Diet & Fitness

 

In some studies, people who consumed more selenium in their diet had a lower risk of heart disease.^1,2 In one double-blind report, people who had already had one heart attack were given 100 mcg of selenium per day or placebo for six months.³ At the end of the trial, there were four deaths from heart disease in the placebo group but none in the selenium group; however, the number of people was too small for this difference to be statistically significant. Some doctors recommend that people with atherosclerosis supplement with 100–200 mcg of selenium per day.

The relation between selenium and protection from heart attacks remains uncertain. Low blood levels of selenium have been reported in people immediately following a heart attack,⁴ suggesting that heart attacks may increase the need for selenium. However, other researchers claim that low selenium levels are present in people before they have a heart attack, suggesting that the lack of selenium might increase heart attack risk.⁵ One report found that low blood levels of selenium increased the risk of heart attack only in smokers,⁶ and another found the link only in former smokers.⁷ Yet others have found no link between low blood levels of selenium and heart attack risk whatsoever.⁸ In a double-blind trial, individuals who already had one heart attack were given 100 mcg of selenium per day or placebo for six months.⁹ At the end of the trial, there were four deaths from heart disease in the placebo group but none in the selenium group (although the numbers were too small for this difference to be statistically significant). In other controlled research, a similar group was given placebo or 500 mcg of selenium six hours or less after a heart attack followed by an ongoing regimen of 100 mcg of selenium plus 100 mg of coenzyme Q10 per day.¹⁰ One year later, six people had died from a repeat heart attack in the placebo group, compared with no heart attack deaths in the supplement group. Despite the lack of consistency in published research, some doctors recommend that people at risk for a heart attack supplement with selenium—most commonly 200 mcg per day.

 

In a preliminary study, individuals with lymphedema of the arm or head-and-neck region were treated with approximately 230 mcg of selenium per day, in the form of sodium selenite, for four to six weeks. A quality-of-life assessment showed an improvement of 59%, and the circumference of the edematous arm was reduced in 10 of 12 cases.¹¹

A meta-analysis of data from eleven randomized controlled trials with a combined total of 1,221 participants found selenium supplementation reduced total cholesterol levels without significantly impacting LDL-, HDL-, or non-HDL-cholesterol levels.¹² Another meta-analysis that included findings from five trials in participants with diseases related to metabolic syndrome also found selenium had no effect on lipid profiles.¹³ Nevertheless, a research review suggested supplementing with 200 micrograms daily may have some cholesterol-lowering benefits in those with high baseline cholesterol levels.¹⁴

 

Gross deficiency of dietary selenium may cause many heart problems, including arrhythmia. Based on this finding, one author has theorized that correction of low selenium status may improve many arrhythmias, even in the absence of overt deficiency symptoms.¹⁵ Controlled research is needed to evaluate this possibility.

 

Selenium deficiency has occasionally been reported as a cause of cardiomyopathy.^16,17 Selenium deficiency is the probable cause of Keshan’s disease, a form of cardiomyopathy found in China^18,19 but only rarely reported in the United States.²⁰ Studies comparing populations in parts of the world other than mainland China have not supported a link between selenium deficiency and DCM,^21,22 except in Taiwan.²³ Moreover, no clinical trials outside of China have explored the effects of supplementation with selenium for people with DCM, nor is there reason to believe that selenium supplementation would help most people outside of China and Taiwan suffering from cardiomyopathy.

Most,^24,25 but not all,²⁶ double-blind studies have shown that elderly people have better immune function and reduced infection rates when taking a multiple vitamin-mineral formula. In one double-blind trial, supplements of 100 mcg per day of selenium and 20 mg per day of zinc, with or without additional vitamin C, vitamin E, and beta-carotene, reduced infections in elderly people, though vitamins without minerals had no effect.²⁷ Burn victims have also experienced fewer infections after receiving trace mineral supplements in double-blind research.²⁸ These studies suggest that trace minerals may be the most important micronutrients for enhancing immunity and preventing infections in the elderly.

Most,^29,30 but not all,³¹ double-blind studies have shown that elderly people have better immune function and reduced infection rates when taking a multiple vitamin-mineral formula. In one double-blind trial, supplements of 100 mcg per day of selenium and 20 mg per day of zinc, with or without additional vitamin C, vitamin E, and beta-carotene, reduced infections in elderly people, though vitamins without minerals had no effect.³² Burn victims have also experienced fewer infections after receiving trace mineral supplements in double-blind research.³³ These studies suggest that trace minerals may be the most important micronutrients for enhancing immunity and preventing infections in the elderly.

Selenium deficiency is an independent factor associated with high mortality among HIV-positive people.³⁴ HIV-positive people who took selenium supplements experienced fewer infections, better intestinal function, improved appetite, and improved heart function (which had been impaired by the disease) than those who did not take the supplements.³⁵ The usual amount of selenium taken was 400 mcg per day.

Selenium deficiency has been found more often in people with HIV-related cardiomyopathy (heart abnormalities) than in those with HIV and normal heart function.³⁶ People with HIV-related cardiomyopathy may benefit from selenium supplementation. In a small preliminary trial, people with AIDS and cardiomyopathy, 80% of whom were found to be deficient in selenium, were given 800 mcg of selenium per day for 15 days, followed by 400 mcg per day for eight days. Improvements in heart function were noted after selenium supplementation.³⁷ People wishing to supplement with more than 200 mcg of selenium per day should be monitored by a doctor.

 

 

Selenium is a mineral nutrient with an important role in immune function and infection prevention,^38,39,40 and selenium deficiency has been reported in patients after intestinal surgery.⁴¹ A controlled trial of critically ill patients, including some with recent major surgery, found that those receiving daily intravenous selenium injections for three weeks showed less biochemical signs of body stress compared with unsupplemented patients. The amount used in this trial was 500 mcg twice daily for the first week, 500 mcg once daily for the second week, and 100 mcg three times daily for the third week.⁴²

 

People with low levels of selenium have a high risk of asthma.^{43,44,45,46,47} Asthma involves free-radical damage⁴⁸ that selenium might protect against. In a small double-blind trial, supplementation with 100 mcg of sodium selenite (a form of selenium) per day for 14 weeks resulted in clinical improvement in six of eleven patients, compared with only one of ten in the placebo group.⁴⁹ Most doctors recommend 200 mcg per day for adults (and proportionately less for children)—a much higher, though still safe, level.

There is some evidence that combinations of antioxidants such as vitamin E, vitamin C, and selenium may help improve symptoms of asthma throught to be caused by air pollution.⁵⁰ In one double-blind study, 46 Dutch bicyclists were randomly assigned to receive a placebo or 100 mg of vitamin E and 500 mg of vitamin C daily for 15 weeks.⁵¹ Lung function was measured before and after each training session on 380 different occasions, and ambient ozone concentrations were measured during each training session. After analysis, researchers concluded that bicyclists with the vitamins C and E blunted the adverse effects of ozone on measures of lung function. In another double-blind study, 17 adults (18 to 39 years old) were randomly assigned to receive either 400 IU per day of vitamin E and 500 mg per day of vitamin C or a placebo for five weeks.⁵² Tests showing improved measures of lung function led researchers to conclude that supplementation with vitamins C and E inhibited the decline in pulmonary function induced in asthmatics by exposure to air pollutants. Also using a double-blind design, another study of 158 children with asthma living in Mexico City were randomly assigned to receive, a daily supplement containing 50 mg of vitamin E and 250 mg of vitamin C or a placebo.⁵³ Tests results suggested that supplementing with vitamins C and E may reduce the adverse effect of ozone exposure on lung function of children with moderate to severe asthma.

 

Less than optimal intake of selenium may have adverse effects on psychological function, even in the absence of signs of frank selenium deficiency. In a preliminary trial of healthy young men, consumption of a high-selenium diet (226.5 mcg selenium per day) was associated with improved mood (i.e., decreased confusion, depression, anxiety, and uncertainty), compared to consumption of a low-selenium diet (62.6 mcg selenium per day.)⁵⁴ In a double-blind trial, people who had a low selenium intake experienced greater improvement in depression symptoms after selenium supplementation (100 mcg per day) than did people with adequate selenium intake, suggesting that low-level selenium deficiency may contribute to depression.⁵⁵

In a preliminary trial, elderly individuals with mild cognitive impairment and low blood levels of selenium consumed one Brazil nut per day (providing an estimated 289 mcg of selenium per day) or no Brazil nuts (control group) for 6 months. The improvement in measures of cognitive function was significantly greater in the group eating Brazil nuts than in the control group.⁵⁶ Additional research is needed to determine whether taking selenium supplements or eating Brazil nuts would be beneficial for people with normal blood levels of selenium.

 

Sunlight triggers oxidative damage in the eye, which in turn can cause macular degeneration.⁵⁷ Animals given antioxidants—which protect against oxidative damage—have a lower risk of this vision problem.⁵⁸ People with high blood levels of antioxidants also have a lower risk.⁵⁹ Those with the highest levels (top 20th percentile) of the antioxidants selenium, vitamin C, and vitamin E may have a 70% lower risk of developing macular degeneration, compared with people with the lowest levels of these nutrients (bottom 20th percentile).⁶⁰ People who eat fruits and vegetables high in beta-carotene, another antioxidant, are also at low risk.⁶¹ Some doctors recommend antioxidant supplements to reduce the risk of macular degeneration; reasonable adult levels include 200 mcg of selenium, 1,000 mg of vitamin C, 400 IU of vitamin E, and 25,000 IU of natural beta-carotene per day. However, a preliminary study found no association between age-related macular degeneration and intake of antioxidants, either from the diet, from supplements, or from both combined.⁶² Moreover, in a double-blind study of male cigarette smokers, supplementing with vitamin E (50 IU per day), synthetic beta-carotene (about 33,000 IU per day), or both did not reduce the incidence of age-related macular degeneration.⁶³

Selenium has been reported to have diverse anticancer actions.^64,65 Selenium inhibits cancer in animals.⁶⁶ Low soil levels of selenium (probably associated with low dietary intake), have been associated with increased cancer incidence in humans.⁶⁷ Blood levels of selenium have been reported to be low in patients with prostate cancer.⁶⁸ In preliminary reports, people with the lowest blood levels of selenium had between 3.8 and 5.8 times the risk of dying from cancer compared with those who had the highest selenium levels.^69,70

The strongest evidence supporting the anticancer effects of selenium supplementation comes from a double-blind trial of 1,312 Americans with a history of skin cancer who were treated with 200 mcg of yeast-based selenium per day or placebo for 4.5 years and then followed for an additional two years.⁷¹ Although no decrease in skin cancers occurred, a dramatic 50% reduction in overall cancer deaths and a 37% reduction in total cancer incidence were observed. A statistically significant 63% decrease in prostate cancer incidence was reported.⁷¹ However, in a follow-up double-blind trial that included 35,533 healthy men, supplementing with 200 mcg per day of selenium for an average of 5.5 years had no effect on the incidence of prostate cancer.⁷³ In another trial, 5,141 men were randomly assigned to receive a placebo or a daily supplement containing 100 mcg of selenium, 120 mg of vitamin C, 30 IU of vitamin E, 6 mg of beta-carotene, and 20 mg of zinc 20 for eight years. Among men with a normal PSA level at the start of the study, there was a statistically significant 48% reduction in the incidence of prostate cancer. Among men with an initially elevated PSA level, the supplemented group had an increased incidence of prostate cancer that was not statistically significant.⁷⁴

There are few controlled trials of antioxidant supplementation to patients with pancreatitis. One small controlled study of acute pancreatitis patients found that sodium selenite at a dose of 500 micrograms (mcg) daily resulted in decreased levels of a marker of free radical activity, and no patient deaths occurred.⁷⁴ In a small double-blind trial including recurrent acute and chronic pancreatitis patients, supplements providing daily doses of 600 mcg selenium, 9,000 IU beta-carotene, 540 mg Vitamin C, 270 IU vitamin E, and 2,000 mg methionine significantly reduced pain, normalized several blood measures of antioxidant levels and free radical activity, and prevented acute recurrences of pancreatitis.⁷⁵ These researchers later reported that continuing antioxidant treatment in these patients for up to five years or more significantly reduced the total number of days spent in hospital and resulted in 78% of patients becoming pain-free and 88% returning to work.⁷⁶

Because oxidative damage is believed to play a role in the development of diabetic complications, such as eye damage (retinopathy), kidney damage (nephropathy), and nerve damage (neuropathy), antioxidant nutrients like selenium might play an important preventive role. In a placebo-controlled trial that included people with type 1 and type 2 diabetes and related nephropathy, those given 200 micrograms of selenium per day for 12 weeks had increased antioxidant capacity but no change in markers of kidney function.⁷⁷ One doctor reported administering a per day regimen of antioxidants including 500 micrograms selenium, plus 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C, per day for several years to 20 people with diabetic eye damage (retinopathy). During that time, the doctor observed that 19 of the 20 people showed either improvement or no progression of their retinopathy.⁷⁸ In a three-month study, taking supplements providing 100 micrograms selenium, 600 mg alpha-lipoic acid, and 1,200 IU vitamin E per day resulted in improvements in neuropathy symptoms in those with long-standing diabetes.⁷⁹ People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.

Because oxidation damage is believed to play a role in the development of diabetic eye damage (retinopathy), antioxidant nutrients might be protective. One doctor has administered a daily regimen of 500 mcg selenium, 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C for several years to 20 people with diabetic eye damage (retinopathy). During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy.⁸⁰ People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.

 

People with RA have been found to have lower selenium levels than healthy people.^81,82 One⁸³ of two double-blind trials using at least 200 mcg of selenium per day for three to six months found that selenium supplementation led to a significant reduction in pain and joint inflammation in RA patients, but the other reported no beneficial effect.⁸⁴ More controlled trials are needed to determine whether selenium reduces symptoms in people with RA.

 

A deficiency in the selenium-containing antioxidant enzyme known as glutathione peroxidase has been reported in DH.^85,86 Preliminary⁸⁵ and double-blind⁸⁶ trials suggest that supplementation with 10 IU of vitamin E and 200 mcg of selenium per day for six to eight weeks corrected this deficiency but did not lead to symptom improvement in the double-blind trial.

 

In a double-blind study of infertile men with reduced sperm motility, supplementation with selenium (100 mcg per day for three months) significantly increased sperm motility, but had no effect on sperm count. Eleven percent of 46 men receiving selenium achieved paternity, compared with none of 18 men receiving a placebo.⁸⁷

In a preliminary trial, elderly individuals with mild cognitive impairment and low blood levels of selenium consumed one Brazil nut per day (providing an estimated 289 mcg of selenium per day) or no Brazil nuts (control group) for 6 months. The improvement in measures of cognitive function was significantly greater in the group eating Brazil nuts than in the control group.⁸⁸ Additional research is needed to determine whether taking selenium supplements or eating Brazil nuts would be beneficial for people with normal blood levels of selenium.

 

Based on the personal experience of a doctor who reported his findings,⁸⁹ some physicians recommend vitamin E (400 IU per day) and selenium (50 mcg three times per day). One well-known, nutritionally oriented doctor reports anecdotally that he has had considerable success with this regimen and often sees results in two to six weeks.⁹⁰

 

Selenium is a mineral known to have antioxidant properties and to be involved in healthy immune system activity. Recent animal and human research suggests that selenium deficiency increases the risk of viral infection and that supplementation prevents viral infection.^{91,92,93,94,95} In a controlled trial, children with a specific viral infection (respiratory syncytial virus) who received a single supplement of 1 mg (1,000 mcg) of sodium selenite (a form of selenium) recovered more quickly than children who did not receive selenium.⁹⁶ While it is possible that childhood exanthemous viral infections might similarly be more severe in selenium-deficient children and helped through supplementation, none of the current research involves these specific viruses.

 

Sunlight triggers oxidative damage in the eye, which in turn can cause macular degeneration.⁹⁷ Animals given antioxidants—which protect against oxidative damage—have a lower risk of this vision problem.⁹⁸ People with high blood levels of antioxidants also have a lower risk.⁹⁹ Those with the highest levels (top 20th percentile) of the antioxidants selenium, vitamin C, and vitamin E may have a 70% lower risk of developing macular degeneration, compared with people with the lowest levels of these nutrients (bottom 20th percentile).¹⁰⁰ People who eat fruits and vegetables high in beta-carotene, another antioxidant, are also at low risk.¹⁰¹ Some doctors recommend antioxidant supplements to reduce the risk of macular degeneration; reasonable adult levels include 200 mcg of selenium, 1,000 mg of vitamin C, 400 IU of vitamin E, and 25,000 IU of natural beta-carotene per day. However, a preliminary study found no association between age-related macular degeneration and intake of antioxidants, either from the diet, from supplements, or from both combined.¹⁰² Moreover, in a double-blind study of male cigarette smokers, supplementing with vitamin E (50 IU per day), synthetic beta-carotene (about 33,000 IU per day), or both did not reduce the incidence of age-related macular degeneration.¹⁰³

 

Selenium plays a role in thyroid hormone metabolism. Severe selenium deficiency has been implicated as a possible cause of goiter.¹⁰⁴ Two months of selenium supplementation in people who were deficient in both selenium and iodine was shown to induce a dramatic fall of the already impaired thyroid function in clinically hypothyroid subjects.¹⁰⁵ Researchers have suggested that people who are deficient in both selenium and iodine should not take selenium supplements without first receiving iodine or thyroid hormone supplementation.¹⁰⁶ There is no research demonstrating that selenium supplementation helps people with hypothyroidism who are not selenium-deficient.

 

Nutritional supplements recommended by some doctors for prevention and treatment of periodontitis include vitamin C (people with periodontitis are often found to be deficient),¹⁰⁷vitamin E, selenium, zinc, coenzyme Q10, and folic acid.¹⁰⁸ Folic acid has also been shown to reduce the severity of gingivitis when taken as a mouthwash.¹⁰⁹

 

Low levels of selenium¹¹⁰ and low dietary intake of vitamin C^111,112 have been observed in women with cervical dysplasia.