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

摘要

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 Hashimoto’s 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 μIU/mL were treated with both substitutional therapy of levothyroxine and Se. Results: In around 37% of the patients treated with Se 3 × 50 μg/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 μg/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 μg/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.