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Selenium

A mineral supplement that may help mild thyroid eye disease, particularly in early stages.

Drug Class: Supportive Care

3 min read

Selenium is an essential mineral with antioxidant properties. It's studied for potential benefits in mild thyroid eye disease, particularly in early, active phases.

Key takeaways

  • Antioxidant mineral
  • May help mild thyroid eye disease
  • Best evidence for early, active disease
  • Generally safe at recommended doses
  • Not a substitute for medical treatment

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Background

The EUGOGO trial showed selenium may improve quality of life and slow progression in mild thyroid eye disease, particularly in selenium-deficient regions. Benefit in selenium-replete areas is less certain.

Evidence

What It May Help

  • Mild, active thyroid eye disease
  • May improve quality of life
  • May slow progression
  • Best in early disease

What It Doesn't Replace

  • Not for moderate to severe disease
  • Not instead of steroids when needed
  • Not for established, inactive disease

Dosing

  • 100 mcg twice daily
  • 200 mcg total daily
  • For 6 months typically
  • Do not extend beyond 6 months unless your clinician specifically recommends it and reviews your total selenium intake from diet and other supplements

Forms

  • Sodium selenite
  • Selenomethionine
  • Available over the counter
  • Various brands available

Safety

  • Upper limit: 400 mcg daily
  • Don't exceed recommended dose
  • Total intake matters-multivitamins, thyroid supplements, and "hair/nail" supplements may already contain selenium

Toxicity Signs (Overdose)

  • Hair loss
  • Nail changes
  • GI upset
  • Garlic breath odor
  • Fatigue or irritability
  • Nerve problems

Who Should Consider It

  • Mild thyroid eye disease
  • Active phase (early)
  • Discussed with doctor
  • As part of overall management

Who Should Avoid It

  • Already getting enough selenium in diet
  • Kidney disease (impaired excretion)
  • Taking selenium from other supplements

With Other Treatments

  • Can use with artificial tears
  • Discuss with doctor before combining with other TED treatments

References

  1. Bartalena 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;185(4):G43-G67.
  2. Marcocci C, et al. Selenium and the course of mild Graves' orbitopathy. N Engl J Med. 2011;364(20):1920-1931.
  3. National Institutes of Health Office of Dietary Supplements. Selenium Fact Sheet for Health Professionals.
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