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  • 1 Department of Medicine & Endocrinology, Polyclinic of the Hospitaller Brother's of St. John of God in Buda, Budapest, Hungary
  • 2 22nd Department of Internal Medicine, Semmelweis University Medical School, Budapest, Hungary
  • 3 Frankel Leó út 17-19, H-1027, Budapest, Hungary
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Abstract

Abstract

Due to its antioxidant capacity, the essential trace element selenium exerts complex effects on the endocrine and immune systems. Selenium may have an important role in autoimmune thyroid diseases because levels of free oxygen radicals are elevated during physiological thyroid hormone synthesis.

Objective

To determine whether selenium therapy can influence anti-thyroid peroxidase and anti-thyroglobulin antibody levels or if there is a correlation between antioxidant capacity and autoantibody titres.

Method

132 patients with autoimmune thyroiditis were investigated in a prospective, blinded and placebo controlled study. L-thyroxine substitution therapy was administered in both groups and TSH levels remained in the normal range. The selenium treated group (70 patients, 68 female, mean age 41.4 ± 9.5 years) was compared with the placebo treated group (62 patients, 61 female, mean age 42.7 ± 8.3 years). Selenium therapy included oral administration of 100 μg L-seleno-methionine tablets twice a day for a year. Determinations of TSH, fT4 and fT3 as well as antibody levels were carried out by chemoluminescent method. Total antioxidant capacity was determined by Randox kit, and serum selenium levels were measured by atomic absorption technique. In the course of the study patients were controlled every third month and at the end of the one year long observation period.

Results

Selenium levels in untreated patients were significantly lower than those in treated patients and controls. The fT3/fT4 ratio proved to be higher in patients after selenium therapy. Titres of antithyroid antibodies (mostly antithyroid peroxidase) significantly decreased at the end of the study. An inverse correlation was found between antioxidant capacity and antithyroid peroxidase levels. The volume of thyroid gland slightly diminished in treated patients. No adverse reactions were observed.

Conclusion

Selenium completed with L-thyroxine is a suitable therapy of patients with autoimmune thyroiditis.

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