Selenium supplementation in patients with subclinical hypothyroidism affected by autoimmune thyroiditis: Results of the SETI study

Pirola, Ilenia; Rotondi, Mario; Cristiano, Alessandra; Maffezzoni, Filippo; Pasquali, Daniela; Marini, F; Coperchini, Francesca; Paganelli, Matteo; Apostoli, Pietro; Chiovato, Luca; Ferlin, Alberto; Cappelli, Carlo

doi:10.1016/j.endinu.2019.03.018

Cited by 21 publications

(15 citation statements)

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“…Moreover, administration of 200 μg/day Se yeast tablets for at least 6 months in HT patients improved thyroid autoantibodies and thyroid function by increasing the antioxidant activity [ 88 ]. The “SETI study” showed that short-course SeMet supplementation was associated with a normalization of serum TSH levels, which is maintained for 6 months after Se withdrawal in 50% of patients with subclinical hypothyroidism, due to chronic autoimmune thyroiditis [ 89 ]. Therefore, considering that low Se levels are related to an increased risk of developing antithyroid antibodies, and Se supplementation can reduce TPOAb titres, we can hypothesize that a reduction in the doses of levothyroxine necessary for hypothyroidism therapy and/or a prevention in the progression of subclinical hypothyroidism are feasible.…”

Section: Selenium and Autoimmune Thyroiditis (Ait)mentioning

confidence: 99%

Selenium: An Element of Life Essential for Thyroid Function

et al. 2021

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Selenium (Se), a microelement essential for life, is critical for homeostasis of several critical functions, such as those related to immune–endocrine function and signaling transduction pathways. In particular, Se is critical for the function of the thyroid, and it is particularly abundant in this gland. Unfortunately, Se deficiency is a very common condition worldwide. Supplementation is possible, but as Se has a narrow safety level, toxic levels are close to those normally required for a correct need. Thus, whether the obtaining of optimal selenium concentration is desirable, the risk of dangerous concentrations must be equally excluded. This review addressed the contribution by environment and food intake on Se circulating levels (e.g., geographical factors, such as soil concentration and climate, and different quantities in food, such as nuts, cereals, eggs, meat and fish) and effects related to its deficiency or excess, together with the role of selenium and selenoproteins in the thyroid pathophysiology (e.g., Hashimoto’s thyroiditis and Graves’ disease).

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Section: Selenium and Autoimmune Thyroiditis (Ait)mentioning

confidence: 99%

Selenium: An Element of Life Essential for Thyroid Function

et al. 2021

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“…The authors indicated that 4 months of Se supplementation allows for normalisation of TSH levels. Thus, Se is a promising therapeutic option for patients with SHT [37]. The aforementioned observation is pursuant with a previous study (2016), which was conducted on a group of patients with mild SHT due to AIT.…”

Section: Se Supplementation In Hypothyroid Ait Patientsmentioning

confidence: 84%

The rationale for selenium supplementation in patients with autoimmune thyroiditis, according to the current state of knowledge

Filipowicz

Majewska

Kalantarova

et al. 2021

Endokrynologia Polska

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Selenium (Se) supplements are commonly prescribed to autoimmune thyroiditis (AIT) patients by European endocrinologists, despite the lack of official guidelines. The majority of Europe is depleted of natural Se sources, and the daily population intake does not comply with recommended values. Optimal individual plasma Se concentration is reached when the selenoproteins (selenoprotein P, glutathione peroxidase) are fully saturated. However, Se intake has to be regulated because both Se shortage and overdose negatively impact health. In the case of AIT, Se may alleviate symptoms or prevent progression to hypothyroidism and postpartum hypothyroidism. Se supplementation in euthyroid, subclinical, or overt hypothyroid AIT patients decreased thyroid autoantibodies, lowered or maintained the TSH level, decreased the fT4/fT3 ratio, reduced the body's oxidative stress and inflammatory status, and amended quality of life and thyroid ultrasound structure and volume. In pregnant females, adequate Se intake protected them against miscarriages, preeclampsia/hypertension, preterm birth, small-for-gestational-age infants' birth, and improved child's neuropsychological development. In the elderly population, adequate Se supplementation decreased cardiovascular diseases and hypertension risk, but prolonged intake of excessive doses increased the all-cause mortality rate. Routine Se supplementation implementation requires from researchers and clinicians consideration of specific populational differences in natural Se and iodine supply, the patient's clinical situation (supplementation simultaneously or before levothyroxine treatment, AIT/non-AIT hypothyroidism), individual response to supplementation (Se and selenoprotein P assessment), predisposition (genetic testing), the status of other trace elements, and the interplay between those micronutrients. Moreover, the safety of commercially available Se formulations, doses, and duration of treatment should be determined. Proper guidelines are warranted to standardise the medical approach to Se supplementation. This article presents a comprehensive review of recent randomised-controlled trials, meta-analyses, and clinical trials concerning the risks and benefits of Se supplementation in different clinical settings and specific populations with particular emphasis on AIT in a practical manner. (Endokrynol Pol 2021; 72 (2): 153-162)

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“…On the other hand, Se supplementation can reduce serum thyroid peroxidase levels in patients with autoimmune thyroiditis with LT4 treatment (Wichman et al, 2016) or lower or maintain the TSH level in an untreated population decrease the fT4/fT3 ratio (Filipowicz et al, 2021). According to Pirola et al (2020) supplementation with selenomethionine is associated with normalization of serum TSH levels that is maintained 6 months after selenium withdrawal in 50% of patients with subclinical hypothyroidism due to chronic autoimmune thyroiditis. Thus, selenium supplementation seems reasonable.…”

Section: Discussionmentioning

confidence: 99%