Selenium

NOTICE: This health information was not created by the University of Michigan Health System (UMHS) and may not necessarily reflect specific UMHS practices. For medical advice relating to your personal condition, please consult your doctor. Complete disclaimer

Selenium

Uses

Selenium

Selenium is an essential trace mineral.

What Are "Star" Ratings?

a7_3star   Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star   Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star   For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

This supplement has been used in connection with the following health conditions:


Used for Amount Why
Asthma
 100 mcg daily 2 stars   Asthma involves free-radical damage that selenium might protect against. In one trial, supplementing with sodium selenite (a form of selenium) improved symptoms in some patients.

2 stars  Asthma

100 mcg daily

People with low levels of selenium have a high risk of asthma.1 , 2 , 3 , 4 , 5 Asthma involves free-radical damage6 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.7 Most doctors recommend 200 mcg per day for adults (and proportionately less for children)—a much higher, though still safe, level.

Used for Amount Why
Atherosclerosis
 100 mcg daily 2 stars   Some doctors recommend that people with atherosclerosis supplement with selenium, which has been shown in one study to help reduce the risk of death from heart disease.

2 stars  Atherosclerosis

100 mcg daily

In some studies, people who consumed more selenium in their diet had a lower risk of heart disease.8 , 9 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.10 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.

Used for Amount Why
Colon Cancer
 200 mcg daily 2 stars   Selenium appears to protect against a variety of cancers, including colon cancer.

2 stars  Colon Cancer

200 mcg daily

Selenium has been reported to have diverse anticancer actions.12 , 13 Selenium inhibits cancer in animals.14 Low soil levels of selenium, probably associated with low dietary intake, have been associated with increased cancer incidence in humans.15 Blood levels of selenium have been reported to be low in patients with a variety of cancers,16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 including colon cancer.24 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.25 , 26

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, then followed for an additional two years.27 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 58% decrease in cancers of the colon and rectum was reported.

Little is known about the effects of selenium in the treatment of people with existing cancer. Selenium supplementation was reported to improve immune function in colon cancer patients,28 but no long-term follow-up was done to evaluate whether these patients ultimately lived longer or fared better.

In the double-blind study cited above,29 the large reduction in cancer deaths found in such a short period of time (6.5 years) suggests that these researchers may have been successfully, though unknowingly, treating some people with undiagnosed cancer. However, this speculation has yet to be proven.


Used for Amount Why
Depression
 100 mcg per day 2 stars   Selenium deficiency may contribute to depression. Taking selenium can counteract this deficiency and improve depression symptoms.

2 stars  Depression

100 mcg per day

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.)30 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.31

Used for Amount Why
Dermatitis Herpetiformis
 200 mcg daily 2 stars   Supplementing with selenium and vitamin E has been shown to correct an antioxidant deficiency common in DH.

2 stars  Dermatitis Herpetiformis

200 mcg daily

A deficiency in the selenium-containing antioxidant enzyme known as glutathione peroxidase has been reported in DH.32 , 33 Preliminary34 and double-blind35 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.

Used for Amount Why
Edema
 230 mcg daily 2 stars   People with lymphedema of the arm or head-and-neck region who were treated with selenium saw an improvement in quality of life and edema symptoms in one study.

2 stars  Edema

230 mcg daily

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.36

Used for Amount Why
Heart Attack
 100 to 200 mcg daily 2 stars   Some doctors recommend that people at risk for a heart attack supplement with selenium.

2 stars  Heart Attack

100 to 200 mcg daily

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,37 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.38 One report found that low blood levels of selenium increased the risk of heart attack only in smokers,39 and another found the link only in former smokers.40 Yet others have found no link between low blood levels of selenium and heart attack risk whatsoever.41 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.42 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.43 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.

Used for Amount Why
HIV and AIDS Support
 Take under medical supervision: 400 mcg daily 2 stars   Supplementing with selenium may result in fewer infections, a healthier appetite, and other benefits.

2 stars  HIV and AIDS Support

Take under medical supervision: 400 mcg daily

Selenium deficiency is an independent factor associated with high mortality among HIV-positive people.44 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.45 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.46 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.47 People wishing to supplement with more than 200 mcg of selenium per day should be monitored by a doctor.

Used for Amount Why
Immune Function and Elderly People
 100 mcg daily with 20 mg zinc daily 2 stars   Selenium supplements have been reported to help improve immune function in seniors.

2 stars  Immune Function and Elderly People

100 mcg daily with 20 mg zinc daily

Most,48 , 49 but not all,50 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.51 Burn victims have also experienced fewer infections after receiving trace mineral supplements in double-blind research.52 These studies suggest that trace minerals may be the most important micronutrients for enhancing immunity and preventing infections in the elderly.


Used for Amount Why
Infection and Elderly People
 100 mcg per day with 20 mg per day of zinc 2 stars   Selenium supplements have been reported to help reduce infections in elderly people.

2 stars  Infection and Elderly People

100 mcg per day with 20 mg per day of zinc

Most,53 , 54 but not all,55 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.56 Burn victims have also experienced fewer infections after receiving trace mineral supplements in double-blind research.57 These studies suggest that trace minerals may be the most important micronutrients for enhancing immunity and preventing infections in the elderly.


Used for Amount Why
Infections in Very Low Birth Weight Infants
 5 to 7 mcg per 2.2 lbs (1 kg) of body weight 2 stars   Premature infants with very low birth weight have an increased susceptibility to infections. In one trial, selenium supplements appeared to reduce hospital-acquired infections.

2 stars  Infections in Very Low Birth Weight Infants

5 to 7 mcg per 2.2 lbs (1 kg) of body weight

Premature infants with very low birth weight have an increased susceptibility to infections. In a double-blind trial, premature infants were given either selenium supplements (5 to 7 mcg per 2.2 pounds of body weight) or placebo. Those receiving the selenium supplements had fewer hospital-acquired infections.58

Used for Amount Why
Lung Cancer
 200 mcg daily 2 stars   Selenium, reported to have diverse anticancer actions, has been shown in one study to reduce lung cancer deaths and lung cancer incidence.

2 stars  Lung Cancer

200 mcg daily

Selenium has been reported to have diverse anticancer actions.59 , 60 Selenium inhibits cancer growth in animals.61 Low soil levels of selenium (probably associated with low dietary intake), have been associated with increased cancer incidence in humans.62 Blood levels of selenium have been reported to be low in patients with many cancers,63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 including lung cancer.71 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.72 , 73

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 a placebo for 4.5 years and then followed for an additional two years.74 Although no decrease in skin cancers occurred, a 50% reduction in overall cancer deaths and a 37% reduction in total cancer incidence was observed. A 46% decrease in lung cancer incidence and a 53% drop in deaths from lung cancer also occurred. These findings were all statistically significant.

Used for Amount Why
Male Infertility
 100 mcg daily 2 stars   In a study of infertile men with reduced sperm motility, supplementing with selenium significantly increased sperm motility.

2 stars  Male Infertility

100 mcg daily

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.75

Used for Amount Why
Osgood-Schlatter Disease
 150 mcg a day with 400 IU a day of vitamin E 2 stars   Taking a combination of vitamin E and selenium may help the healing.

2 stars  Osgood-Schlatter Disease

150 mcg a day with 400 IU a day of vitamin E

Based on the personal experience of a doctor who reported his findings,76 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.77

Used for Amount Why
Pancreatic Insufficiency
 600 mcg, taken under the supervision of a doctor 2 stars   Taking antioxidant supplements, such as selenium, may lessen pain and prevent pancreatitis recurrences.
Phenylketonuria and Selenium Deficiency
 Adolescents and adults: 55 mcg daily; for infants and children: 15 to 40 mcg daily, according to age 2 stars   Selenium deficiency may develop on the PKU diet, and supplementation may help correct this.

2 stars  Phenylketonuria and Selenium Deficiency

Adolescents and adults: 55 mcg daily; for infants and children: 15 to 40 mcg daily, according to age

People with PKU may be deficient in several nutrients, due to the restricted diet which is low in protein and animal fat. Deficiencies of long-chain polyunsaturated fatty acids (LC-PUFAs),78 , 79 , 80 selenium,81 , 82 , 83 , 84 vitamin B12,85 and vitamin K may develop on this diet.86

Selenium is important for normal antioxidant function. Research suggests that selenium deficiency and decreased antioxidant activity may contribute to the brain and nerve disorders associated with PKU.87 In two preliminary studies involving selenium-deficient people with PKU, supplementation with selenium in the form of sodium selenite corrected the deficiency,88 whereas supplementation with selenium in the form of selenomethionine did not.89

Used for Amount Why
Prostate Cancer
 200 mcg daily 2 stars   Selenium has been reported to have diverse anticancer actions. Supplementing with this mineral may decrease your prostate cancer risk.

2 stars  Prostate Cancer

200 mcg daily

Selenium has been reported to have diverse anticancer actions.90 , 91 Selenium inhibits cancer in animals.92 Low soil levels of selenium (probably associated with low dietary intake), have been associated with increased cancer incidence in humans.93 Blood levels of selenium have been reported to be low in patients with prostate cancer.94 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.95 , 96

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.97 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.98 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.99 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.100 In a double-blind study of men who already had non-metastatic prostate cancer, supplementation with selenium 200 or 800 mcg per day for up to 5 years had no significant effect on the progression rate of the cancer.101

Used for Amount Why
Rheumatoid Arthritis
 200 mcg daily 2 stars   People with rheumatoid arthritis have been found to have lower selenium levels than healthy people. Supplementing with selenium may reduce pain and joint inflammation.

2 stars  Rheumatoid Arthritis

200 mcg daily

People with RA have been found to have lower selenium levels than healthy people.102 , 103 One104 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.105 More controlled trials are needed to determine whether selenium reduces symptoms in people with RA.

Used for Amount Why
Abnormal Pap Smear
 Refer to label instructions 1 star   Low levels of selenium have been observed in women with cervical dysplasia.

1 star  Abnormal Pap Smear

Low levels of selenium106 and low dietary intake of vitamin C107 , 108 have been observed in women with cervical dysplasia.


Used for Amount Why
Asthma
(Vitamin C, Vitamin E)
 Refer to label instructions 1 star   There is some evidence that a combination of antioxidants vitamin E, vitamin C, and selenium may help prevent asthma throught to be caused by air pollution.

1 star  Asthma

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.109 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.110 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.111 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.112 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.


Used for Amount Why
Cardiac Arrhythmia
 Refer to label instructions 1 star   Supplementing with selenium may improve many arrhythmias.

1 star  Cardiac Arrhythmia

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.113 Controlled research is needed to evaluate this possibility.


Used for Amount Why
Cardiomyopathy and Keshan's Cardiomyopathy
 Refer to label instructions 1 star   Supplementing with selenium can correct selenium deficiency, which is believed to be a cause of Keshan’s disease, a form of cardiomyopathy found in China.

1 star  Cardiomyopathy and Keshan's Cardiomyopathy

Selenium deficiency has occasionally been reported as a cause of cardiomyopathy.114 , 115 Selenium deficiency is the probable cause of Keshan’s disease, a form of cardiomyopathy found in China116 , 117 but only rarely reported in the United States.118 Studies comparing populations in parts of the world other than mainland China have not supported a link between selenium deficiency and DCM,119 , 120 except in Taiwan.121 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.

Used for Amount Why
Childhood Diseases
 Refer to label instructions 1 star   Supplementing with selenium, an antioxidant mineral, supports a healthy immune system and has been found to prevent viral infections.

1 star  Childhood Diseases

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.122 , 123 , 124 , 125 , 126 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.127 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.

Used for Amount Why
Down’s Syndrome
 Refer to label instructions 1 star   People with Down’s syndrome may be deficient in selenium. A preliminary study found that antioxidant activity in the body improved when children with Down’s syndrome took selenium.

1 star  Down’s Syndrome

Blood levels of the antioxidant minerals selenium and zinc were normal in one study of people with Down’s syndrome,128 but others have found selenium129 , 130 and zinc131 , 132 , 133 levels to be low. In some studies more than 60% of patients with Down’s syndrome had low zinc levels.134 , 135 A preliminary study of selenium supplementation in children with Down’s syndrome found that the antioxidant activity in the body improved; however, the implications of this finding on the long-term health of these people is unclear.136 Zinc is critical for proper immune function, and in one preliminary study the majority of patients with Down’s syndrome examined had low zinc levels and low immune cell activity. Supplementation with zinc resulted in improved immune cell activity.137 In preliminary intervention trials, improved immune cell activity was associated with reduced rates of infection in Down’s syndrome patients given supplemental zinc in the amount of 1 mg per 2.2 pounds of body weight per day.138 , 139 A controlled trial, however, did not find zinc, at 25 mg daily for children under 10 years of age and 50 mg for older children, to have these benefits.140 Zinc has other roles in the body; preliminary data have indicated that zinc supplementation, at 1 mg per 2.2 pounds of body weight per day, improved thyroid function in Down’s syndrome patients,141 , 142 , 143 and increased growth rate in children with Down’s syndrome.144

Used for Amount Why
Halitosis and Gum Disease
 Spray a lotion containing 3.7% citronella in a slow-release formula every morning for six days per week 1 star   Selenium is often recommended by doctors to help prevent and treat periodontitis.

1 star  Halitosis and Gum Disease

Spray a lotion containing 3.7% citronella in a slow-release formula every morning for six days per week

Nutritional supplements recommended by some doctors for prevention and treatment of periodontitis include vitamin C (people with periodontitis are often found to be deficient),145 vitamin E, selenium, zinc, coenzyme Q10, and folic acid.146 Folic acid has also been shown to reduce the severity of gingivitis when taken as a mouthwash.147

Used for Amount Why
Hepatitis
 100 mg per 1 star   In one trial, a combination of alpha lipoic acid, silymarin, and selenium led to significant improvements in liver function and overall health in people with hepatitis C.

1 star  Hepatitis

100 mg per

A potent antioxidant combination may protect the liver from damage in people with hepatitis C, possibly decreasing the necessity for a liver transplant. In a preliminary trial,148 three people with liver cirrhosis and esophageal varices (dilated veins in the esophagus that can rupture and cause fatal bleeding) caused by hepatitis C received a combination of Alpha lipoic acid (300 mg twice daily), silymarin (from milk thistle; 300 mg three times daily), and selenium (selenomethionine; 200 mcg twice daily). After five to eight months of therapy that included other “supportive supplements,” such as vitamin C and B vitamins, all three people had significant improvements in their liver function and overall health. Larger clinical trials are needed to confirm these promising preliminary results.

Used for Amount Why
Hypothyroidism and Selenium Deficiency
 Refer to label instructions 1 star   Selenium plays a role in thyroid hormone metabolism. People who are deficient in selenium may benefit from supplementation.

1 star  Hypothyroidism and Selenium Deficiency

Selenium plays a role in thyroid hormone metabolism. Severe selenium deficiency has been implicated as a possible cause of goiter.149 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.150 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.151 There is no research demonstrating that selenium supplementation helps people with hypothyroidism who are not selenium-deficient.

Used for Amount Why
Liver Cirrhosis
 Refer to label instructions 1 star   People with liver cirrhosis often have low selenium levels and a greater need for antioxidants. In one study, selenium improved liver function in people with alcoholic cirrhosis.

1 star  Liver Cirrhosis

Selenium levels have been found to be low in people with liver cirrhosis152 and the need for antioxidants has been found to be increased.153 A small, preliminary trial suggested that 100 mcg per day of selenium may improve liver function in people with alcoholic cirrhosis.154 Larger, double-blind trials of selenium in people with liver cirrhosis are needed.

Used for Amount Why
Macular Degeneration
 Refer to label instructions 1 star   Sunlight triggers oxidative damage in the eye, which can cause macular degeneration. Selenium protects against oxidative damage and may reduce macular degeneration risk.

1 star  Macular Degeneration

Sunlight triggers oxidative damage in the eye, which in turn can cause macular degeneration.155 Animals given antioxidants—which protect against oxidative damage—have a lower risk of this vision problem.156 People with high blood levels of antioxidants also have a lower risk.157 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).158 People who eat fruits and vegetables high in beta-carotene, another antioxidant, are also at low risk.159 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.160 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.161

Used for Amount Why
Pre- and Post-Surgery Health
 Refer to label instructions 1 star   Selenium has an important role in immune function and infection prevention, and supplementing with it may correct a postoperative selenium deficiency.

1 star  Pre- and Post-Surgery Health

Selenium is a mineral nutrient with an important role in immune function and infection prevention,162 , 163 , 164 and selenium deficiency has been reported in patients after intestinal surgery.165 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.166

Used for Amount Why
Type 1 Diabetes
(Vitamin A, Vitamin C, Vitamin E)
 Refer to label instructions 1 star   A combination of the antioxidants selenium, vitamin A, vitamin C, and vitamin E has been shown to improve diabetic retinopathy.

1 star  Type 1 Diabetes

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.167 People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.

Used for Amount Why
Type 1 Diabetes and Diabetic Retinopathy
(Vitamin A, Vitamin C, Vitamin E)
 Refer to label instructions 1 star   Antioxidant nutrients including selenium, vitamin A, vitamin C, and vitamin E may combat free radicals associated with diabetic retinopathy.

1 star  Type 1 Diabetes and Diabetic Retinopathy

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.168 People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.

Used for Amount Why
Type 2 Diabetes and Diabetic Neuropathy
(Vitamin A, Vitamin C, Vitamin E)
 Refer to label instructions 1 star   A combination of the antioxidants selenium, vitamin A, vitamin C, and vitamin E has been shown to improve diabetic retinopathy.

1 star  Type 2 Diabetes and Diabetic Neuropathy

Because oxidation damage is believed to play a role in the development of diabetic 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 retinopathy. During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy.169 People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.

How It Works

How to Use It

While the Recommended Dietary Allowance for most adults is 55 mcg per day, an adult intake of 100–200 mcg of selenium per day is recommended by many doctors.

Where to Find It

Brazil nuts are the best source of selenium. Yeast, whole grains, and seafood are also good sources. Animal studies have found that selenium from yeast is better absorbed than selenium in the form of selenite.170

Possible Deficiencies

While most people probably don’t take in enough selenium, gross deficiencies are rare in Western countries. Soils in some areas are selenium-deficient and people who eat foods grown primarily on selenium-poor soils are at risk for deficiency. People with AIDS have been reported to be depleted in selenium.171 Similarly, limited research has reported an association between heart disease and depleted levels of selenium.172 People who are deficient in selenium have an increased risk of developing certain types of rheumatoid arthritis.173

Interactions

Interactions with Supplements, Foods, & Other Compounds

Selenium enhances the antioxidant effect of vitamin E.

Interactions with Medicines

Certain medicines interact with this supplement.

May Be Beneficial: Some medicines may increase the need for this supplement.
Avoid: Some medicines interact with this supplement, so they should not be taken together.
Check: Some interactions between this supplement and certain medicines require more explanation. Click the link to see details.

Note: The following list only includes the generic or class name of a medicine. To find a specific brand name, use the Medicines Index.

May Be Beneficial: Bicalutamide
May Be Beneficial: Busulfan
May Be Beneficial: Capecitabine
May Be Beneficial: Carboplatin
May Be Beneficial: Carmustine
May Be Beneficial: Chlorambucil
May Be Beneficial: Cisplatin
May Be Beneficial: Cladribine
May Be Beneficial: Clozapine
May Be Beneficial: Cortisone
May Be Beneficial: Cyclophosphamide
May Be Beneficial: Cytarabine
May Be Beneficial: Dexamethasone
May Be Beneficial: Docetaxel
May Be Beneficial: Erlotinib
May Be Beneficial: Etoposide
May Be Beneficial: Floxuridine
May Be Beneficial: Fludarabine
May Be Beneficial: Fluorouracil
May Be Beneficial: Hydroxyurea
May Be Beneficial: Ifosfamide
May Be Beneficial: Irinotecan
May Be Beneficial: Lomustine
May Be Beneficial: Mechlorethamine
May Be Beneficial: Melphalan
May Be Beneficial: Mercaptopurine
May Be Beneficial: Methotrexate
May Be Beneficial: Methylprednisolone
May Be Beneficial: Polifeprosan 20 with Carmustine
May Be Beneficial: Prednisolone
May Be Beneficial: Prednisone
May Be Beneficial: Streptozocin
May Be Beneficial: Thioguanine
May Be Beneficial: Thiotepa
May Be Beneficial: Uracil Mustard
May Be Beneficial: Vinblastine
Check: Valproate

Side Effects

Side Effects

Selenium is safe at the level people typically supplement (100–200 mcg); however, taking more than 900 mcg of selenium per day has been reported to cause adverse effects in some people.174 Selenium toxicity can result in loss of fingernails, skin rash, and changes in the nervous system. In the presence of iodine-deficiency-induced goiter, selenium supplementation has been reported to exacerbate low thyroid function.175 Although most research suggests that selenium prevents cancer, one study found an increased risk of a type of skin cancer (squamous cell carcinoma) in people taking selenium supplements.176 The National Academy of Sciences recommends that selenium intake not exceed 400 mcg per day, unless the higher intake is monitored by a healthcare professional.177 In a double-blind study of people who took 200 mcg of selenium per day for several years to prevent recurrences of skin cancer, the incidence of diabetes was higher in people who received selenium (9.7%) than in those who received a placebo (6.5%).178 While this difference was statistically significant, this finding should be considered preliminary, since the study was not originally designed to test whether selenium influences the risk of developing diabetes.

References

1. Stone J, Hinks LJ, Beasley R, et al. Reduced selenium status of patients with asthma. Clin Sci 1989;77:495–500.

2. Flatt A, Pearce N, Thomson CD, et al. Reduced selenium in asthmatic subjects in New Zealand. Thorax 1990;45:95–9.

3. Kadrabova J, Mad’aric A, Kovacikova Z, et al. Selenium status is decreased in patients with intrinsic asthma. Biol Trace Elem Res 1996;52:241–8.

4. Misso NL, Powers KA, Gillon RL, et al. Reduced platelet glutathione peroxidase activity and serum selenium concentration in atopic asthmatic patients. Clin Exp Allergy 1996;26:838–47.

5. Shaw R, Woodman K, Crane J, et al. Risk factors for asthma symptoms in Kawerau children. N Z Med J 1994;107:387–91.

6. Owen S, Pearson D, Suarez-Mendez V, et al. Evidence of free-radical activity in asthma. N Engl J Med 1991;325:586–7 [letter].

7. Hasselmark L, Malmgren R, Zetterstrom O, Unge G. Selenium supplementation in intrinsic asthma. Allergy 1993;48:30–6.

8. Salonen JT et al. Association between cardiovascular death and myocardial infarction and serum selenium in a matched-pair longitudinal study. Lancet 1982;ii:175.

9. Shamberger RJ, Willis CE. Epidemiological studies on selenium and heart disease. Fed Proc 1976;35:578 [abstract #2061].

10. Korpela H, Kumpulainen J, Jussila E, et al. Effect of selenium supplementation after acute myocardial infarction. Res Comm Chem Pathol Pharmacol 1989; 65:249–52.

11. Berger MM, Baines M, Raffoul W, et al. Trace element supplementation after major burns modulates antioxidant status and clinical course by way of increased tissue trace element concentrations. Am J Clin Nutr 2007;85:1293–300.

12. Medina D. Mechanisms of selenium inhibition of tumorigenesis. Adv Exp Med Biol 1986;206:465–72.

13. Beisel WR. Single nutrients and immunity. Am J Clin Nutr 1982;35:417–68.

14. Medina D, Morrison DG. Current ideas on selenium as a chemopreventative agent. Pathol Immunopathol Res 1988;7:187–99.

15. Shamberger RJ, Rukoven E, Lonfield AK, et al. Antioxidants and cancer. I. Selenium in the blood of normals and cancer patients. J Natl Cancer Inst 1973;4:863–70.

16. Burney PGJ, Comstock GW, Morris JS. Serologic precursors of cancer: serum micronutrients and the subsequent risk of pancreatic cancer. Am J Clin Nutr 1989;49:895–900.

17. Toma S, Micheletti A, Giacchero A, et al. Selenium therapy in patients with precancerous and malignant oral cavity lesions: preliminary results. Cancer Detection Prev 1991;15:491–3.

18. Willett WC, Polk BF, Morris JS, et al. Prediagnostic serum Selenium and risk of cancer. Lancet 1983;42:130–4.

19. Helzlsouer KJ, Comstock GW, Morris JS. Selenium, lycopene, alpha-tocopherol, ß-carotene, retinol, and subsequent bladder cancer. Cancer Res 1989;49:6144–8.

20. Jaskiewicz K, Marasas WF, Rossouw JE, et al. Selenium and other mineral elements in populations at risk for esophageal cancer. Cancer 1988;62:2635–9.

21. Knekt P, Aromaa A, Maatela J, et al. Serum selenium and subsequent risk of cancer among Finnish men and women. J Natl Cancer Inst 1990;82:864–8.

22. Yu M-W, Horng I-S, Hsu K-H, et al. Plasma selenium levels and risk of hepatocellular carcinoma among men with chronic hepatitis virus infection. Am J Epidemiol 1999;150:367–74.

23. Knekt P, Marniemi J, Teppo L, et al. Is low selenium status a risk factor for lung cancer? Am J Epidemiol 148:975–82.

24. Scieszka M, Danch A, Machalski M, Drozdz M. Plasma selenium concentration in patients with stomach and colon cancer in the Upper Silesia. Neoplasma 1997;44:395–7.

25. Fex G, Pettersson B, Akesson B. Low plasma selenium as a risk factor for cancer death in middle-aged men. Nutr Cancer 1987;10:221–9.

26. Salonen J, Salonen R, Lappetelainen R, et al. Risk of cancer in relation to serum concentrations of selenium and vitamins A and E; matched case-control analysis of prospective data. BMJ 1985;290:417–20.

27. Clark LC, Combs GF Jr, Turnbull BW, et al. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. JAMA 1996;276:1957–63.

28. Yu B, Wang M, Li D. Chung Hua Wai Ko Tsa Chih 1996;34:50–3.

29. Clark LC, Combs GF Jr, Turnbull BW, et al. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. JAMA 1996;276:1957–63.

30. Finley JW, Penland JG. Adequacy or deprivation of dietary selenium in healthy men: Clinical and psychological findings. J Trace Elem Exp Med 1998;11:11–27.

31. Benton D, Cook R. The impact of selenium supplementation on mood. Biol Psychiatry 1991;29:1092–8.

32. Juhlin L, Edqvist LE, Ekman LG, et al. Blood glutathione-peroxidase levels in skin diseases: effect of selenium and vitamin E treatment. Acta Derm Venereol 1982;62:211–4.

33. Ljunghall K, Juhlin L, Edqvist LE, Plantin LO. Selenium, glutathione-peroxidase and dermatitis herpetiformis. Acta Derm Venereol 1984;64:546–7.

34. Juhlin L, Edqvist LE, Ekman LG, et al. Blood glutathione-peroxidase levels in skin diseases: effect of selenium and vitamin E treatment. Acta Derm Venereol 1982;62:211–4.

35. Ljunghall K, Juhlin L, Edqvist LE, Plantin LO. Selenium, glutathione-peroxidase and dermatitis herpetiformis. Acta Derm Venereol 1984;64:546–7.

36. Micke O, Bruns F, Mucke R, et al. Selenium in the treatment of radiation-associated secondary lymphedema. Int J Radiat Oncol Biol Phys 2003;56:40–9.

37. Auzepy P, Blondeau M, Richard C, et al. Serum selenium deficiency in myocardial infarction and congestive cardiomyopathy. Acta Cardiol 1987;42:161–6.

38. Oster O, Drexler M, Schenk J, et al. The serum selenium concentration of patients with acute myocardial infarction. Ann Clin Res 1986;18:36–42.

39. Beaglehole R, Jackson R, Watkinson J, et al. Decreased blood selenium and risk of myocardial infarction. Int J Epidemiol 1990;19:918–22.

40. Kardinaal AFM, Kok FJ, Kohlmeier L, et al. Association between toenail selenium and risk of acute myocardial infarction in European men. Am J Epidemiol 1997;145:373–9.

41. Salvini S, Hennekenes CH, Morris JS, et al. Plasma levels of the antioxidant selenium and risk of myocardial infarction among U.S. physicians. Am J Cardiol 1995;76:1218–21.

42. Korpela H, Kumpulainen J, Jussila E, et al. Effect of selenium supplementation after acute myocardial infarction. Res Commun Chem Pathol Pharmacol 1989;65:249–52.

43. Kuklinski B, Weissenbacher E, Fahnrich A. Coenzyme Q10 and antioxidants in acute myocardial infarction. Mol Aspects Med 1994;15 Suppl:s143–7.

44. Baum MK, Shor-Posner G, Lai S, et al. High risk of HIV-related mortality is associated with selenium deficiency. J Acquir Immune Defic Syndr Hum Retrovirol 1997;15:370–4.

45. Olmsted L, Schrauzer GN, Flores-Arce M, Dowd J. Selenium supplementation of symptomatic human immunodeficiency virus infected patients. Biol Trace Elem Res 1989;25:89–96.

46. Chariot P, Perchet H, Monnet I. Dilated cardiomyopathy in HIV-infected patients [letter; comment]. N Engl J Med 1999;340:732 (discussion 733–5).

47. Zazzo JF, Lafont A, Darwiche E, et al. Is non-obstructive myocardiopathy (NOMC) in AIDS selenium-deficiency related? In: Neve J, Favier A, eds. Selenium in biology and medicine. W. DeGruyter & Co.: Berlin New York, 1988, 281–2.

48. Pike J, Chandra RK. Effect of vitamin and trace element supplementation on immune indices in healthy elderly. Int J Vitam Nutr Res 1995;65:117–21.

49. Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet 1992;340:1124–7.

50. Chavance M, Herbeth B, Lemoine A, et al. Does multivitamin supplementation prevent infections in healthy elderly subjects? A controlled trial. Int J Vitam Nutr Res 1993;63:11–6.

51. Girodon F, Lombard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab 1997;41:98–107.

52. Berger MM, Spertini F, Shenkin A, et al. Trace element supplementation modulates pulmonary infection rates after major burns: a double-blind, placebo-controlled trial. Am J Clin Nutr 1998;68:365–71.

53. Pike J, Chandra RK. Effect of vitamin and trace element supplementation on immune indices in healthy elderly. Int J Vitam Nutr Res 1995;65:117–21.

54. Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet 1992;340:1124–7.

55. Chavance M, Herbeth B, Lemoine A, et al. Does multivitamin supplementation prevent infections in healthy elderly subjects? A controlled trial. Int J Vitam Nutr Res 1993;63:11–6.

56. Girodon F, Lombard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab 1997;41:98–107.

57. Berger MM, Spertini F, Shenkin A, et al. Trace element supplementation modulates pulmonary infection rates after major burns: a double-blind, placebo-controlled trial. Am J Clin Nutr 1998;68:365–71.

58. Darlow BA, Winterbourn CC, Inder TE, et al. The effect of selenium supplementation on outcome in very low birth weight infants: a randomized controlled trial. The New Zealand Neonatal Study Group. J Pediatr 2000;136:473–80.

59. Medina D. Mechanisms of selenium inhibition of tumorigenesis. Adv Exp Med Biol 1986;206:465–72.

60. Beisel WR. Single nutrients and immunity. Am J Clin Nutr 1982;35:417–68.

61. Medina D, Morrison DG. Current ideas on selenium as a chemopreventative agent. Pathol Immunopathol Res 1988;7:187–99.

62. Shamberger RJ, Rukoven E, Lonfield AK, et al. Antioxidants and cancer. I. Selenium in the blood of normals and cancer patients. J Natl Cancer Inst 1973;4:863–70.

63. Burney PGJ, Comstock GW, Morris JS. Serologic precursors of cancer: serum micronutrients and the subsequent risk of pancreatic cancer. Am J Clin Nutr 1989;49:895–900.

64. Toma S, Micheletti A, Giacchero A, et al. Selenium therapy in patients with precancerous and malignant oral cavity lesions: preliminary results. Cancer Detection Prev 1991;15:491–3.

65. Willett WC, Polk BF, Morris JS, et al. Prediagnostic serum Selenium and risk of cancer. Lancet 1983;42:130–4.

66. Helzlsouer KJ, Comstock GW, Morris JS. Selenium, lycopene, alpha-tocopherol, ß-carotene, retinol, and subsequent bladder cancer. Cancer Res 1989;49:6144–8.

67. Jaskiewicz K, Marasas WF, Rossouw JE, et al. Selenium and other mineral elements in populations at risk for esophageal cancer. Cancer 1988;62:2635–9.

68. Knekt P, Aromaa A, Maatela J, et al. Serum selenium and subsequent risk of cancer among Finnish men and women. J Natl Cancer Inst 1990;82:864–8.

69. Yu M-W, Horng I-S, Hsu K-H, et al. Plasma selenium levels and risk of hepatocellular carcinoma among men with chronic hepatitis virus infection. Am J Epidemiol 1999;150:367–74.

70. Scieszka M, Danch A, Machalski M, Drozdz M. Plasma selenium concentration in patients with stomach and colon cancer in the Upper Silesia. Neoplasma 1997;44:395–7.

71. Knekt P, Marniemi J, Teppo L, et al. Is low selenium status a risk factor for lung cancer? Am J Epidemiol 148:975–82.

72. Fex G, Pettersson B, Akesson B. Low plasma selenium as a risk factor for cancer death in middle-aged men. Nutr Cancer 1987;10:221–9.

73. Salonen J, Salonen R, Lappetelainen R, et al. Risk of cancer in relation to serum concentrations of selenium and vitamins A and E; matched case-control analysis of prospective data. BMJ 1985;290:417–20.

74. Clark LC, Combs GF Jr, Turnbull BW, et al. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. JAMA 1996;276:1957–63.

75. Scott R, MacPherson A, Yates RWS, et al. The effect of oral selenium supplementation on human sperm motility. Br J Urol 1998;82:76–80.

76. Reich, CJ. Vitamin E, selenium, and knee problems. Lancet 1976;i:257 [letter].

77. Wright JW. Personal correspondence, April 1997.

78. Agostoni C, Marangoni F, Riva E, et al. Plasma arachidonic acid and serum thromboxane B2 concentrations in phenylketonuric children negatively correlate with dietary compliance. Prostaglandins Leukot Essent Fatty Acids 1997;56:219–22.

79. Giovannini M, Agostoni C, Biasucci G, et al. Fatty acid metabolism in phenylketonuria. Eur J Pediatr 1996;155 Suppl 1:S132–5.

80. Poge AP, Baumann K, Muller E, et al. Long-chain polyunsaturated fatty acids in plasma and erythrocyte membrane lipids of children with phenylketonuria after controlled linoleic acid intake. J Inherit Metab Dis 1998;21:373–81.

81. Jochum F, Terwolbeck K, Meinhold H, et al. Effects of a low selenium state in patients with phenylketonuria. Acta Paediatr 1997;86:775–7.

82. Kauf E, Seidel J, Winnefeld K, et al. Selenium in phenylketonuria patients. Effects of sodium selenite administration. Med Klin 1997;92 Suppl 3:31–4 [in German].

83. Sierra C, Vilaseca MA, Moyano D, et al. Antioxidant status in hyperphenylalaninemia. Clin Chim Acta 1998;276:1–9.

84. Gropper SS, Naglak MC, Nardella M, et al. Nutrient intakes of adolescents with phenylketonuria and infants and children with maple syrup urine disease on semisynthetic diets. J Am Coll Nutr 1993;12:108–14.

85. Hanley WB, Feigenbaum AS, Clarke JT, et al. Vitamin B12 deficiency in adolescents and young adults with phenylketonuria. Eur J Pediatr 1996;155 Suppl 1:S145–7.

86. Schulpis KH, Platokouki H, Papakonstantinou ED, et al. Haemostatic variables in phenylketonuric children under dietary treatment. J Inherit Metab Dis 1996;19:603–9.

87. Sierra C, Vilaseca MA, Moyano D, et al. Antioxidant status in hyperphenylalaninemia. Clin Chim Acta 1998;276:1–9.

88. Kauf E, Seidel J, Winnefeld K, et al. Selenium in phenylketonuria patients. Effects of sodium selenite administration. Med Klin 1997;92 Suppl 3:31–4 [in German].

89. Lombeck I, Jochum F, Terwolbeck K. Selenium status in infants and children with phenylketonuria and in maternal phenylketonuria. Eur J Pediatr 1996;155 Suppl 1:S140–4.

90. Medina D. Mechanisms of selenium inhibition of tumorigenesis. Adv Exp Med Biol 1986;206:465–72.

91. Beisel WR. Single nutrients and immunity. Am J Clin Nutr 1982;35:417–68.

92. Medina D, Morrison DG. Current ideas on selenium as a chemopreventative agent. Pathol Immunopathol Res 1988;7:187–99.

93. Shamberger RJ, Rukoven E, Lonfield AK, et al. Antioxidants and cancer. I. Selenium in the blood of normals and cancer patients. J Natl Cancer Inst 1973;4:863–70.

94. Willett WC, Polk BF, Morris JS, et al. Prediagnostic serum Selenium and risk of cancer. Lancet 1983;42:130–4.

95. Fex G, Pettersson B, Akesson B. Low plasma selenium as a risk factor for cancer death in middle-aged men. Nutr Cancer 1987;10:221–9.

96. Salonen J, Salonen R, Lappetelainen R, et al. Risk of cancer in relation to serum concentrations of selenium and vitamins A and E; matched case-control analysis of prospective data. BMJ 1985;290:417–20.

97. Clark LC, Combs GF Jr, Turnbull BW, et al. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. JAMA 1996;276:1957–63.

98. Clark LC, Combs GF Jr, Turnbull BW, et al. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. JAMA 1996;276:1957–63.

99. Lippman SM, Klein EA, Goodman PJ, et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2009;301:39–51.

100. Meyer F, Galan P, Douville P, et al. Antioxidant vitamin and mineral supplementation and prostate cancer prevention in the SU.VI.MAX trial. Int J Cancer 2005;116:182–6.

101. Stratton MS, Algotar AM, Ranger-Moore J, et al. Oral selenium supplementation has no effect on prostate-specific antigen velocity in men undergoing active surveillance for localized prostate cancer. Cancer Prev Res 2010;3:1035–43.

102. Tarp U, Overvad K, Hansen JC, Thorling EB. Low selenium level in severe rheumatoid arthritis. Scand J Rheumatol 1985;14:97–101.

103. Aaseth J, Munthe E, Forre O, Steinnes E. Trace elements in serum and urine of patients with rheumatoid arthritis. Scand J Rheumatol 1978;7:237–40.

104. Peretz A, Neve J, Duchateau J, Famaey JP. Adjuvant treatment of recent onset rheumatoid arthritis by selenium supplementation: preliminary observations. Br J Rheumatol 1992;31:281–2 [letter].

105. Tarp U, Overvad K, Thorling EB, et al. Selenium treatment in rheumatoid arthritis. Scand J Rheumatol 1985;14:364–8.

106. Dawson EB, Nosovitch JT, Hannigan EV. Serum vitamin and selenium changes in cervical dysplasia. Fed Proc 1984;43:612.

107. Wassertheil-Smoller S, Romney SL, Wylie-Rosett J, et al. Dietary vitamin C and uterine cervical dysplasia. Am J Epidemiol 1981;114:714–24.

108. Ho GY, Palan PR, Basu J, et al. Viral characteristics of human papillomavirus infection and antioxidant levels as risk factors for cervical dysplasia. Int J Cancer 1998;78:594–9.

109. Ames BN, Shigenaga MK, Hagen TM. Oxidants, antioxidants, and the degenerative diseases of aging. Proc Natl Acad Sci 1993;90:7915-22.

110. Grievink L, Zijlstra AG, Ke X, Brunekreef B. Double-blind intervention trial on modulation of ozone effects on pulmonary function by antioxidant supplements. Am J Epidemiol 1999;149:306-14.

111. Trenga CA, Koenig JQ, Williams PV. Dietary antioxidants and ozone-induced bronchial hyperresponsiveness in adults with asthma. Arch Environ Health 2001;56:242-9.

112. Romieu I, Sienra-Monge JJ, Ramirez-Aguilar M, Tellez-Rojo MM, Moreno-Macias H, Reyes-Ruiz NI, et al. Antioxidant supplementation and lung functions among children with asthma exposed to high levels of air pollutants. Am J Respir Crit Care Med 2002;166:703-9.

113. Lehr D. A possible beneficial effect of selenium administration in antiarrhythmic therapy. J Am Coll Nutr 1994;13:496–8.

114. Auzepy P, Blondeau M, Richard C, et al. Serum selenium deficiency in myocardial infarction and congestive cardiomyopathy. Acta Cardiol 1987;42:161–6.

115. Oster O, Prellwitz W, Kasper W, Meinertz T. Congestive cardiomyopathy and the selenium content of serum. Clin Chim Acta 1983;29(128):125–32.

116. Xu GL, Wang SC, Gu BQ, et al. Further investigation on the role of selenium deficiency in the aetiology and pathogenesis of Keshan disease. Biomed Environ Sci 1997;10:316–26.

117. Neve J. Selenium as a risk factor for cardiovascular diseases. J Cardiovasc Risk 1996;3:42–7.

118. Collipp PJ, Chen SY. Cardiomyopathy and selenium deficiency in a two-year-old girl. N Engl J Med 1981;304:1304–5 [letter].

119. Raines DA, Kinsara AJ, Eid Fawzy M, et al. Plasma and urinary selenium in Saudi Arabian patients with dilated cardiomyopathy. Biol Trace Elem Res 1999;69:59–68.

120. Ikram H, Crozier IG, Webster M, Low CJ. The role of selenium deficiency in occidental dilated cardiomyopathy. N Z Med J 1989;102:100–2.

121. Chou HT, Yang HL, Tsou SS,et al. Status of trace elements in patients with idiopathic dilated cardiomyopathy in central Taiwan. Chung Hua I Hsueh Tsa Chih (Taipei) 1998;61:193–8.

122. Levander OA, Beck MA. Selenium and viral virulence. Br Med Bull 1999;55:528–33.

123. Beck MA, Levander OA. Host nutritional status and its effect on a viral pathogen. J Infect Dis 2000;182:S93–S96 [review].

124. Beck MA. Nutritionally induced oxidative stress: effect on viral disease. Am J Clin Nutr 2000;71:1676S–81S [review].

125. Beck MA. Selenium and host defence towards viruses. Proc Nutr Soc 1999;58:707–11 [review].

126. Beck MA, Levander OA. Dietary oxidative stress and the potentiation of viral infection. Annu Rev Nutr 1998;18:93–116 [review].

127. Liu X, Yin S, Li G. Effects of selenium supplement on acute lower respiratory tract infection caused by respiratory syncytial virus. Chung Hua Yu Fang I Hsueh Tsa Chih 1997;31:358–61 [in Chinese].

128. Teksen F, Sayli BS, Aydin A, et al. Antioxidative metabolism in Down syndrome. Biol Trace Elem Res 1998;63:123–7.

129. Kadrabova J, Madaric A, Sustrova M, Ginter E. Changed serum trace element profile in Down’s syndrome. Biol Trace Elem Res 1996;54:201–6.

130. Neve J, Sinet PM, Molle L, Nicole A. Selenium, zinc and copper in Down’s syndrome (trisomy 21): blood levels and relations with glutathione peroxidase and superoxide dismutase. Clin Chim Acta 1983;133:209–14.

131. Purice M, Maximilian C, Dumitriu I, Ioan D. Zinc and copper in plasma and erythrocytes of Down’s syndrome children. Endocrinologie 1988;26:113–7.

132. Bruhl HH, Foni J, Lee YH, Madow A. Plasma concentrations of magnesium, lead, lithium, copper, and zinc in mentally retarded persons. Am J Ment Defic 1987;92:103–11.

133. Anneren G, Johansson E, Lindh U. Trace element profiles in individual blood cells from patients with Down’s syndrome. Acta Paediatr Scand 1985;74:259–63.

134. Stabile A, Pesaresi MA, Stabile AM, et al. Immunodeficiency and plasma zinc levels in children with Down’s syndrome: a long-term follow-up of oral zinc supplementation. Clin Immunol Immunopathol 1991;58:207–16.

135. Anneren G, Gebre-Medhin M. Trace elements and transport proteins in serum of children with Down syndrome and of healthy siblings living in the same environment. Hum Nutr Clin Nutr 1987;41:291–9.

136. Antila E, Nordberg UR, Syvaoja EL, Westermarck T. Selenium therapy in Down syndrome (DS): a theory and a clinical trial. Adv Exp Med Biol 1990;264:183–6.

137. Stabile A, Pesaresi MA, Stabile AM, et al. Immunodeficiency and plasma zinc levels in children with Down’s syndrome: a long-term follow-up of oral zinc supplementation. Clin Immunol Immunopathol 1991;58:207–16.

138. Licastro F, Chiricolo M, Mocchegiani E, et al. Oral zinc supplementation in Down’s syndrome subjects decreased infections and normalized some humoral and cellular immune parameters. J Intellect Disabil Res 1994;38:149–62.

139. Franceschi C, Chiricolo M, Licastro F, et al. Oral zinc supplementation in Down’s syndrome: restoration of thymic endocrine activity and of some immune defects. J Ment Defic Res 1988;32:169–81.

140. Lockitch G, Puterman M, Godolphin W, et al. Infection and immunity in Down syndrome: a trial of long-term low oral doses of zinc. J Pediatr 1989;114:781–7.

141. Bucci I, Napolitano G, Giuliani C, et al. Zinc sulfate supplementation improves thyroid function in hypozincemic Down children. Biol Trace Elem Res 1999;67:257–68.

142. Licastro F, Mocchegiani E, Zannotti M, et al. Zinc affects the metabolism of thyroid hormones in children with Down’s syndrome: normalization of thyroid stimulating hormone and of reversal triiodothyronine plasmic levels by dietary zinc supplementation. Int J Neurosci 1992;65:259–68.

143. Napolitano G, Palka G, Lio S, et al. Is zinc deficiency a cause of subclinical hypothyroidism in Down syndrome? Ann Genet 1990;33:9–15.

144. Napolitano G, Palka G, Grimaldi S, et al. Growth delay in Down syndrome and zinc sulphate supplementation. Am J Med Genet Suppl 1990;7:63–5.

145. Vaananen MK, Markkanen HA, Tuovinen VJ, et al. Periodontal health related to plasma ascorbic acid. Proc Finn Dent Soc 1993;89:51–9.

146. Murray M, Pizzorno J. Encyclopedia of Natural Medicine, rev2d ed. Rocklin, CA: Prima Publishing, 1998, 722–9.

147. Pack AR. Folate mouthwash: effects on established gingivitis in periodontal patients. J Clin Periodontol 1984;11:619–28.

148. Berkson BM. A conservative triple antioxidant approach to the treatment of hepatitis C. Combination of Alpha lipoic acid (thioctic acid), silymarin, and selenium: three case histories. Med Klin 1999;94 Suppl 3:84–9.

149. Thilly CH, Swennen B, Bourdoux P, et al. The epidemiology of iodine-deficiency disorders in relation to goitrogenic factors and thyroid-stimulating-hormone regulation. Am J Clin Nutr 1993;57(2 Suppl):267S–70S.

150. Contempre B, Dumont JE, Ngo B, et al. Effect of selenium supplementation in hypothyroid subjects of an iodine and selenium deficient area: the possible danger of indiscriminate supplementation of iodine-deficient subjects with selenium. J Clin Endocrinol Metab 1991;73:213–5.

151. Vanderpas JB, Contempre B, Duale NL, et al. Selenium deficiency mitigates hypothyroxinemia in iodine-deficient subjects. Am J Clin Nutr 1993;57(2 suppl):271S–5S [review].

152. Burk RF, Early DS, Hill KE, et al. Plasma selenium in patients with cirrhosis. Hepatology 1998;27:794–8.

153. Feher J, Lengyel G, Blazovics A. Oxidative stress in the liver and biliary tract diseases. Scand J Gastroenterol Suppl 1998;228:38–46.

154. Van Gossum A, Neve J. Low selenium status in alcoholic cirrhosis is correlated with aminopyrine breath test. Preliminary effects of selenium supplementation. Biol Trace Elem Res 1995;47:201–7.

155. Young RW. Solar radiation and age-related macular degeneration. Surv Ophthalmol 1988:32:252–69.

156. Katz ML, Parker KR, Handelman GJ, et al. Effects of antioxidant nutrient deficiency on the retina and retinal pigment epithelium of albino rats: a light and electron microscopic study. Exp Eye Res 1982;34:339–69.

157. West S, Vitale S, Hallfrisch J, et al. Are anti-oxidants or supplements protective of age-related macular degeneration? Arch Ophthalmol 1994:112:222–7.

158. Eye Disease Case-Control Study Group. Antioxidant status and neovascular age-related macular degeneration. Arch Ophthalmol 1993:111:104–9.

159. Goldberg J, Flowerdew G, Smith E, et al. Factors associated with age-related macular degeneration. Am J Epidemiol 1988:128:700–10.

160. Smith W, Mitchell P, Webb K, Leeder SR. Dietary antioxidants and age-related maculopathy: the Blue Mountains Eye Study. Ophthalmology 1999;106:761–7.

161. Teikari JM, Laatikainen L, Virtamo J, et al. Six-year supplementation with alpha-tocopherol and beta-carotene and age-related maculopathy. Acta Ophthalmol Scand 1998;76:224–9.

162. McKenzie RC, Rafferty TS, Beckett GJ. Selenium: an essential element for immune function. Immunol Today 1998;19:342–5 [review].

163. Hughes DA. Effects of dietary antioxidants on the immune function of middle-aged adults. Proc Nutr Soc 1999;58:79–84 [review].

164. Lesourd BM. Nutrition and immunity in the elderly: modification of immune responses with nutritional treatments. Am J Clin Nutr 1997;66:478S–84S [review].

165. Gjorup I, Gjorup T, Andersen B. Serum selenium and zinc concentrations in morbid obesity. Comparison of controls and patients with jejunoileal bypass. Scand J Gastroenterol 1988;23:1250–2.

166. Lehmann C, Egerer K, Weber M, et al. Effect of selenium administration on various laboratory parameters of patients at risk for sepsis syndrome. Med Klin 1997;92:14–6 [in German].

167. Crary EJ, McCarty MF. Potential clinical applications for high-dose nutritional antioxidants. Med Hypotheses 1984;13:77–98.

168. Crary EJ, McCarty MF. Potential clinical applications for high-dose nutritional antioxidants. Med Hypotheses 1984;13:77–98.

169. Crary EJ, McCarty MF. Potential clinical applications for high-dose nutritional antioxidants. Med Hypotheses 1984;13:77–98.

170. Yoshida M, Fukunaga K, Tsuchita H, Yasumoto K. An evaluation of the bioavailability of selenium in high-selenium yeast. J Nutr Sci Vitaminol 1999;45:119–28.

171. Dworkin BM. Selenium deficiency in HIV infection and the acquired immunodeficiency syndrome (AIDS). Chem Biol Iteract 1994;91:181–6.

172. Moore JA, Noiva R, Wells IC. Selenium concentrations in plasma of patients with arteriographically defined coronary atherosclerosis. Clin Chem 1984;30:1171–3.

173. Knekt P, Heliovaara M, Aho K, et al. Serum selenium, serum alpha-tocopherol, and the risk of rheumatoid arthritis. Epidemiology 2000;11:402–5.

174. Yang GQ, Zhou RH. Further observations on the human maximum safe dietary selenium intake in a seleniferous area of China. J Trace Elem Electrolytes Hlth Dis 1994;8:159–65.

175. Contempre B, Dumont JE, Ngo B, et al. Effects of selenium supplementation in hypothyroid subjects of an iodine and selenium deficient area: The possible danger of indiscriminate supplementation of iodine deficient subjects with selenium. J Clin Endocrinol Metabol 1991;73:213–5.

176. Duffield-Lillico AJ, Slate EH, Reid ME, et al. Selenium supplementation and secondary prevention of nonmelanoma skin cancer in a randomized trial. J Natl Cancer Inst 2003;95:1477–81.

177. Panel on Dietary Antioxidants and Related Compounds, Food and Nutrition Board, Institute of Medicine, National Academy of Sciences. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. National Academy Press, Washington, D.C., 2000.

178. Stranges S, Marshall JR, Natarajan R, et al. Effects of long-term selenium supplementation on the incidence of type 2 diabetes: a randomized trial. Ann Intern Med 2007;147:217–23.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.