Effects of selenium on short-term control of hyperthyroidism due to Graves’ disease treated with methimazole: results of a randomized clinical trial

Leo, Marenza; Bartalena, Luigi; Dottore, Giovanna Rotondo; Piantanida, Eliana; Premoli, Paola; Ionni, Ilaria; Di, Martynchik; Masiello, E.; Sassi, Lorenza; Tanda, Maria Laura; Latrofa, Francesco; Vitti, Paolo; Marcocci, Claudio; Marinò, Michele

doi:10.1007/s40618-016-0559-9

Cited by 53 publications

(46 citation statements)

References 20 publications

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“…In another recent randomized clinical trial performed in selenium-sufficient patients, we did not observe a beneficial effect of selenium in patients with Graves hyperthyroidism treated with methimazole, in terms of short-term, prompter control of thyroid hyperfunction [5] . Based on the combined results of these two studies, we believe that selenium supplementation might be offered to patients with Graves hyperthyroidism only if selenium deficiency is documented.…”

contrasting

confidence: 72%

Selenium in the Treatment of Thyroid Diseases

et al. 2017

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contrasting

confidence: 72%

Selenium in the Treatment of Thyroid Diseases

et al. 2017

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“…A recently published double-blind, placebo-controlled trial could not provide evidence of an effect of Se supplementation (300 µg/day) on either the response to treatment or the recurrence rate in GD [19]. Similarly, a trial with Se supplementation in an Se-sufficient cohort of patients failed to demonstrate an adjuvant role in the short-term control of hyperthyroidism [20]. On the other hand, two randomized studies, from China [21] and from Sweden [22], reported a faster remission of GD with Se treatment, and the Chinese trial additionally demonstrated a decrease in serum TSH receptor antibody (TRAb) concentrations.…”

Section: Introductionmentioning

confidence: 99%

A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Graves’ Hyperthyroidism and Graves’ Orbitopathy

Negro¹,

Attanasio²,

Papini³

et al. 2018

Eur Thyroid J

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Objective: Selenium (Se) supplementation has been suggested in the treatment of Graves’ disease (GD). We sought to investigate Se prescription patterns for GD across European countries. Methods: Members of the European Thyroid Association were invited to participate in an online survey investigating the use of Se in GD either without or with orbitopathy (GO). Of 872 invited members, 244 (28%) completed the survey. After exclusion of basic scientists and non-European members, 197 responses were retrieved out of clinical trials (nearly half of clinician members), of whom 61 do not use Se. Thus, 136 respondents remained for further analyses. Results: Among the 136 analyzed respondents, most (64.7%) were not aware of the Se status in their populations, did not assess Se levels (78.7%), nor considered iodine status (74.3%). In GD without GO, 38.2% recommend Se supplementation (“sometimes” [27.2%], “frequently” [5.9%] or “always” [5.1%]). When GO occurs, 94.1% recommend Se supplementation (“sometimes” [39%], “frequently” [30.1%] or “always” [25%]). Of these, 60.1% recommend Se as an alternative to watchful waiting in patients with mild ocular involvement and 44.9% as an adjuvant to the established treatment modalities in patients with moderate to severe ocular involvement. Conclusions: In Graves’ hyperthyroidism without GO, 38.2% of ETA (European Thyroid Association) members recommend Se supplementation. Conversely, Se is recommended by the majority of respondents in GO, both in patients with mild and moderate to severe ocular involvement. This clinical practice is partially in disagreement with current European treatment guidelines that recommend Se as a 6-month treatment in mild GO only.

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“…The discrepancy may be explained by the fact that patients in that study had a mild GO [8], whereas the majority of patients in our study had a moderate-to-severe GO, thereby making the 2 populations difficult to compare. In addition, the study by Tanda et al [8] was performed in a secondary referral center, where patients are more likely to receive a prompt treatment for both hyperthyroidism and ophthalmopathy, with anti-thyroid drugs and/or selenium [22][23][24][25], which may result in an overall better GO outcome in the long term and in the prevention of GO deterioration over time. In contrast, our study was performed in a tertiary referral center, where most patients are seen long after the initial diagnosis, and may not have received a prompt initial treatment.…”

Section: Discussionmentioning

confidence: 99%

Does Graves’ Orbitopathy Ever Disappear Answers to an Old Question

et al. 2017

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Objectives: There is a general belief that Graves' orbitopathy (GO) is a "chronic" disease, namely that patients' eyes do not return to how they were before GO appeared. Here, we investigate this issue from both the patient's and the physician's point of view. Study Design: We studied the disappearance of GO, regardless of treatment, in all consecutive patients with a GO history of at least 10 years who came for a follow-up visit over a period of 5 years. Patients underwent an ophthalmological examination and were asked to answer a questionnaire on self-perception related to GO. Results: We studied 99 consecutive patients with a GO duration ≥10 years. Between the first and the last observation, patients received several types of treatment for their thyroid disease and/or for GO. At the end of follow-up, GO was considered disappeared based on objective criteria in 8 patients (∼8%) and based on subjective criteria in 24 patients (∼24%). When we considered both subjective and objective criteria, only 2 patients (∼2%) had all criteria fulfilled and could be considered as GO-free. Conclusions: GO is a chronic disease in the vast majority of patients. Even after a very long time since its onset, complete disappearance is rare, although a minority of patients believe they do not have GO anymore and an even lower proportion do not have relevant GO signs. Our findings have obvious implications in patient management and counseling.

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Effects of selenium on short-term control of hyperthyroidism due to Graves’ disease treated with methimazole: results of a randomized clinical trial

Cited by 53 publications

References 20 publications

Selenium in the Treatment of Thyroid Diseases

Selenium in the Treatment of Thyroid Diseases

A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Graves’ Hyperthyroidism and Graves’ Orbitopathy

Does Graves’ Orbitopathy Ever Disappear Answers to an Old Question

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