Selenium treatment in autoimmune thyroiditis: 9-month follow-up with variable doses

The aim of this study is to investigate the long-term (9 months) effects of variable doses (200/100 mu g/day) of L-selenomethionine on autoimmune thyroiditis (AIT) and the parameters affecting the success rate of this therapy. The present study was designed in three steps: (1) 88 female patients with AIT (mean age = 40(.)1 +/- 13(.)3 years) were randomized into two groups according to their initial serum TSH, thyroid peroxidase antibody (TPOAb) concentrations, and age. All the patients were receiving L-thyroxine to keep serum TSH <= 2 mIU/1. Group S2 (n = 48, mean TPOAb = 803(.)9 +/- 483(.)8 IU/ml) received 200 mu g L-selenomethionine per day, orally for 3 months, and group C (n=40, mean TPOAb=770(.)3 +/- 406(.)2 IU/ml) received placebo. (2) 40 volunteers of group S2 were randomized into two age- and TPOAb-matched groups. Group S22 (n = 20) went on taking L-selenomethionine 200 mu g/day, while others (group S21) lowered the dose to 100 mu g/day. (3) 12 patients of group S22 (group S222) went on taking L-Selenomethionine 200 mu g/day, while 12 patients of group S21 (S212) increased the dose to 200 mu g/day. Serum titers of TPOAb decreased significantly in group S2 (26(.)2%, P < 0(.)001), group S22 (23(.)7%, P < 0(.)01) and group S212 (30(.)3%, P < 0(.)01). There were no significant changes in group C and group S222 (P > 0(.)05). TPOAb titers increased significantly in group S21 (38(.)1 %, P < 0(.)01). A significant decrease in thyroglobulin antibody titers was only noted in group S2 (5(.)2%, P < 0(.)01). L-Selenornethionine substitution suppresses serum concentrations of TPOAb in patients with AIT, but suppression requires doses higher than 100 mu g/day which is sufficient to maximize glutathione peroxidase activities. The suppression rate decreases with time.