the thyroid gland were maintained, but reduced selenoprotein expression was observed in the liver and kidneys, targets of thyroid hormones [ 214 ]. While selenium supplementation was reported to induce no significant therapeutic effect on patients with subclinical hypothyroidism [ 215 ], co-treatment of selenium was found to enhance the efficacy of levothyroxine sodium (LT4) in treating chronic lymphocytic thyroiditis patients with hypothyroidism, yielding greater improvements to inflammatory factors, compared to treatment with LT4 alone [ 216 ]. Selenium supplementation was also found to increase the efficacy of antithyroid drugs in the treatment of Graves’ disease [ 217 ].…”

Section: Signals From Brain To Bodymentioning

confidence: 99%

Selenium in Bodily Homeostasis: Hypothalamus, Hormones, and Highways of Communication

Toh

Nicholson

Vetter

et al. 2022

IJMS

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The ability of the body to maintain homeostasis requires constant communication between the brain and peripheral tissues. Different organs produce signals, often in the form of hormones, which are detected by the hypothalamus. In response, the hypothalamus alters its regulation of bodily processes, which is achieved through its own pathways of hormonal communication. The generation and transmission of the molecules involved in these bi-directional axes can be affected by redox balance. The essential trace element selenium is known to influence numerous physiological processes, including energy homeostasis, through its various redox functions. Selenium must be obtained through the diet and is used to synthesize selenoproteins, a family of proteins with mainly antioxidant functions. Alterations in selenium status have been correlated with homeostatic disturbances in humans and studies with animal models of selenoprotein dysfunction indicate a strong influence on energy balance. The relationship between selenium and energy metabolism is complicated, however, as selenium has been shown to participate in multiple levels of homeostatic communication. This review discusses the role of selenium in the various pathways of communication between the body and the brain that are essential for maintaining homeostasis.

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“…Selenium has been reported to be associated with various inflammatory diseases [21][22][23][24][25][26][27][28] such as inflammatory bowel disease, 26 experimental colitis, 24 chronic lymphocytic thyroiditis and hypothyroidism. 25 Federico Galusso et al 29 reported that low plasma selenium status and Development or risk of severe active inflammatory disease, such as systemic inflammatory response syndrome and multiple organ dysfunction syndromes, are closely linked. In addition, individuals with asthma, a chronic inflammatory disease, have been reported to have lower selenium status and decreased activity of glutathione peroxidase.…”

Section: Figurementioning

confidence: 99%

The Relationship Between Plasma Selenium, Antioxidant Status, Inflammatory Responses and Ischemic Cardiomyopathy: A Case-Control Study Based on Matched Propensity Scores

Luo¹,

He²,

Hu³

et al. 2022

JIR

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Background Ischemic cardiomyopathy (ICM) with high morbidity and mortality is closely associated with an abnormal equilibrium of circulation selenium levels. The oxidative stress theory is the most accepted theory of selenium causing ischemic cardiomyopathy. However, the role of inflammatory responses in ICM has received limited attention. Methods This study included 119 subjects, 43 of whom were patients with ICM, and 76 were healthy controls. Blood specimens were collected from subjects and serum levels of inflammatory and oxidative stress indicators and plasma levels of selenium were measured. Results When plasma selenium and indicators of inflammation and oxidative stress were compared between groups, plasma selenium levels were significantly lower in the ICM group than in the control group (68.83874 vs 104.39775, p =0.02032), while indicators of inflammation such as tumour necrosis factor-alpha (TNF-α) (79.09773 vs 46.15634, p <0.001), interleukin-6 (IL-6) (49.41484 vs 38.46923, p <0.01) and neutrophil/lymphocyte ratio (3.696574 vs 2.383658, p <0.001) were significantly higher in the ICM group than in the control group (all of these results were statistically different). Additionally, malondialdehyde (MDA), a marker of oxidative stress, was considerably higher in the ICM group than in the control group (61.63078 vs 39.0609, p <0.01). In contrast, there were no significant differences in superoxide dismutase (SOD) levels between groups ( p >0.05). The Poisson regression analysis revealed a significant association between selenium and high levels of MDA, IL-6 and TNF-α ( p <0.05). Additionally, selenium was negatively connected with SOD levels and the neutrophil/lymphocyte ratio, but this relationship was not statistically significant ( p =0.96, 0.15, respectively). Conclusion Selenium deficiency is strongly associated with the development of ICM, and with levels of inflammation and oxidative stress in patients with ICM. Selenium can prevent the development and delay the progression of ICM by alleviating inflammatory responses.

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Clinical Observation of Levothyroxine Sodium Combined with Selenium in the Treatment of Patients with Chronic Lymphocytic Thyroiditis and Hypothyroidism and the Effects on Thyroid Function, Mood, and Inflammatory Factors

Cited by 9 publications

References 25 publications

Survey on selenium clinical supplementation in autoimmune thyroid disease

Survey on selenium clinical supplementation in autoimmune thyroid disease

Selenium in Bodily Homeostasis: Hypothalamus, Hormones, and Highways of Communication

The Relationship Between Plasma Selenium, Antioxidant Status, Inflammatory Responses and Ischemic Cardiomyopathy: A Case-Control Study Based on Matched Propensity Scores

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