Selenium Treatment Effect in Auto-Immune Hashimoto Thyroiditis in Macedonian Population

Abstract

Background: Selenium (Se), a necessary trace mineral for humans, has the highest concentration in the thyroid gland and is known of its anti-oxidant and anti-inflammatory properties. Many studies have reported that Se has a close relationship with auto-immune Hashimotos thyroiditis (HT), characterized by the presence of anti-thyroid peroxidase (aTPO) auto-antibodies.

Methods: Five hundred thyroid patients, males and females, mean age 46 19 years, with diagnosed HT, were included in the study. Euthyroid forms of HT were treated with Se only, while patients with thyroid-stimulating hormone (TSH) > 10 IU/mL were treated with both substitutional therapy of levothyroxine and Se.

Results: In around 37% of the patients treated with Se 3 50 g/day with aTPO > 1,000 IU/mL, aTPO remained unchanged after 12 months, while 24.16% had aTPO < 500 IU/mL and 38.20% had aTPO between 500 and 1,000 IU/mL. Eighty-three out of 150 (55.33%) patients treated with Se 2 50 g/day with aTPO between 500 and 1,000 IU/mL responded. More than half of the patients (91/172, 52.90%) with aTPO < 500 IU/mL treated with Se 50 g/day normalized in 1 year. In hypothyroid group of patients, 12 months after treatment with levothyroxine and Se, 47.18% were responders with aTPO > 1,000 IU/mL, while 79.20% with aTPO between 500 and 1,000 IU/mL. In euthyroid group (Se only), the biggest response (30.56%) was seen in patients with the highest titer of aTPO > 1,000 IU/mL.

Conclusion: Se treatment is effective in reducing the levels of aTPO in patients with HT, alone or in combination with levothyroxine. This is due to the anti-inflammatory and anti-oxidant effect of Se. Our study promotes the concept of Se treatment in patients with euthyroid or hypothyroid state, with increased titers of aTPO.




J Endocrinol Metab. 2019;9(1-2):22-28
doi: https://doi.org/10.14740/jem551