33. Selenium for Hashimoto's Thyroiditis
Susan has Hashimoto's Thyroiditis, an autoimmune
thyroid disorder causing fatigue, puffy face and muscle weakness. For the past year, she had been under the
care of other doctors who started her on Synthroid, the most widely used thyroid
medication. Later, her doctors re-tested the thyroid antibody
levels (TPO thyroid peroxidase and thyroglobulin antibodies). The disturbing thing was that her antibodies
kept climbing higher on each follow up lab test. The doctors had no explanation, so she came
to see me, asking if there was anything else that could be done.
Can Decrease Antibody Levels
As it turns out, a trace mineral called selenium
plays an important role in thyroid.
Selenium deficiency has been implicated in the etiology of Hashimoto's Thyroiditis,
and selenium supplementation has been found beneficial.
Selenium Studies Show Benefits of Selenium for Hashimoto's Thyroiditis
The first study by Mazokopakis from Crete was
published in the 2007 Thyroid Journal.(1)
This study reported a 21 per cent reduction in TPO antibodies after one
year of seleno-methionine supplements
(200 mcg per day). A second study from
Germany in the 2002 Journal of Clinical Endocrinology & Metabolism showed a
40 per cent reduction in antibody levels after selenium supplementation with 9
of 36 (25%) patients completely normalizing their antibody levels.(2) A third study done in Turkey by Omer Turker
et al. was published in the 2006 Journal of Endocrinology. (5) They showed a 30 per cent decrease in
anti-thyroid antibodies after three months of L-seleno-methionine
supplementation at 200 mcg per day in women with Hashimoto’s Thyroiditis. The
starting average Thyroid Peroxidase (TPO) antibodies of 803 and after three
months the average was 572.
Left Image: 1912 Photograph of Dr. Hakaru Hashimoto, credited with the
discovery of Hashimoto’s Thyroiditis. Source: reprinted in: Hashimoto K. My Father
and his Teachers. Endocr J. 49, 4, 389-91. 2002. Author Unknown. Public domain
photo Courtesy of wikimedia commons.
is Selenium So Important for Thyroid Function?
Recent advances in research into thyroid cell
physiology shows that selenium is very important for thyroid function. (3-4)(11-12)
There are at least 30 selenium dependent
proteins, including the glutathione peroxidase enzyme, and the Iodothyronine
deiodinases enzyme (this is the one that converts thyroxine (T4) to
bioactive (T3). These proteins all need selenium as a
co-factor in order to function properly.
The selenoprotein, glutathione peroxidase, protects thyroid cells from damage by hydrogen
peroxide (H2O2) produced by the thyroid cell.
H2O2 is needed as a normal step in thyroid hormone production. However, excess hydrogen peroxide (H202) can
damage the thyroid cell. In the event of
selenium deficiency, the glutathione peroxidase enzyme cannot do its job
protecting the thyroid cell, and the thyroid cells are damaged by excess H2O2.(11-12) The current theory is that this damaged cell
material is then recognized by the immune system as foreign, leading to
Hashimoto's autoimmune disease.
to the Patient
Susan was started on selenomethionine 200 mcg per
day. In addition, her thyroid medication
was switched from Synthroid to natural desiccated thyroid. Three months later Susan returned for follow
up labs which showed a decline in her thyroid antibody levels. Although not all patients will see a dramatic
decline in antibody levels, I have found that many patients will benefit from
Testing and Treatment
A good thyroid testing protocol includes the
following lab values, Thyroid Stimulating Hormone (TSH), Free T3
(tri-iodiodothyronine), Free T4, Thyroid Peroxidase (TPO) Antibodies, Thyroglobulin
(Tgb) Antibodies, selenium level, and iodine level. The thyroid panel is usually part of a larger
evaluation with additional lab tests tailored to the clinical history and
examination. A good thyroid treatment protocol uses natural desiccated thyroid
medication such as Nature-Throid from RLC labs.
Dosage for natural desiccated thyroid medication varies, based on
residual thyroid function, body weight, starting thyroid labs, and other
Safety or Toxicity Depends on Dosage
Although Selenium is an inexpensive mineral
supplement available without a prescription at the health food store, I would
recommend working closely with your physician if you are considering selenium
supplementation. Although selenium is
generally considered safe at standard doses, very high dosage can cause
selenium toxicity. In addition, your
physician will determine if you need thyroid medication, the type and dosage of
the medication, etc. By the way, for
those looking for a food source for selenium, Brazil Nuts are high in selenium.
and Treatment in Hashimoto's Thyroiditis
Thyroid function in Hashimoto's Thyroiditis can have
a variable course, with thyroid function varying, and the thyroid medication dosage
may vary as thyroid function changes. Lab
studies at any one time may show low, normal or high thyroid function in
patients with elevated antibody levels and Hashimoto's thyroid disease. Dr. David Brownstein's protocols are
excellent recommendations regarding thyroid testing and treatment. See his
book, "Overcoming Thyroid Disorders"
2nd Edition which shows how a holistic treatment program can effectively
treat Hashimoto’s Disease. His book,
Overcoming Thyroid Disorders provides information on safe and effective natural
therapies with over 30 actual case studies. The book contains information
on: Natural Thyroid Hormone,
Bioidentical Natural Hormones, Diet, Vitamins and Minerals Important for
Sites with Reliable Information about Selenium for Hashimoto's
Janie Bowthorpe's book and the Stop the Thyroid
Madness Blog is an excellent source of reliable information. Mary Shomon's,
Thyroid web site and newsletter is also an excellent source of reliable
information. Beware and avoid anonymous
message boards that may give false or incorrect information about
selenium. One question to ask about
information on anonymous message boards: Is the information backed up by
citations or references in the peer reviewed medical literature? If not, then
it may not be reliable information.
For references see web site: www.bioidenticalhormones101.com
References for Chapter 33.
Selenium for Hashimoto’s Thyroiditis
(1) http://www.ncbi.nlm.nih.gov/pubmed/17696828 Thyroid. 2007 Jul;17(7):609-12.
Effects of 12 months treatment with L-selenomethionine on serum anti-TPO Levels
in Patients with Hashimoto's thyroiditis. Mazokopakis EE, Papadakis JA,
Papadomanolaki MG, Batistakis AG, Giannakopoulos TG, Protopapadakis EE,
Ganotakis ES. Department of Internal Medicine, University Hospital of
Heraklion, Crete, Greece.
(2) http://jcem.endojournals.org/cgi/content/full/87/4/1687 The Journal of Clinical
Endocrinology & Metabolism Vol. 87, No. 4 1687-1691, 2002 Selenium
supplementation in patients with autoimmune thyroiditis decreases thyroid
peroxidase antibodies concentrations. Gärtner R, Gasnier BC, Dietrich JW, Krebs
B, Angstwurm MW. Department of Endocrinology, Medizinische Klinik Innenstadt,
University of Munich, D-80336 Munich, Germany.
(3) http://www.ncbi.nlm.nih.gov/pubmed/12487769 Thyroid. 2002 Oct;12(10):867-78.The
impact of iron and selenium deficiencies on iodine and thyroid metabolism:
biochemistry and relevance to public health.
Zimmermann MB, Köhrle J.Laboratory for Human Nutrition, Swiss Federal Institute
of Technology, Zürich, Switzerland.
(4) http://nuclmed.web.auth.gr/magazine/eng/jan07/8.pdf Hashimoto’s thyroiditis and the
role of selenium. Current concepts. by Hellenic in the Journal of Nuclear
Medicine January - April 2007 Review Article
(5) http://joe.endocrinology-journals.org/cgi/content/full/190/1/151 Journal of Endocrinology (2006)
190, 151-156 . Selenium treatment in autoimmune thyroiditis: 9-month
follow-up with variable doses
Omer Turker et al Thyroidology Unit, Department of Nuclear Medicine, GATA
Haydarpasa, Istanbul, Turkey
(6) http://edrv.endojournals.org/cgi/content/abstract/26/7/944 Endocrine Reviews 26 (7):
Selenium, the Thyroid, and the Endocrine System by J. Köhrle, F. Jakob, B.
Contempré and J. E. Dumont Institut für Experimentelle Endokrinologie
(J.K.), Charité Universitätsmedizin Berlin, Humboldt Universität, D-10098
(7) https://www.drbrownstein.com/bookstore_Thyroid.php David Brownstein,M.D.
Overcoming Thyroid Disorders, 2nd
Edition, Medical Alternatives Press, Inc.
(8) http://lpi.oregonstate.edu/infocenter/minerals/selenium/ Selenium Page . Linus Pauling Institute Micronutrient
Research for Optimum Health
(9) http://www.stopthethyroidmadness.com/blog/ Stop the Thyroid Madness Blog
(10) http://thyroid.about.com/bio/Mary-Shomon-350.htm Mary Shomon Thyroid Web Site
(11) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721352/ Biologics. 2008 June; 2(2):
265–273. Selenium and thyroid autoimmunity
(12) http://jn.nutrition.org/content/127/6/1214.full Dietary Iodine and Selenium
Interact To Affect Thyroid Hormone Metabolism of Rats by Christine S. Hotz,
Dennis W. fitzpatrick, Keith D. Trick,
and Mary R. L'Abbé
Author: Dr Dach
Jeffrey Dach MD