Selenium and the thyroid - a close-knit connection

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Somethine else that caught my eye while I was perusing the Journal of Clinical Endocrinology website. NadiaThe Journal of Clinical Endocrinology & Metabolism

December 1, 2010

vol. 95

no. 12

5180-5188

Selenium and the Thyroid: A Close-Knit Connection

Leonidas H. Duntas- Author Affiliations

Endocrine Unit, Evgenidion Hospital, University of Athens, Medical School, 115 28 Athens, Greece

Address all correspondence and requests for reprints to: Leonidas H. Duntas, M.D., Professor of Endocrinology, Endocrine Unit,

Evgenidion Hospital, University of Athens, 20 Papadiamantopoulou Street 115 28 Athens, Greece. E-mail: ledunt@....

Abstract

Context: The recent recognition that the essential trace element selenium is incorporated as

selenocysteine in all three deiodinases

has decisively confirmed the clear-cut link between

selenium and thyroid function. It has additionally been established that

the thyroid contains more selenium than any other tissue and that selenium deficiency aggravates the manifestation of endemic

myxedematous cretinism and autoimmune thyroid disease.

Evidence Acquisition: Clinical reports as well as a large number of biochemical articles linking selenium to thyroid have been considered. Interventional,

prospective, randomized, controlled studies, including large observational studies, supplementing selenium in autoimmune thyroid

disease, together with review articles published in

Medline and Pubmed have undergone scrutiny. The methodological differences

and variety of results emerging from these trials have been analyzed.

Evidence Synthesis: Evidence in support of selenium supplementation in thyroid autoimmune disease is evaluated, the results herein presented

demonstrating the potential effectiveness of selenium in reducing the antithyroid peroxidase titer and improving the echostructure

in the ultrasound examination. However, considerable discord remains as to who should comprise target groups for

selenium

treatment, who will most benefit from such treatment, the precise impact of the basal antithyroid peroxidase level,

and the

effect of disease duration on the treatment outcome. Clearly, further in-depth studies and evaluation are required concerning

the mechanism of action of selenium as well as the choice of supplements or dietary intake.

Conclusions: Maintenance of "selenostasis" via optimal intake not only aids preservation of general health but also contributes substantially

to the prevention of thyroid disease.

Received January 25, 2010.

Accepted August 2, 2010.