Influence of short-term selenium supplementation on the natural course of Hashimoto’s thyroiditis: clinical results of a blinded placebo-controlled randomized prospective trial
- 751 Downloads
The real efficacy of selenium supplementation in Hashimoto’s thyroiditis (HT) is still an unresolved issue.
We studied the short-term effect of l-selenomethionine on the thyroid function in euthyroid patients with HT. Our primary outcome measures were TSH, thyroid hormones, thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb) levels and thyroid echogenicity after 6 months of l-selenomethionine treatment. The secondary outcome measure was serum CXCL10 levels.
In a placebo-controlled randomized prospective study, we have enrolled untreated euthyroid patients with HT. Seventy-six patients were randomly assigned to receive l-selenomethionine 166 µg/die (SE n = 38) or placebo (controls n = 38) for 6 months. TSH, free T4 (FT4), free T3 (FT3), TPOAb and CXCL10 serum levels were assayed at time 0, after 3 and 6 months. An ultrasound examination of the left and right thyroid lobe in transverse and longitudinal sections was performed. A rectangular region, the region of interest, was selected for analysis.
TSH, FT4, FT3, TPOAb, thyroid echogenicity and CXCL10 were not statistically different between SE and control groups at time 0, after 3 and 6 months. In the SE group, FT4 levels were significantly decreased (P < 0.03) after 3 months, while FT3 increased (P < 0.04) after 3 and 6 months versus baseline values. In the control group, the FT3 decreased after 3 and 6 months (P < 0.02) compared to baseline.
The short-term l-selenomethionine supplementation has a limited impact on the natural course in euthyroid HT. Our results tip the balance toward the ineffectiveness of short-term l-selenomethionine supplementation in HT.
KeywordsHashimoto's thyroiditis 1-selenomethionine Thyroid function Thyroid echogenicity CXCL 10 levels
Compliance with ethical standards
Conflict of interest
The authors have nothing to declare.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 2.Renzullo A, Accardo G, Esposito D, De Bellis A, Bizzarro A, Romano M, Federico A, Gravina AG, Conzo G, Pannone G, Faggiano A, Colao A, Pasquali D (2013) Hashimoto’s thyroiditis and entero-chromaffin-like cell hyperplasia: early detection and somatostatin analogue treatment. Eur J Inflamm 11:863–870Google Scholar
- 6.Rotondi M, Coperchini F, Pignatti P, Sideri R, Groppelli G, Leporati P, La Manna L, Magri F, Mariotti S, Chiovato L (2013) Interferon-γ and tumor necrosis factor-α sustain secretion of specific CXC chemokines in human thyrocytes: a first step toward a differentiation between autoimmune and tumor-related inflammation? J Clin Endocrinol Metab 98:308–313CrossRefPubMedGoogle Scholar
- 12.Nacamulli D, Mian C, Petricca D, Lazzarotto F, Barollo S, Pozza D, Masiero S, Faggian D, Plebani M, Girelli ME, Mantero F, Betterle C (2010) Influence of physiological dietary selenium supplementation on the natural course of autoimmune thyroiditis. Clin Endocrinol (Oxf) 73:535–539Google Scholar
- 15.Petricca D, Nacamulli D, Mian C, Mantero F, Cavedon E, Girelli ME, Betterle C (2012) Effects of selenium supplementation on the natural course of autoimmune thyroiditis: a short review. J Endocrinol Investig 35:419–424Google Scholar
- 17.van Zuuren EJ, Albusta AY, Fedorowicz Z, Carter B, Pijl H (2013) Selenium supplementation for Hashimoto’s thyroiditis. Cochrane Database Syst Rev 6:D010223Google Scholar
- 19.De Fusco C, Nettore IC, Colao A, Macchia P (2013) Selenium in the thyroid: physiology and pathology. Rev Endocrinol Metab CIC Edizioni Int 1:34–40Google Scholar
- 29.de Farias CR, Cardoso BR, de Oliveira GM, de Mello Guazzelli IC, Catarino RM, Chammas MC, Cozzolino SM, Knobel M (2015) A randomized-controlled, double-blind study of the impact of selenium supplementation on thyroid autoimmunity and inflammation with focus on the GPx1 genotypes. J Endocrinol Invest 38:1065–1074CrossRefPubMedGoogle Scholar
- 31.Bartalena L, Baldeschi L, Boboridis K, Eckstein A, Kahaly GJ, Marcocci C, Perros P, Salvi M, Wiersinga WM, European Group on Graves’ Orbitopathy (EUGOGO) (2016) The 2016 European Thyroid Association/European Group on Graves’ orbitopathy guidelines for the management of graves’ orbitopathy. Eur Thyroid J 5:9–26CrossRefPubMedPubMedCentralGoogle Scholar
- 32.Pilli T, Cantara S, Schomburg L, Cenci V, Cardinale S, Heid EC, Kühn EC, Cevenini G, Sestini F, Fioravanti C, D’Hauw G, Pacini F (2015) IFNγ-inducible chemokines decrease upon selenomethionine supplementation in women with euthyroid autoimmune thyroiditis: comparison between two doses of selenomethionine (80 or 160 μg) versus Placebo. Eur Thyroid J 4:226–233CrossRefPubMedPubMedCentralGoogle Scholar