Selenium supplements: is it advisable to use them in treatment of pathology of the thyroid gland?




review, selenium, thyroid pathology, autoimmune thyroiditis, Graves’ orbitopathy


The article is a review of the literature in Scopus, Web of Science, MedLine and The Cochrane Library and is devoted to the analysis of the evidence base of the use of selenium supplements for the treatment of thyroid pathology. Despite the variety of thyroid pathology: changes in size and structure, hypo- and hyperfunction, autoimmune, oncopathology, there are not so many drugs used in its medical treatment. Drugs that are justified for various thyroid pathologies include iodine, levothyroxine and, to some extent, triiodothyronine, thyrostatics (methimazole, carbimazole, propylthiouracil), radioactive iodine and glucocorticoids, such as beta-blockers. Acute thyroiditis requires the appointment of antibacterial therapy, and oncopathology — specific chemotherapeutic agents, the effectiveness of which, unfortunately, is not high, and the frequency of appointment is significant. Along with these drugs, selenium drugs have become unprecedented in the last decade in thyroid pathology as a component of possible pathogenetic therapy. These drugs are prescribed to patients with diametrically opposed functional state of the thyroid gland, autoimmune patho­logy, nodules. It appears that thyroid carcinogenesis remains the only pathology where the use of selenium drugs is not recommen­ded, although there are studies that indicate a link between thyroid cancer and selenium deficiency. The results of clinical studies and meta-analyzes are provided through the prism of a survey of Italian and European endocrinologists on the appointment of selenium drugs for the treatment of relevant thyroid pathology. The lack of evidence base for the use of selenium in most types of pathology of the thyroid gland: autoimmune thyroiditis, overt and subclini­cal hypothyroidism, Graves’ disease. According to most studies, the supplementation of selenium to therapy increases its plasma level, affects the activity of selenoproteins and level of antithyroid antibodies, but in no way affects the main clinical parameters such as thyroid hormones, levothyroxine dose, clinical symptoms. In ge­neral, the use of selenium in thyroid pathology cannot be considered appropriate, except for a mild form of Graves’ orbitopathy. Signi­ficant differences in the data of clinical trials and recommendations of thyroid societies with a real frequency of selenium administration by practitioner for the treatment and prevention of thyroid pathology are indicated.


Download data is not yet available.


Rouland A, Buffier P, Petit JM, Vergès B, Bouillet B. Thyroiditis: What's new in 2019?. Rev Med Interne. 2020;41(6):390-395. (in French). doi: 10.1016/j.revmed.2020.02.003.

Bible KC, Kebebew E, Brierley J, et al. 2021 American Thyroid Association Guidelines for Management of Patients with Anaplastic Thyroid Cancer. Thyroid. 2021;31(3):337-386. doi: 10.1089/thy.2020.0944.

Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133. doi: 10.1089/thy.2015.0020.

Negro R, Attanasio R, Grimaldi F, Marcocci C, Guglielmi R, Papini E. A 2016 Italian Survey about the Clinical Use of Selenium in Thyroid Disease. Eur Thyroid J. 2016;5(3):164-170. doi: 10.1159/000447667.

Pirola I, Rotondi M, Cristiano A, et al. Selenium supplementation in patients with subclinical hypothyroidism affected by autoimmune thyroiditis: Results of the SETI study. Endocrinol Diabetes Nutr (Engl Ed). 2020;67(1):28-35. (in English, Spanish). doi: 10.1016/j.endinu.2019.03.018.

Honcharova O, Illinа I. Selenium Deficiency and Age-Related Diseases (in the Focus of Deiodinase). International journal of endocrinology (Ukraine). 2015;(5):87-92. doi: 10.22141/2224-0721.4.68.2015.75020.

Pankiv V. Problem of Combined Selenium and Iodine Deficiency in the Development of Thyroid Pathology. International Journal of Endocrinology (Ukraine). 2014;61(5):75–80. doi: 10.22141/2224-0721.5.61.2014.76859.

Gorini F, Sabatino L, Pingitore A, Vassalle C. Selenium: An Element of Life Essential for Thyroid Function. Molecules. 2021;26(23):7084. doi: 10.3390/molecules26237084.

Negro R, Hegedüs L, Attanasio R, Papini E, Winther KH. A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Graves' Hyperthyroidism and Graves' Orbitopathy. Eur Thyroid J. 2019;8(1):7-15. doi: 10.1159/000494837.

Köhrle J, Jakob F, Contempré B, Dumont JE. Selenium, the thyroid, and the endocrine system. Endocr Rev. 2005 Dec;26(7):944-84. doi: 10.1210/er.2001-0034.

Winther KH, Rayman MP, Bonnema SJ, Hegedüs L. Selenium in thyroid disorders – essential knowledge for clinicians. Nat Rev Endocrinol. 2020;16(3):165-176. doi: 10.1038/s41574-019-0311-6. 

Kryukov GV, Castellano S, Novoselov SV, et al. Characterization of mammalian selenoproteomes. Science. 2003 May 30;300(5624):1439-43. doi: 10.1126/science.1083516.

Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017;2017:1297658. doi: 10.1155/2017/1297658.

Drutel A, Archambeaud F, Caron P. Selenium and the thyroid gland: more good news for clinicians. Clin Endocrinol (Oxf). 2013 Feb;78(2):155-64. doi: 10.1111/cen.12066.

Luongo C, Dentice M, Salvatore D. Deiodinases and their intricate role in thyroid hormone homeostasis. Nat Rev Endocrinol. 2019 Aug;15(8):479-488. doi: 10.1038/s41574-019-0218-2.

Zimmermann MB, Köhrle J. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid. 2002 Oct;12(10):867-78. doi: 10.1089/105072502761016494.

Köhrle J. Selenium and the control of thyroid hormone metabolism. Thyroid. 2005 Aug;15(8):841-53. doi: 10.1089/thy.2005.15.841.

Rostami R, Nourooz-Zadeh S, Mohammadi A, Khalkhali HR, Ferns G, Nourooz-Zadeh J. Serum Selenium Status and Its Interrelationship with Serum Biomarkers of Thyroid Function and Antioxidant Defense in Hashimoto's Thyroiditis. Antioxidants (Basel). 2020 Oct 31;9(11):1070. doi: 10.3390/antiox9111070.

Błażewicz A, Wiśniewska P, Skórzyńska-Dziduszko K. Selected Essential and Toxic Chemical Elements in Hypothyroidism – A Literature Review (2001–2021). Int J Mol Sci. 2021;22(18):10147. doi: 10.3390/ijms221810147.

Zagrodzki P, Przybylik-Mazurek E. Selenium and hormone interactions in female patients with Hashimoto disease and healthy subjects. Endocr Res. 2010 Jan;35(1):24-34. doi: 10.3109/07435800903551974.

Khorasani E, Mirhafez SR, Niroumand S. Assessment of the Selenium Status in Hypothyroid Children from North East of Iran. J Biol Today’s World. 2017;6(2):21-26. doi: 10.15412/J.JBTW.01060201.

Krassas GE, Pontikides N, Tziomalos K, et al. Selenium status in patients with autoimmune and non-autoimmune thyroid diseases from four European countries. Expert Rev Endocrinol Metab. 2014 Nov;9(6):685-692. doi: 10.1586/17446651.2014.960845.

Nourbakhsh M, Ahmadpour F, Chahardoli B, et al. Selenium and its relationship with selenoprotein P and glutathione peroxidase in children and adolescents with Hashimoto's thyroiditis and hypothyroidism. J Trace Elem Med Biol. 2016 Mar;34:10-4. doi: 10.1016/j.jtemb.2015.10.003.

Benamer S, Aberkane L, Benamar MA. Study of Blood Selenium Level in Thyroid Pathologies by Instrumental Neutron Activation Analysis. Instrum Sci Technol. 2006;34(2):417-423. doi: 10.1080/10739140600648837.

Verni ER, Nahan K, Lapiere AV, et al. Metalloprotein and Multielemental Content Profiling in Serum Samples from Diabetic and Hypothyroid Persons Based on PCA Analysis. Microchem J. 2018;137:258-265. doi: 10.1016/j.microc.2017.10.021.

Liu N, Liu P, Xu Q, et al. Elements in erythrocytes of population with different thyroid hormone status. Biol Trace Elem Res. 2001 Winter;84(1-3):37-43. doi: 10.1385/BTER:84:1-3:037.

Cayir A, Doneray H, Kurt N, et al. Thyroid functions and trace elements in pediatric patients with exogenous obesity. Biol Trace Elem Res. 2014 Feb;157(2):95-100. doi: 10.1007/s12011-013-9880-8.

Przybylik-Mazurek E, Zagrodzki P, Kuźniarz-Rymarz S, Hubalewska-Dydejczyk A. Thyroid disorders-assessments of trace elements, clinical, and laboratory parameters. Biol Trace Elem Res. 2011 Jun;141(1-3):65-75. doi: 10.1007/s12011-010-8719-9.

Erdal M, Sahin M, Hasimi A, Uckaya G, Kutlu M, Saglam K. Trace element levels in hashimoto thyroiditis patients with subclinical hypothyroidism. Biol Trace Elem Res. 2008 Summer;123(1-3):1-7. doi: 10.1007/s12011-008-8117-8.

Federige MAF, Romaldini JH, Miklos ABPP, Koike MK, Takei K, Portes ES. Serum selenium and selenoprotein-P levels in autoimmune thyroid diseases patients in a select center: a transversal study. Arch Endocrinol Metab. 2017 Dec;61(6):600-607. doi: 10.1590/2359-3997000000309.

Stojsavljević A, Rovčanin B, Jagodić J, et al. Significance of arsenic and lead in Hashimoto's thyroiditis demonstrated on thyroid tissue, blood, and urine samples. Environ Res. 2020 Jul;186:109538. doi: 10.1016/j.envres.2020.109538.

Toulis KA, Anastasilakis AD, Tzellos TG, Goulis DG, Kouvelas D. Selenium supplementation in the treatment of Hashimoto's thyroiditis: a systematic review and a meta-analysis. Thyroid. 2010 Oct;20(10):1163-73. doi: 10.1089/thy.2009.0351.

van Zuuren EJ, Albusta AY, Fedorowicz Z, Carter B, Pijl H. Selenium Supplementation for Hashimoto's Thyroiditis: Summary of a Cochrane Systematic Review. Eur Thyroid J. 2014 Mar;3(1):25-31. doi: 10.1159/000356040.

Eskes SA, Endert E, Fliers E, et al. Selenite supplementation in euthyroid subjects with thyroid peroxidase antibodies. Clin Endocrinol (Oxf). 2014 Mar;80(3):444-51. doi: 10.1111/cen.12284.

Gärtner R, Gasnier BC, Dietrich JW, et al. Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. J Clin Endocrinol Metab. 2002;87(4):1687-91. doi: 10.1210/jcem.87.4.8421.

Rayman MP, Thompson AJ, Bekaert B, et al. Randomized controlled trial of the effect of selenium supplementation on thyroid function in the elderly in the United Kingdom. Am J Clin Nutr. 2008 Feb;87(2):370-8. doi: 10.1093/ajcn/87.2.370.

Winther KH, Watt T, Bjørner JB, et al. The chronic autoimmune thyroiditis quality of life selenium trial (CATALYST): study protocol for a randomized controlled trial. Trials. 2014 Apr 9;15:115. doi: 10.1186/1745-6215-15-115.

Wichman J, Winther KH, Bonnema SJ, Hegedüs L. Selenium Supplementation Significantly Reduces Thyroid Autoantibody Levels in Patients with Chronic Autoimmune Thyroiditis: A Systematic Review and Meta-Analysis. Thyroid. 2016 Dec;26(12):1681-1692. doi: 10.1089/thy.2016.0256.

Qiu Y, Xing Z, Xiang Q, et al. Insufficient evidence to support the clinical efficacy of selenium supplementation for patients with chronic autoimmune thyroiditis. Endocrine. 2021;73(2):384-397. doi: 10.1007/s12020-021-02642-z.

Marcocci C, Leo M, Altea MA. Oxidative stress in graves' disease. Eur Thyroid J. 2012 Jul;1(2):80-7. doi: 10.1159/000337976.

Bülow Pedersen I, Knudsen N, Carlé A, et al. Serum selenium is low in newly diagnosed Graves' disease: a population-based study. Clin Endocrinol (Oxf). 2013 Oct;79(4):584-90. doi: 10.1111/cen.12185.

Khong JJ, Goldstein RF, Sanders KM, et al. Serum selenium status in Graves' disease with and without orbitopathy: a case-control study. Clin Endocrinol (Oxf). 2014 Jun;80(6):905-10. doi: 10.1111/cen.12392.

Dehina N, Hofmann PJ, Behrends T, Eckstein A, Schomburg L. Lack of Association between Selenium Status and Disease Severity and Activity in Patients with Graves' Ophthalmopathy. Eur Thyroid J. 2016 Mar;5(1):57-64. doi: 10.1159/000442440.

Marcocci C, Kahaly GJ, Krassas GE; European Group on Graves' Orbitopathy. Selenium and the course of mild Graves' orbitopathy. N Engl J Med. 2011 May 19;364(20):1920-31. doi: 10.1056/NEJMoa1012985.

Bartalena L, Kahaly GJ, Baldeschi L, et al. The 2021 European Group on Graves' orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves' orbitopathy. Eur J Endocrinol. 2021 Aug 27;185(4):G43-G67. doi: 10.1530/EJE-21-0479.

Bednarczuk T, Schomburg L. Challenges and perspectives of selenium supplementation in Graves' disease and orbitopathy. Hormones (Athens). 2020 Mar;19(1):31-39. doi: 10.1007/s42000-019-00133-5.

Thangaratinam S, Tan A, Knox E, Kilby MD, Franklyn J, Coomarasamy A. Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence. BMJ. 2011 May 9;342:d2616. doi: 10.1136/bmj.d2616.

Krassas GE. Thyroid disease and female reproduction. Fertil Steril. 2000 Dec;74(6):1063-70. doi: 10.1016/s0015-0282(00)01589-2.

Bonfig W, Gärtner R, Schmidt H. Selenium supplementation does not decrease thyroid peroxidase antibody concentration in children and adolescents with autoimmune thyroiditis. ScientificWorldJournal. 2010 Jun 1;10:990-6. doi: 10.1100/tsw.2010.91.

Mantovani G, Isidori AM, Moretti C, et al. Selenium supplementation in the management of thyroid autoimmunity during pregnancy: results of the "SERENA study", a randomized, double-blind, placebo-controlled trial. Endocrine. 2019 Dec;66(3):542-550. doi: 10.1007/s12020-019-01958-1.

Mao J, Pop VJ, Bath SC, Vader HL, Redman CW, Rayman MP. Effect of low-dose selenium on thyroid autoimmunity and thyroid function in UK pregnant women with mild-to-moderate iodine deficiency. Eur J Nutr. 2016 Feb;55(1):55-61. doi: 10.1007/s00394-014-0822-9.

Guo X, Zhou L, Xu J, Liu Z, Liu J, Yan C. Prenatal Maternal Low Selenium, High Thyrotropin, and Low Birth Weights. Biol Trace Elem Res. 2021 Jan;199(1):18-25. doi: 10.1007/s12011-020-02124-9.

Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71. doi: 10.1136/bmj.n71.

Risher J, McDonald R, Citra MJ, Bosch S, Amata RJ, M.S. Syracuse Research Corporation: Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological Profile for Selenium (Update). Atlanta: Public Health Service, Department of Health and Human Services; 2003.

Kupka R, Mugusi F, Aboud S, et al. Randomized, double-blind, placebo-controlled trial of selenium supplements among HIV-infected pregnant women in Tanzania: effects on maternal and child outcomes. Am J Clin Nutr. 2008 Jun;87(6):1802-8. doi: 10.1093/ajcn/87.6.1802.

Alexander EK, Pearce EN, Brent GA, et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017 Mar;27(3):315-389. doi: 10.1089/thy.2016.0457.

De Groot L, Abalovich M, Alexander EK, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012 Aug;97(8):2543-65. doi: 10.1210/jc.2011-2803.

Stuss M, Michalska-Kasiczak M, Sewerynek E. The role of selenium in thyroid gland pathophysiology. Endokrynol Pol. 2017;68(4):440-465. doi: 10.5603/EP.2017.0051.



How to Cite

Katerenchuk, V., & Katerenchuk, A. (2022). Selenium supplements: is it advisable to use them in treatment of pathology of the thyroid gland?. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 18(2), 124–132.



Literature Review