Selenium deficiency is one of the most common nutrient deficiencies that I see in people with Hashimoto’s, and research suggests that thyroid disease is linked to selenium deficiency.
In my clinical experience, most people with Hashimoto’s have a deficiency in selenium, and being deficient in this key thyroid nutrient is a very common and widely recognized trigger of autoimmune thyroid conditions!
The good news is that supplementing with selenium at a therapeutic dosage, has been found to reduce thyroid antibodies, reduce thyroid symptoms, and improve overall well-being. (1-3)
When I surveyed my Root Cause readers, 63 percent of respondents said that taking a selenium supplement helped them feel better.
As an added bonus, selenium has been shown to help reduce anxiety as well. I remember my own disbelief when, after taking selenium supplements, my frequent panic attacks completely disappeared! You may not have even realized that the anxiety you are being treated for is a very common thyroid symptom, but it is.
Interestingly, a 2004 study found an association between the presence of an anxiety or mood disorder, and the presence of thyroid peroxidase (TPO) antibodies. (4)
Because selenium can reduce thyroid antibodies, I believe this is why it can help with thyroid-related anxiety. Many of my clients who come to me already taking anxiety medications, have been able to wean off them completely, under the guidance of their physicians, after implementing my recommended interventions.
Beyond Hashimoto’s, other populations at risk for selenium deficiency include: people on certain diets (grain-free, gluten-free – just the type of diets that we usually find to be helpful for those with Hashimoto’s!), people with celiac disease or gluten sensitivities, those with IBS or Graves’ disease, women who are pregnant or experiencing postpartum thyroiditis, and people with thyroid eye disease. (5-8)
Why such an impact on so many? Selenium is vital to our body’s ability to convert T4 to T3, and has a balancing effect on our thyroid and immune health. It also plays an important role in managing our oxidative stress within the thyroid, through a complex relationship with iodine, which I’ll discuss in more detail in this article. Additionally, new research has shown that selenium may have synergistic benefits, when used alongside myo-inositol. (9-12)
Research has shown that the optimal intake of selenium is difficult to get through diet alone, especially if you are like many people with Hashimoto’s who experience gut issues that cause poor nutrient absorption.
Absorption challenges can even be seen with supplementation, so it’s important to address this issue for optimal selenium levels.
In this article, you’ll discover:
- The link between selenium and thyroid health
- How selenium supplementation can reduce your symptoms
- The connection between selenium levels and anxiety symptoms
- How to optimize your intake of selenium
- Synergistic benefits of selenium and myo-inositol
The Link Between Selenium and Thyroid Health
Selenium is an important trace element and antioxidant required for healthy thyroid hormone synthesis and metabolism. The human thyroid gland has been found to have the highest content of selenium per gram of tissue among all the organs in the human body. Selenium supports the conversion of your body’s inactive thyroid hormone thyroxine (T4) into triiodothyronine (T3), the biologically active form your body needs. It protects your body’s thyroid cells from oxidative damage during this process. (13)
I’ll talk more about selenium’s role during the thyroid hormone conversion process, its relationship with iodine levels, and how it can be a trigger for Hashimoto’s. But first, let me review why selenium deficiencies are so commonly seen in Hashimoto’s in the first place.
We see many nutrient deficiencies in people with Hashimoto’s. I also believe that these types of nutrient issues are not just happening in Hashimoto’s, but are generally applicable to just about everyone these days. Unfortunately, too many people in the United States eat an overly processed and gut-unfriendly Western diet, which often leads to food sensitivity reactions, digestion issues, gut permeability problems, and other nutrient absorption challenges. Add to that the toxins in our everyday environment, stress, and other real world impacts… and it is no wonder that our bodies are not functioning optimally.
Most of my clients come to me with one or more deficiencies in the key nutrients important for proper thyroid function, including: iron/ferritin and B12 (both associated with anemia), vitamin D, thiamine, and magnesium. Selenium is also high on this list.
The three-legged stool of autoimmune disease theory states that you need to meet three requirements in order to have an autoimmune disease such as Hashimoto’s: a genetic predisposition, gut permeability issues (like leaky gut), and one or more environmental triggers. So, gut permeability problems are inherent in someone with Hashimoto’s, which leads to poor nutrient extraction and absorption. (14)
When people with Hashimoto’s embark on a gluten-free diet to heal their gut permeability issues, they may inadvertently worsen their selenium deficiency. While the gluten-free diet has been found to improve Hashimoto’s symptoms and reduce the autoimmune attack on the thyroid, it’s important to note that selenium deficiency can be caused or worsened by gluten and grain-free diets, as demonstrated in nutritional studies involving people with celiac disease. (15, 16)
Thus, a selenium deficiency may prevent someone who is already on a gluten-free diet from feeling better.
We also know from the research that many symptoms of Hashimoto’s, such as my own experience with low stomach acid while dealing with acid reflux and trying every acid blocker known to mankind, are correlated with nutrient deficiencies. The list of symptoms and root causes is long here (gut infections, stress, toxins, etc.), and so many of them can affect nutrient absorption!
Selenium absorption and intake are affected by many of these same triggers and conditions, likely resulting in the deficiency being seen so often in Hashimoto’s.
How Selenium Deficiency Can Trigger Hashimoto’s
It can be a bit complicated, but it’s worth spending a few minutes talking about how a deficiency in selenium can be a trigger for Hashimoto’s. It’s also important to understand the iodine piece of this, as high levels of iodine can increase the risk for selenium deficiency.
Adequate levels of both iodine and selenium are required for optimal thyroid hormone metabolism. Thyroxine (T4) is produced by the thyroid gland in ample amounts, but is relatively biologically inactive. Therefore, triiodothyronine (T3), the biologically active thyroid hormone, must be produced by a hormone conversion process, converting T4 to T3. This conversion occurs mostly in the liver and iodine supports this process.
The antioxidant selenium is required during this conversion process, its role being to neutralize the toxic build-up of hydrogen peroxide (H2O2) which is produced as a by-product of the hormone conversion.
Remember I mentioned that the thyroid contained the highest amount of selenium in the body?
This high concentration of selenium in the thyroid gland is incorporated into proteins called selenoproteins. There are many different types of selenoproteins that focus on different functions relating to thyroid and immune system support. Some types of selenoproteins make the antioxidant glutathione peroxidase, which specifically removes the excess hydrogen peroxide produced during the thyroid hormone T4 to T3 conversion process. Glutathione peroxidase breaks down the hydrogen peroxide into water particles. This allows for the removal of any cells affected by oxidative damage.
This removal process is important, as hydrogen peroxide is a reactive oxygen species, which causes oxidative damage and inflammation. The build-up of reactive oxygen species in cells can cause damage to DNA or even cell death. Selenium’s job of neutralizing the hydrogen peroxide produced during thyroid hormone conversion (via the actions of glutathione peroxidase), becomes even more critical when a person has high iodine levels.
In the case of too much iodine, a greater amount of hydrogen peroxide is created. So even if your selenium levels are “normal,” too much iodine creates a relative selenium deficiency in the body. In other words, there is too much iodine and too much hydrogen peroxide for the “normal” level of selenium/glutathione peroxidase to deal with, so a toxic build-up of hydrogen peroxide occurs. And that is worsened even more if a person is also deficient in selenium.
When the reactive hydrogen peroxide is left unchecked, it causes oxidative damage and inflammation of the surrounding thyroid tissues. This inflammation triggers lymphocytes or white blood cells (WBCs) to converge for clean-up. (17-20)
As the WBCs converge, small amounts of antibodies are formed to help mark the damaged cells that need to be cleaned up. In instances of higher turnovers of cells seen with excess oxidative damage (due to iodine excess and selenium deficiency), more antibodies are produced, and an immune system shift can be induced. The shift can result in the failure to distinguish self from non-self.
This is how autoimmunity starts. Thus, selenium deficiency has also been recognized as a risk factor for Hashimoto’s. In fact, selenium deficiency has been particularly associated with autoimmune disorders in general. But selenium supplementation has also been shown to halt this progression. (21-23)
In a study performed using mice, autoimmune thyroiditis was induced by iodine, but the development of the autoimmune disease was prevented when selenium was administered. Selenium reduced the number of thyroid antibodies while increasing the number of regulatory T cells (which help the immune system recognize itself and prevent WBC infiltration of the thyroid cells). (24)
Here’s a helpful graphic which shows what is going on during thyroid hormone synthesis when there is both selenium deficiency as well as excess iodine:
After autoimmunity occurs, this T4 to T3 conversion can continue to be impaired, leading to decreased production of thyroid hormones. The decreased production results in the stimulation of the hypothalamic-pituitary axis, increasing TSH production. This in turn stimulates the selenoproteins to convert more T4, and the hydrogen peroxide continues to build up instead of being neutralized. More of it accumulates in thyroid tissue, creating further damage. (25, 26)
With this explanation in hand, let’s now talk about some of the research that has been done regarding the optimization of selenium in people with various thyroid issues, including Hashimoto’s, selenium’s synergistic effects with myo-inositol, hypothyroidism relating to pregnancy, and autoimmune hyperthyroidism (Graves’ disease). We’ll also talk about the connection between selenium deficiency and anxiety.
Thyroid Benefits of Selenium Supplementation
Selenium Supplementation and Hashimoto’s
Research suggests that selenium supplementation for people with Hashimoto’s is associated with a reduction in TPO antibody levels, improved thyroid ultrasound features, and improved quality of life. In fact, thyroid antibodies in people with Hashimoto’s have been shown to be reduced by 40 percent in three to six months, with therapeutic doses of selenium. (27)
But before digging into the research on this topic, let’s remember the importance of reducing thyroid antibodies, even if TSH levels may be telling us that we don’t have a thyroid problem.
I’ve found antibodies are an early warning system for Hashimoto’s, with positive antibody levels seen years before someone may see abnormal levels for their TSH. Research suggests that 80 to 90 percent of people with Hashimoto’s will have elevated TPO or TG antibodies, or both. (28)
A reduction in antibodies can result in people feeling better, and interventions such as nutrient supplementation can have fast results!
Years ago, before I was diagnosed with my own thyroid issues, I had not had my antibodies tested, only my TSH, which was deemed normal (even though it was 4.5 μIU/mL and I now know that the optimal range is 0.5-2.0 μIU/mL for most women of childbearing age). I struggled for almost a decade until finally being tested for TPO antibodies. At that time, my antibodies tested in the 2000 IU/mL range. (Note: the optimal range is less than 2 IU/mL!) Once I was diagnosed and started focusing on addressing my root causes, I was able to reduce my antibodies and finally start feeling better.
There are many interventions that are associated with a reduction in both antibodies as well as symptoms. If you’d like to read more about antibodies (how you can easily test for them, and interventions to reduce them, for example), check out this article on the importance of thyroid antibodies.
Now on to the research showing that selenium supplementation – at consistent, therapeutic levels – has been shown to reduce thyroid antibodies, improve thyroid symptoms, and make people feel better.
In a 2002 study led by Dr. Roland Gärtner, 71 patients with Hashimoto’s (who also had high levels of antibodies) were treated. Half of the participants were given selenium supplementation at a dosage of 200 mcg per day, along with levothyroxine, for a 90-day period. The other half was only given levothyroxine and a placebo. Those with selenium supplementation showed a 40 percent decrease in TPO antibodies. The other group (placebo group) only showed a 10 percent decrease. In 24 percent of those taking a selenium supplement, antibody levels completely normalized! Those taking supplementation also reported better well-being compared to the placebo group. (29, 30)
In a follow-up study by the same researchers, four groups were created from the initial 71 patients who agreed to participate in the first study. One group continued to take selenium, and their TPO concentrations continued to decrease. Another group who had been taking selenium supplementation was removed from it, and their antibodies significantly increased. A group who had not been originally taking supplementation started it, and their antibodies decreased. The final group had not been taking selenium, continued to not take it, and their antibodies remained the same. (31)
Another study from Greece evaluated the effects of selenium supplementation (200 mcg/day) in patients suffering from amiodarone-induced thyrotoxicosis (AIT). AIT is a side effect for people taking the antiarrhythmic drug amiodarone, as the drug contains iodine. After 6 months of treatment, a 9.9 percent reduction of TPO antibodies was observed. Afterwards, supplementation in one group was continued, resulting in further decreases in antibodies; while in the other group, supplementation was stopped, and an increase in antibodies occurred. (32)
(I’ve written an article about thyroid toxic drugs and their alternatives if you want to cross-check it with your medication list.)
Findings that suggest that thyroid antibodies can be reduced with therapeutic dosages of selenium supplementation (despite an increased intake of iodine) have been supported by additional studies relating to Hashimoto’s.
Synergistic Effects With Myo-Inositol
In most of the studies on myo-inositol and Hashimoto’s, myo-inositol has been evaluated in conjunction with selenium.
Research has shown that a combination of selenium and myo-inositol can have a synergistic effect that maximizes the benefit to thyroid function — consuming both of these together may not just reduce thyroid antibodies, but can also reduce TSH by an average of 30 percent. In some cases, this can normalize TSH levels (both for low and high TSH levels), reduce the risk of developing overt hypothyroidism, and improve overall well-being for those who have Hashimoto’s. (33-37)
Today’s research strongly points to the benefits of taking both together. (38)
In one study done in 2013, patients with autoimmune thyroiditis were split into two groups, with one group being treated with 600 mg of myo-inositol and 83 mcg of selenium (selenomethionine) per day for 6 months, and the other being treated with just 83 mcg of selenium. While both groups showed a decrease in thyroid antibodies, the group treated with myo-inositol also experienced a 31 percent reduction in TSH levels! The selenium group showed no change in TSH levels.
The group taking the myo-inositol and selenium also showed a 44 percent reduction in thyroid antibodies, while the group taking selenium alone showed a 42 percent reduction in antibodies — not a huge difference here; however, interestingly, thyroglobulin was reduced by 48 percent with the myo-inositol/selenium combination, versus 38 percent with just selenium alone.
Some people actually went into remission after starting the myo-inositol, with thyroid antibodies testing below the levels associated with Hashimoto’s. The results weren’t just in the numbers either. Improvements were seen in people’s assessment of their personal well-being. (39)
Selenium Supplementation and Pregnancy
It is estimated that up to 10 percent of pregnant women are positive for TPO antibodies, and that about 8 percent of all pregnant women develop postpartum thyroiditis. So the research relating to pregnant women with TPO antibodies is important, as selenium supplementation can significantly decrease the percentage of those with postpartum thyroiditis and hypothyroidism.
In an interesting study involving 2143 pregnant women with autoimmune thyroiditis in euthyroidism (this is when people have thyroid symptoms or thyroid antibodies but their TSH level may still test as normal), selenium supplementation was given during and after pregnancy. Of the original group, 169 were positive for thyroid peroxidase (TPO) antibodies and were divided into two groups: 77 pregnant women received 200 mcg of selenomethionine a day, and 74 received placebo doses. (40, 41)
The group that supplemented with selenium during their pregnancy as well as postpartum, showed a decrease in the progression of autoimmune thyroiditis, including a reduction in TPO antibody levels. They also showed a decreased incidence of thyroid dysfunction in the postpartum period, better thyroid ultrasound patterns, and decreased permanent hypothyroidism.
This suggests that selenium supplementation for pregnant women with TPO antibodies can lead to a reduction in antibodies and a decrease in postpartum thyroiditis and hypothyroidism. There have also been studies focused on pregnant women, suggesting that selenium administration may have a protective role relating to pregnancy loss.
Selenium Supplementation for Autoimmune Hyperthyroidism
Selenium supplementation has also resulted in thyroid improvements in a few studies relating to Graves’ disease, and appears to also have a beneficial effect on Graves’ orbitopathy or ophthalmopathy (which is when antibodies are directed at the receptors presented behind the eyes, leading to a bulging eye appearance). (42)
In one study, serum selenium levels in patients with remission and relapse of Graves’ disease were compared. The authors found that the highest serum selenium levels (>120 mg/L) were seen in the remission group, indicating a positive effect of selenium levels on the outcome of Graves’ disease.
Regarding Graves’ orbitopathy, one study found that treatment with selenium was associated with less eye involvement, improved quality of life, and delayed progression of Graves’ orbitopathy at six months.
As of 2018, there have been at least two active studies underway to gain more definitive results, the GRASS (Graves’ Disease Selenium Supplementation) and the CATALYST (The Chronic Autoimmune Thyroiditis Quality of Life Selenium Trial). These trials are focused on obtaining data concerned with the optimal amount of selenium supplementation necessary for patients with Graves’ hyperthyroidism that will provide the fastest remission and improved quality of life. (43, 44)
Even without this definitive data, however, a recommendation for selenium’s use in mild cases was incorporated into the recent guidelines for the European Group On Graves’ Orbitopathy (EUGOGO). This is very significant and suggests that selenium may be recommended for Graves’ disease-related conditions in the near future.
Why Selenium Levels May Be Connected to Anxiety Symptoms
Along with seeing a reduction in thyroid antibodies, I have found that selenium supplementation also often results in a reduction in anxiety in many people with Hashimoto’s. (45)
Anxiety, irritability, and moodiness are all symptoms which are frequently associated with Hashimoto’s and Graves’ disease. As I mentioned earlier, I suffered from significant anxiety myself, but taking selenium supplements and balancing my blood sugar worked wonders at providing me a renewed sense of calm. (You can read more about anxiety and Hashimoto’s.)
When the thyroid is under attack by the immune system, and as thyroid cells are broken down, they release thyroid hormones into the bloodstream. This causes transient hyperthyroidism, otherwise known as thyroid hormone surges. This can result in making people extremely anxious, irritable, and on edge.
Some studies have linked selenium deficiency with anxiety and depression, which are also common symptoms seen in those with Hashimoto’s. A study in New Zealand found that low selenium intakes were associated with the most depressive symptoms in young adults. The researchers theorized that oxidative damage to the brain and nervous system was due to the inability of the body to neutralize excess hydrogen peroxide. (46-48)
This research underscores a point I will make in the next section, and that is that the nutrient content of foods can differ dramatically depending on where it is grown! Let’s take the New Zealand study as an example. New Zealand’s soil is low in mineral content such as selenium. Gaining consistent levels of any given nutrient through diet is difficult for a number of reasons, one of them being unknown nutrient levels (depending on where the food has been grown) — you can’t look at a chart to know the nutrient levels of the particular food you are eating.
So whether we are attempting to reduce our antibodies, reduce anxiety symptoms, or just feel better, we want to ensure our selenium intake is at an optimal and therapeutic level, as demonstrated by the research. So how do we do that if food sources alone are often inadequate?
Let’s discuss how you can achieve the optimal level of selenium to improve your thyroid health.
Dietary Sources of Selenium
Our bodies do get selenium from the foods we eat. According to one study, the main sources of selenium are meat products (31 percent), fish (19 percent), pasta or rice (12 percent), and bread or cereals (11 percent). Note that this study was done in Belgium, so the US diet – or the diet you are personally following – may not be reflective of these percentages. (49)
Many people with Hashimoto’s may turn to a gut-friendlier diet such as a gluten-free or grain-free diet, so they will actually lower their selenium intake through such a diet. Reduced selenium levels have also been associated with the consumption of eggs, white rice, alcohol, and coffee, in addition to smoking.
The average intake of selenium in the United States was reported to be 93 mcg per day in women, and 134 mcg per day in men. Given that the RDA (recommended daily allowance) for selenium in the United States is only 55 mcg daily, what’s the issue then, you might ask? (50-52)
The issue is that the RDA of 55 mcg will not be sufficient for TPO antibody reduction.
Studies have shown that the minimal dose of selenium necessary for TPO antibody reduction is 200 mcg daily. Even a 100 mcg dose did not produce a statistically significant TPO antibody reduction. (53)
And you are unlikely to get to that daily dose through your diet.
Some nutrition charts suggest that one serving of certain foods like Brazil nuts, contains more than enough selenium, so you might think that all you need to do is eat a few Brazil nuts each day, but I don’t suggest this strategy.
While it may be tempting to increase selenium intake by increasing your consumption of selenium-rich foods such as Brazil nuts, it is important to realize that selenium content varies widely for foods grown in different soils. Remember my earlier comment on New Zealand?
While the Dakotas have selenium-rich soils, other areas such as Russia and China have deficient levels of selenium.
The importation of foods further complicates these issues. The amounts of selenium in a single Brazil nut have been reported to vary tenfold depending on where the nut was grown. This means there could be anywhere from 55 mcg to 550 mcg per ounce of nuts.
Additionally, absorption issues due to gastrointestinal (GI) problems and food sensitivities may limit the availability of selenium from food sources.
Supplementation
For these reasons, I routinely recommend selenium supplementation in order to get the therapeutic level of selenium that addresses antibody reduction. Supplementation also allows for a consistent dose each day. I’ve tested Brazil nuts vs. selenium supplements personally and with clients, and have always found a more significant impact on symptoms and antibodies by using a supplement.
You might wonder if you can easily test your selenium levels so you see where they are at as you progress through your healing journey. I don’t routinely recommend testing for selenium levels; rather, I’ve found that selenium supplementation in the studied range of 200 to 400 mcg per day is generally safe and effective for most people with Hashimoto’s.
Remember, in my Root Cause survey, 63 percent of respondents said that taking a selenium supplement helped them feel better. Thirty-four percent saw no difference, while only 3.5 percent felt worse.
There is also research that shows selenium supplementation has significant immune-stimulatory effects even outside of Hashimoto’s, and I have found toxicity problems to be very rare. (54) Talk with your practitioner if you are curious as to whether selenium supplementation may be right for you.
While multivitamins may contain the RDA of selenium, keep in mind that it won’t be the correct therapeutic dose. Multivitamins also have so many different ingredients in them, and sometimes even fillers, resulting in reduced absorption of selenium.
Additionally, please note that while many prenatal vitamins contain up to 200 mcg of selenium, some only contain 100 mcg, and others do not contain any selenium. Nonetheless, even if they contain selenium, an additional standalone supplement may be required to ensure adequate absorption.
If you are thinking about adding a standalone selenium supplement, I have had a lot of success with recommending Selenium from Pure Encapsulations, at a dose of 200 mcg per day. In my clinical experience, I have observed that it can take 3-5 days for symptoms to show improvement, and three full months to see the full impact on reduced thyroid antibodies. This version is generally very well tolerated and helpful. Some individuals use this product along with an additional myo-inositol supplement (find more information on myo-inositol in this article).
Because of new emerging research on the synergistic benefits of selenium with myo-inositol, because I know it’s easier to take one supplement instead of multiple supplements per day, and because some of my more sensitive readers were reporting side effects with even 200 mcg of selenium when used as a standalone dose, I was excited to create a new supplement that combines selenium and myo-inositol in the same exact doses that were studied by researchers. (55)
Rootcology Selenium + Myo-inositol delivers the therapeutic range of both selenium and myo-inositol.* This formula is compliant with an Autoimmune Paleo diet. It is free of dairy, gluten, GMOs, shellfish, and soy, and has been tested for purity.
Please note that both versions of selenium contain methionine, which is a sulfur-containing amino acid. Some individuals may react to or be sensitive to sulfur. However, selenium methionine is the form of selenium that has been studied in Hashimoto’s, so I am unable to vouch for the effectiveness of other forms of selenium in autoimmune thyroid conditions. Additionally, sulfur and selenium are closely related, and processed in the same way by the body. As such, those with sulfur sensitivities may react to other forms of selenium as well.
How to Ensure Proper Absorption of Selenium
Because of the absorption issues many people have with their gut, I do always recommend people take a selenium supplement with a vitamin E supplement, as it works in synergy with selenium to ensure proper absorption. I recommend taking selenium and vitamin E together on an empty stomach.
Be aware, however, that many vitamin E supplements are soy-based. (Soy is a common sensitivity that I’ve seen in those with Hashimoto’s!)
Finding a soy-free version of vitamin E has actually been a big challenge for me over the last few years. I would often recommend a brand, and then the brand would be reformulated or discontinued.
I’ve found that NOW brand’s Sun-E 400 offers a soy-free, natural vitamin E, which is derived from Identity Preserved (IP) non-GMO sunflower seed oil. It contains 400 IU vitamin E (as D-Alpha Tocopherol).
Optimal vs. Toxic Doses of Selenium
Selenium has a narrow therapeutic index, and doses of under 100 mcg per day may not be sufficient for improving Hashimoto’s symptoms and markers, while doses in excess of 800 mcg per day can be toxic. (56)
As I mentioned earlier, the RDA for selenium has been defined as 55 mcg in the United States, and an upper limit of 400 mcg has been suggested.
A study done in South Dakota did not find any signs of selenium toxicity at levels as high as 724 mcg. However, changes in nail structure, a sign of toxicity, were reported with a selenium intake of 900 mcg per day in China. (57)
That said, everyone’s chemistry is different, and you may have an underlying health issue that adds risk to you reacting to selenium supplements, so I always recommend that you discuss any type of supplementation with your practitioner. They will be able to help guide you as to what dosage is most appropriate for you.
In my clinical practice and in listening to what my readers tell me about their own experiences, I have found selenium toxicity to be extremely rare. When taken in therapeutic doses, selenium does not typically have side effects.
But it is always important to understand the flip side of optimal results. While most reported toxicity cases have been associated with industrial accidents and manufacturing errors, it is important to at least be aware of the symptoms of selenium toxicity.
Some symptoms of selenium toxicity that have been reported included GI disturbances, hair loss, changes in hair and nails, fatigue, peripheral neuropathy, irritability, garlic-smelling breath, fever, nausea, and a jaundice-like yellow tint to the skin. Potentially serious side effects include liver, kidney, and heart problems. At high enough levels, selenium can cause death (reports of this level of toxicity exist, but are extremely rare). (58, 59)
It’s important to note that selenium may also interact with other supplements and medications, such as cholesterol-lowering statin drugs, antacids, chemotherapy drugs, corticosteroids, niacin, and even birth control pills.
Those with a CBS gene mutation have difficulty breaking down selenium. (Research has found that selenomethionine needs to be converted into its active form via the CBS gene. So, if this gene is mutated, the body cannot break down selenomethionine properly.) (60) Thus, those with a CBS gene mutation may have excess levels of selenium compared to those without this mutation, even with the same supplemental dose taken.
If you know you have a CBS gene mutation, then regularly monitoring your selenium levels is necessary. If you suspect that you may have this mutation, be sure to test for it using a genetic test like the one offered by 23andMe. You’ll also want to check out the Sulfur Toxicity Protocol in the Advanced Protocols section of Hashimoto’s Protocol. I heard from one reader, who had the CBS mutation, and this individual ended up with selenium toxicity due to this very reason.
Selenium supplements are also associated with a risk of non-melanoma skin cancer (squamous cell carcinoma), so people at high risk of skin cancer should not take these supplements.
There is conflicting data on the connection between selenium and prostate cancer. A study by the National Cancer Institute shows that men who already have high concentrations of selenium in their bodies are nearly twice at risk of aggressive prostate cancer if they take selenium supplements. (61) But other research suggests that selenium supplements can help prostate cancer. Selenium-enriched yeast has been researched as a supplement that may reduce the risk of prostate cancer. (62, 63) (I recommend that men concerned with prostate cancer consult with their practitioner before supplementing with selenium, and get annual PSA screenings and prostate exams starting at age 40.)
Selenium intake may also cause side effects in those with diabetes. One study found that people who took 200 micrograms a day of selenium, were 50 percent more likely to develop type 2 diabetes. (64) So far, it’s unknown whether it’s the selenium that actually caused the disease (as opposed to a factor that was co-occurring along with the selenium supplementation).
It is also important to note that herbal supplements, such as those taken for lactation support, may be sources of selenium. These include burdock root, alfalfa, fenugreek, fennel seed, catnip, chamomile, garlic, cayenne, nettle, oat-straw, yarrow, peppermint, sarsaparilla, lemongrass, ginseng, hawthorn berry, rose hips, and raspberry-leaf. Thus, you may need to adjust your supplementation dosage to avoid having too much selenium.
As mentioned previously, food sources that are rich in selenium can also contribute to excess selenium, especially if your typical diet includes Brazil nuts in addition to a selenium supplement. If you are consuming Brazil nuts from selenium-rich soils, you could be consuming up to an additional 550 mcg of selenium, on top of your 200-400 mcg dose of selenium supplementation.
My best advice is to work with your practitioner to determine the appropriate dosage for you.
Additionally, most product recommendations are intended for adults. Please consult with your pediatrician before giving supplements to children. The tolerable upper limit for children, ages 9-13, is 280 mcg. Since one of the supplements I recommend, Pure Encapsulations Selenium, can contain up to 320 mcg per capsule (specifications state that the product can contain up to 160 percent of the label claim), it is not recommended for children.
This is one of the reasons I was super excited to create a selenium and myo-inositol supplement with a lower dose of selenium that has still shown benefits. The Rootcology Selenium + Myo-Inositol supplement contains 83 mcg and 600 mg, respectively, and can be a great starting place for many individuals.
What to Do If You Have Low Levels of Iodine
Many people come to me already in the midst of iodine supplementation (which I generally do not support without other root cause investigations). However, most people with Hashimoto’s are not deficient in iodine. Furthermore, too much iodine can be a bad thing as we’ve seen, especially if you have not addressed the underlying issues triggering your Hashimoto’s.
That said, I have heard from a few clients and readers that adding selenium in the presence of low iodine levels has made them feel worse. (You can read more about iodine, and the different views on iodine supplementation in Hashimoto’s, in my article on iodine and Hashimoto’s.)
If you do have an adverse reaction to selenium (again, this is very rare), you may find that you have an iodine deficiency. While I don’t usually recommend taking iodine supplements until addressing other root causes, you can certainly talk with your practitioner about whether a low-dose iodine supplement might be right for you. (Up to 250 mcg a day has been well-tolerated in people with Hashimoto’s.)
Some potential factors that may lead me to suspect an iodine deficiency include: eating a diet low in seafood, eating a vegan diet, having fibrocystic breasts (though this could be caused by magnesium deficiency), or having low reverse T3 levels. You can find out more about iodine in the Advanced Protocols section of my book Hashimoto’s Protocol.
Monitoring Your Thyroid Hormones When Taking Selenium (with or Without Myo-Inositol)
Whenever you start a lifestyle or complementary intervention to address Hashimoto’s, I encourage you to work with your doctor to monitor your thyroid symptoms, thyroid hormones, and thyroid antibodies. This is a great idea for any lifestyle intervention, but a must for lifestyle changes that could impact your TSH, like myo-inositol, especially if you are already taking thyroid medications.
Studies have shown that selenium can reduce thyroid antibodies by at least 40 percent over three months. Additionally, myo-inositol can lower TSH by an average of 30 percent within six months. (65, 66)
What this means is that myo-inositol could lower/normalize TSH in some cases, thus potentially reducing your requirement (or need) for thyroid meds. So as you move forward with supplementation, please look out for the following symptoms of being overmedicated: rapid or irregular heartbeat, nervousness, irritability or mood swings, muscle weakness or tremors, diarrhea, heat intolerance, menstrual irregularities, hair loss, weight loss, insomnia, chest pain, and/or excessive sweating.
I recommend testing thyroid hormone levels every six to 12 weeks while using complementary therapies, including root cause approach-based medicine, diet, or supplements, to ensure your thyroid medication dosage is optimized, or sooner, if you are showing any of the above symptoms. Thyroid medications are goldilocks hormones — they need to be used in just the right dose — and there are risk factors of being overmedicated.
Testing TSH, T4, T3, and the two most common Hashimoto’s antibodies (TPO and TG antibodies) is an important part of ensuring that the lifestyle changes you are making are both safe and helpful. 🙂 You can read more about thyroid tests here.
If your doctor is ordering these thyroid labs for you, be sure to request a copy so that you can see them for yourself and ensure that they are interpreted correctly. If you aren’t able to use your physician for ordering, or have a high deductible insurance plan like I do, you may also wish to self-order your own thyroid monitoring labs. I recommend the Ulta Labs thyroid panel for monitoring your progress, which can be ordered anywhere in the U.S. (Some, but not all, insurance companies may reimburse you for self-ordered labs. Please be sure to check with your plan.)
What You Can Do Today to Start Feeling Better
If you have Hashimoto’s, you likely have one or more nutrient deficiencies. And while you do need to investigate and correct any underlying root causes (such as gut issues or food sensitivities), in the meantime, selenium supplementation could help you to feel better.
While there isn’t specific testing I would recommend relating to measuring selenium levels, taking a consistent, therapeutic dosage of selenium each day has been shown to reduce thyroid antibodies, reduce symptoms (including anxiety), and improve overall well-being.
Selenium is necessary for thyroid hormone conversion of T4 to T3, promotes blood flow, and may support immune health. Selenium and myo-inositol together may help to optimize TSH levels, reduce thyroid antibodies, help you reduce your risk of developing more severe forms of hypothyroidism, and even promote a more balanced mood. In synergy with vitamin E, selenium can protect normal cell function, and enhance the function of certain energy-producing cells.
I created an infographic that you can use on social media to share the benefits of selenium:
Even if you haven’t yet been diagnosed with thyroid disease due to having a “normal” TSH level, you could still have thyroid antibodies, and I recommend testing for those. It is easy and inexpensive, and antibody testing provides you with “early warning” information that can help you prevent further damage to your thyroid.
I hope this helps you on your healing journey! Let me know how taking selenium works for you. 🙂
Looking for more info? Supplements can help or hurt your thyroid! Download my FREE eBook to learn about safe and effective supplements that can help your thyroid symptoms naturally.
P.S. You can download a free Thyroid Diet Guide, 10 thyroid-friendly recipes, and the Nutrient Depletions and Digestion chapter of my first book for free by signing up for my newsletter. You will also receive occasional updates about new research, resources, giveaways, and helpful information.
For future updates, make sure to follow me on Facebook, Instagram, TikTok, and Pinterest!
References
- Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017;2017:1297658. doi:10.1155/2017/1297658
- Tian X, Li N, Su R, Dai C, Zhang R. Selenium Supplementation May Decrease Thyroid Peroxidase Antibody Titer via Reducing Oxidative Stress in Euthyroid Patients with Autoimmune Thyroiditis. Int J Endocrinol. 2020;2020:9210572. Published 2020 Jun 30. doi:10.1155/2020/9210572
- Gärtner R, Gasnier BC, Dietrich JW, Krebs B, Angstwurm MW. Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. J Clin Endocrinol Metab. 2002;87(4):1687-1691.
- Carta MG, Loviselli A, Hardoy MC, et al. The link between thyroid autoimmunity (antithyroid peroxidase autoantibodies) with anxiety and mood disorders in the community: a field of interest for public health in the future. BMC Psychiatry. 2004;4:25. Published 2004 Aug 18. doi:10.1186/1471-244X-4-25
- Rybicka I, Krawczyk M, Stanisz E, Gliszczyńska-Świgło A. Selenium in Gluten-free Products. Plant Foods for Human Nutrition. 2015;70(2):128-134. doi:10.1007/s11130-015-0467-8.
- Zheng H, Wei J, Wang L, et al. Effects of Selenium Supplementation on Graves’ Disease: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2018;2018:3763565. Published 2018 Sep 26. doi:10.1155/2018/3763565
- Hofstee P, Bartho LA, McKeating DR, et al. Maternal selenium deficiency during pregnancy in mice increases thyroid hormone concentrations, alters placental function and reduces fetal growth. J Physiol. 2019;597(23):5597-5617. doi:10.1113/JP278473
- Sadaka A, Nguyen K, Malik A, Brito R, Berry S, Lee AG. Vitamin D and Selenium in a Thyroid Eye Disease Population in Texas. Neuroophthalmology. 2019;43(5):291-294. Published 2019 Jan 25. doi:10.1080/01658107.2019.1566382
- Köhrle J. The trace element selenium and the thyroid gland. Biochimie. 1999;81(5):527-533. doi:10.1016/s0300-9084(99)80105-9
- Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017;2017:1297658. doi:10.1155/2017/1297658
- Nordio M, Pajalich R. Combined Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Subclinical Hypothyroidism Patients with Autoimmune Thyroiditis. Journal of Thyroid Research. 2013;2013:424163. doi:10.1155/2013/424163.
- Nordio M, Basciani S. Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis. International Journal of Endocrinology. 2017;2017:2549491. doi:10.1155/2017/2549491.
- Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017;2017:1297658. doi:10.1155/2017/1297658
- Fasano A. Leaky gut and autoimmune disease. Clin Rev Allergy Immunol. 2012;42(1):71-78.
- Krysiak R, Szkróbka W, Okopień. The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto’s Thyroiditis: A Pilot Study. Exp Clin Endocrinol Diabetes. 2018 Jul 30. doi: 10.1055/a-0653-7108.
- Stazi AV, Trinti B. Carenza di selenio nella malattia celiaca: rischio di tireopatie autoimmuni [Selenium deficiency in celiac disease: risk of autoimmune thyroid diseases]. Minerva Med. 2008;99(6):643-653.
- Köhrle J. The trace element selenium and the thyroid gland. Biochimie. 1999;81(5):527-533. doi:10.1016/s0300-9084(99)80105-9
- Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017;2017:1297658. doi:10.1155/2017/1297658
- Negro R. Selenium and thyroid autoimmunity. Biologics: Targets & Therapy. 2008;2(2):265-273.
- Mittal M, Siddiqui MR, Tran K, Reddy SP, Malik AB. Reactive oxygen species in inflammation and tissue injury. Antioxid Redox Signal. 2014;20(7):1126-1167. doi:10.1089/ars.2012.5149
- Krysiak R, Szkróbka W, Okopień. The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto’s Thyroiditis: A Pilot Study. Exp Clin Endocrinol Diabetes. 2018 Jul 30. doi: 10.1055/a-0653-7108.
- Winther KH, Watt T, Bjørner JB, et al. The chronic autoimmune thyroiditis quality of life selenium trial (CATALYST): study protocol for a randomized controlled trial. Trials. 2014;15:115. doi:10.1186/1745-6215-15-115
- Levander OA, Beck MA. Interacting nutritional and infectious etiologies of Keshan disease: insights from Coxackie virus B-induced myocarditis in mice deficient in selenium or vitamin E. Biol Trace Elem Res. 1997;56:5–21
- Vasiliu I, Ciobanu-Apostol DG, Armasu I, Bredetean O, Serban IL, Preda C. Protective role of selenium on thyroid morphology in iodine-induced autoimmune thyroiditis in Wistar rats. Exp Ther Med. 2020;20(4):3425-3437. doi:10.3892/etm.2020.9029
- Kobayashi R, Hasegawa M, Kawaguchi C, et al. Thyroid function in patients with selenium deficiency exhibits high free T4 to T3 ratio. Clin Pediatr Endocrinol. 2021;30(1):19-26. doi:10.1297/cpe.30.19
- Stuss M, Michalska-Kasiczak M, Sewerynek E. The role of selenium in thyroid gland pathophysiology. Endokrynol Pol. 2017;68(4):440-465. doi:10.5603/EP.2017.0051
- Mazokopakis EE, Papadakis JA, Papadomanolaki MG, et al. Effects of 12 months treatment with L-selenomethionine on serum anti-TPO Levels in patients with Hashimoto’s thyroiditis. Thyroid. 2007 Jul;17(7):609-12.
- Mazokopakis EE, Papadakis JA, Papadomanolaki MG, et al. Effects of 12 months treatment with L-selenomethionine on serum anti-TPO Levels in patients with Hashimoto’s thyroiditis. Thyroid. 2007 Jul;17(7):609-12.
- Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017;2017:1297658. doi:10.1155/2017/1297658
- Gärtner R, Gasnier BC, Dietrich JW, Krebs B, Angstwurm MW. Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. J Clin Endocrinol Metab. 2002;87(4):1687-1691. doi:10.1210/jcem.87.4.8421
- Gärtner R, Gasnier BC. Selenium in the treatment of autoimmune thyroiditis. Biofactors. 2003;19(3-4):165-170. doi:10.1002/biof.5520190309
- Negro R. Selenium and thyroid autoimmunity. Biologics: Targets & Therapy. 2008;2(2):265-273.
- Nordio M, Basciani S. Evaluation of thyroid nodule characteristics in subclinical hypothyroid patients under a myo-inositol plus selenium treatment. Eur Rev Med Pharmacol Sci. 2018;22(7):2153-2159. doi:10.26355/eurrev_201804_14749
- Nordio M, Pajalich R. Combined Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Subclinical Hypothyroidism Patients with Autoimmune Thyroiditis. Journal of Thyroid Research. 2013;2013:424163. doi:10.1155/2013/424163.
- Nordio M, Basciani S. Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis. International Journal of Endocrinology. 2017;2017:2549491. doi:10.1155/2017/2549491.
- Ferrari SM, Fallahi P, Di Bari F, Vita R, Benvenga S, Antonelli A. Myo-inositol and selenium reduce the risk of developing overt hypothyroidism in patients with autoimmune thyroiditis. Eur Rev Med Pharmacol Sci. 2017;21(2 Suppl):36-42.
- Ferrari, SM et al. Precision Medicine in Autoimmune Thyroiditis and Hypothyroidism. Front. Pharmacol., 17 November 2021 | https://doi.org/10.3389/fphar.2021.750380
- Wichman J, Winther KH, Bonnema SJ, Hegedüs L. Selenium Supplementation Significantly Reduces Thyroid Autoantibody Levels in Patients with Chronic Autoimmune Thyroiditis: A Systematic Review and Meta-Analysis. Thyroid. 2016;26(12):1681-1692. doi:10.1089/thy.2016.0256
- Nordio M, Pajalich R. Combined treatment with Myo-inositol and selenium ensures euthyroidism in subclinical hypothyroidism patients with autoimmune thyroiditis. J Thyroid Res. 2013;2013:424163. doi:10.1155/2013/424163
- Stagnaro-Green A. Postpartum thyroiditis. Best Pract Res Clin Endocrinol Metab. 2004 Jun;18(2):303-16.
- Negro R, Greco G, Mangieri T, Pezzarossa A, Dazzi D, Hassan H. The influence of selenium supplementation on postpartum thyroid status in pregnant women with thyroid peroxidase autoantibodies. The Journal of Clinical Endocrinology and Metabolism. 2007;92(4):1263–1268. doi: 10.1210/jc.2006-1821.
- Bartalena L, Baldeschi L, Boboridis K, et al. The 2016 European Thyroid Association/European Group on Graves’ Orbitopathy Guidelines for the Management of Graves’ Orbitopathy. European Thyroid Journal. 2016;5(1):9–26. doi: 10.1159/000443828
- Watt T, Cramon P, Bjorner JB, et al. Selenium supplementation for patients with Graves’ hyperthyroidism (the GRASS trial): study protocol for a randomized controlled trial. Trials. 2013;14:119. Published 2013 Apr 30. doi:10.1186/1745-6215-14-119
- Winther KH, Watt T, Bjørner JB, et al. The chronic autoimmune thyroiditis quality of life selenium trial (CATALYST): study protocol for a randomized controlled trial. Trials. 2014;15:115. doi:10.1186/1745-6215-15-115
- Benton D, Cook R. The impact of selenium supplementation on mood. Biological Psychiatry. 1991;29(11):1092-1098.
- Wang J, Um P, Dickerman BA, Liu J. Zinc, Magnesium, Selenium and Depression: A Review of the Evidence, Potential Mechanisms and Implications. Nutrients. 2018;10(5):584. Published 2018 May 9. doi:10.3390/nu10050584
- Benton D, Cook R. The impact of selenium supplementation on mood. Biological psychiatry. 1991;29(11):1092-1098.
- Conner TS, Richardson AC, Miller JC. Optimal serum selenium concentrations are associated with lower depressive symptoms and negative mood among young adults. J Nutr. 2015;145(1):59-65. doi:10.3945/jn.114.198010
- Waegeneers N, Thiry C, De Temmerman L, Ruttens A. Predicted dietary intake of selenium by the general adult population in Belgium. Food Additives & Contaminants. 2013;30(2):278–285. doi: 10.1080/19440049.2012.746474.
- Park K, Rimm E, Siscovick D, Spiegelman D, Morris JS, Mozaffarian D. Demographic and lifestyle factors and selenium levels in men and women in the U.S. NutritionResearch and Practice. 2011;5(4):357–364. doi: 10.4162/nrp.2011.5.4.357
- Rayman MP. Selenium and human health. Lancet. 2012;379(9822):1256–1268. doi: 10.1016/S0140-6736(11)61452-9.
- Office of Dietary Supplements. Selenium Fact Sheet for Health Professionals. NIH. https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/. Updated March 2, 2018. Accessed September 3, 2018.
- Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017;2017:1297658. doi:10.1155/2017/1297658
- MacFarquhar JK, Broussard DL, Melstrom P, et al. Acute selenium toxicity associated with a dietary supplement. Archives of Internal Medicine. 2010;170(3):256–261. doi: 10.1001/archinternmed.2009.495
- Nordio M, Basciani S. Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis. International Journal of Endocrinology. 2017;2017:2549491. doi:10.1155/2017/2549491.
- Selenium. Institute of Medicine (US) Panel on Dietary Antioxidants and Related Compounds. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington (DC): National Academies Press (US); 2000.
- MacFarquhar JK, Broussard DL, Melstrom P, et al. Acute selenium toxicity associated with a dietary supplement. Archives of Internal Medicine. 2010;170(3):256–261. doi: 10.1001/archinternmed.2009.495
- MacFarquhar JK, Broussard DL, Melstrom P, et al. Acute selenium toxicity associated with a dietary supplement. Archives of Internal Medicine. 2010;170(3):256–261. doi: 10.1001/archinternmed.2009.495
- Hadrup N, Ravn-Haren G. Acute human toxicity and mortality after selenium ingestion: A review. J Trace Elem Med Biol. 2020;58:126435. doi:10.1016/j.jtemb.2019.126435
- Speckmann B, Grune T. Epigenetic effects of selenium and their implications for health. Epigenetics. 2015;10(3):179-190. doi:10.1080/15592294.2015.1013792.
- Office of Dietary Supplements. Selenium Fact Sheet for Health Professionals. NIH. https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/. Updated March 2, 2018. Accessed September 3, 2018.
- Stanisławska IJ, Figat R, Kiss AK, Bobrowska-Korczak B. Essential Elements and Isoflavonoids in the Prevention of Prostate Cancer. Nutrients. 2022;14(6):1225. Published 2022 Mar 14. doi:10.3390/nu14061225
- Richie JP Jr, Das A, Calcagnotto AM, et al. Comparative effects of two different forms of selenium on oxidative stress biomarkers in healthy men: a randomized clinical trial. Cancer Prev Res (Phila). 2014;7(8):796-804. doi:10.1158/1940-6207.CAPR-14-0042
- 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(4):217-223. doi:10.7326/0003-4819-147-4-200708210-00175
- Gärtner R, Gasnier BC, Dietrich JW, Krebs B, Angstwurm MW. Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. J Clin Endocrinol Metab. 2002;87(4):1687-1691. doi:10.1210/jcem.87.4.8421
- Nordio M, Basciani S. Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis. International Journal of Endocrinology. 2017;2017:2549491. doi:10.1155/2017/2549491.
- Unfer V, Facchinetti F, Orrù B, Giordani B, Nestler J. Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrine Connections. 2017;6(8):647-658. doi:10.1530/EC-17-0243.
- Dinicola S, Minini M, Unfer V, Verna R, Cucina A, Bizzarri M. Nutritional and Acquired Deficiencies in Inositol Bioavailability. Correlations with Metabolic Disorders. International Journal of Molecular Sciences. 2017;18(10):2187. doi:10.3390/ijms18102187.
Note: Originally published in February 2015, this article has been revised and updated for accuracy and thoroughness.
Hudson2006 says
My thyroid function test result was high in Anti-TPO(114<34(Reference Value)). I took the selenium supplement tablet 200mcg once per day, I find myself have better energy now. However, my thyroud gland still have nodule and I feel that there are some fluid flow down from my thyroid gland everyday. How can I do to make this symptom getting better?
Dr. Izabella says
Hudson – thank you for reaching out and sharing your journey. I am happy to hear the selenium is helping. Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Have you read my books?
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Pamela Joy Sell says
So, so appreciative of your time in sharing information and providing guidance!
Thank you.
Dr. Izabella says
Pamela – you are very welcome! I hope you keep me posted on your progress here. 🙂
Melinda Eggers says
I do have your book Root Cause and just started selenium on an empty stomach along with my Synthroid. I get confused about the timing of things. I thought it was all minerals to be taken 4 hours away from Thyroid?
Dr. Izabella says
Melinda – thank you for reaching out. Thyroid medication absorption can be impacted by many things, including food, other medications, and supplements. Thyroid medication should be taken on an empty stomach, one to two hours before eating, taking other medications, supplements or coffee to ensure appropriate absorption. Antacids such as Tums, iron, magnesium, and calcium supplements can impair the absorption of thyroid medications. Thus, you need to have at least 4 hours of time in between your thyroid medications and these agents. Please be sure to read the directions provided with the medication. I hope you find this free ebook helpful. https://thyroidpharmacist.com/meds-ebook/
Joni says
Thank you for this information. I have been looking for your input on selenium overdose even at recommended levels. My son (14 yrs. old now, but 5’7″ & 130 lbs at the time took it) and I both started taking selenium after reading your book a year or so ago. His eye doctor also recommended it after some eye issues he was having. Doc said he recommends it to all his eye surgery patients. My son within just a few weeks became very moody, irratible and emotional. He is normally a kid who wakes up singing and goes to bed singing and cracking jokes, so this was noticeable. We together recalled the only thing that had changed over the past couple weeks was he started taking selenium. So he stopped. Within about a week he was back to his old self and has been fine ever since. I continued to take it for another couple months and then the same thing happened. I decided to stop the selenium and see if it helped and to my surprise it did. We were only taking your recommended dose so I was confused why we both had such dramatic symptoms. Any thoughts?
Dr. Izabella says
Joni – thank you for reaching out and sharing your journey as well as your son’s. I am so sorry you both had this experience with selenium. Unfortunately, I am not able to advise on you without a comprehensive health assessment. I recommend that you discuss this with your practitioner. Here are some resources you might find helpful.
CLINICIAN DATABASE
https://www.thyroidpharmacistconsulting.com/pages/clinician-database
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
http://www.thyroidpharmacistconsulting.com/recommended-compounding-pharmacies.html
MTHFR
https://thyroidpharmacist.com/articles/mthfr-hashimotos-and-nutrients/
Anna I says
Hi Dr. Wentz,
This was a fantastic and thorough description of the issues we do and can encounter. I had heard of selenium and made sure to take a multivitamin with a good amount and it didn’t seem to work. I happened to read an article by Dr. Childs and realized that maybe I needed to get both zinc and selenium for my hypothyroidism – and separate high quality products rather than a multivitamin. I ordered a pharmaceutical-grade selenium yeast and an organic zinc. And now that I think back, I didn’t realize that I actually gained some mental benefits in addition to just feeling better as well. Just like you (in hindsight) it lifted my anxiety and depression noticeably. I really want to thank you for making the physiological journey easy to understand – I am really glad I found this article.
Anna
Dr. Izabella says
Anna – thank you so much for sharing your journey. I am happy to hear you have taken charge of your health and feeling better. <3 Please keep me posted on your progress.
Nana says
also if you have the MTHFA gene can you take these supplements, also Hashimoto and poor metabolizer, being on antidepressants and benzo
Dr. Izabella says
Nana – thank you for reaching out. I am not able to advise on whether this supplement or any other supplement would be appropriate for you and your specific health needs without a comprehensive health assessment. This would be a good conversation to have with your practitioner. Here is an article on MTHFR that you may find interesting as well.
MTHFR
https://thyroidpharmacist.com/articles/mthfr-hashimotos-and-nutrients/
Jaye says
This is fascinating information. I was consuming lots of roasted seaweed in the year before a goiter showed up on my neck. I bet that contributed to the problem.
Dr. Izabella says
Jaye – thank you for reaching out. Seaweed should be avoided because it can exacerbate autoimmunity and may contain high doses of iodine; excess iodine can be toxic in Hashimoto’s. I am very hesitant in recommending iodine in Hashimoto’s. Although iodine serves as fuel for our thyroid and is very important in iodine deficiency hypothyroidism, Hashimoto’s is a different mechanism. It’s like pouring gas into an engine that’s on fire… that’s essentially what’s happening in Hashi’s, thyroid inflammation. Adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, in animal and human studies.
I have spent 4 years researching about this issue, and have seen too many people suffering the consequences of adding iodine too soon. My approach is, let’s fix the engine first (usually a gut issue), and then add the fuel once we know that the engine is no longer on fire. Hope that you will check out my books. I do have a chapter on the iodine controversy that references numerous studies as well as the work of Abraham and Brownstein. Here are the links to my books :
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Krystal Rivani says
Hi Dr. Wentz, I am so thankful for all the incredible information you put out there this is really helping my husband who suffers from Hashi’s amongst other health issues. I am currently reading your protocol book and wanted to ask, one other issue he is dealing with is heavy metal detox and I am giving him spirulina since I read it was good for getting rid of mercury. However, it does come from seaweed, would you advice against using the spirulina?
Dr. Izabella says
Krystal – thank you so much for sharing your husbands journey. Spirulina and Chlorella have immune stimulating properties that can worsen autoimmunity and even cause new onset autoimmunity. Additionally, the iodine is problematic and can cause further thyroid damage. For cleansing, I recommend green juicing and Rootcology’s Liver Reset. Here is the link to this supplement: https://www.rootcology.com/collections/supplements/products/liver-reset
You can find more information about juicing and alkalizing foods inside my Toxins Chapter in my books. If you didn’t read it yet, here is the link to my latest book, Hashimoto’s Protocol: http://amzn.to/2B5J1mq
Dr Rehana says
Hi Dr. Wentz . Thank you for all the insights. I have been diagnosed with Hashimotos since 7 years .I have been following you since then and on gluten-free , diary free diet , avoiding eggs completely .. I feel much better with this. I request you to please opine on duck egg intake .Could we have it occasionally? Awaiting for your kind reply .Thank you in advance.
Dr. Izabella Wentz says
Dr. Rehana – thank you for following! ❤️🙏🏻 Duck eggs are find as long as you are not sensitive to them.
Barbara says
I am so glad I read this on Selenium! I was told by a practitioner to eat a handful of Brazil nuts a day instead of taking a supplement. I am definitely going to get the supplement now. I hope you publish an article about the dangers of CT scans with ingestible or intravenous dye that contains iodine. I am scheduled to have an abdominal scan Monday and was told I was drinking dye and having it put in my veins as well. I am canceling the appointment because I have Hashimotos. I have not read good things about having high amounts of iodine like that with thyroid disease…
I have your book and am planning to start following your advice soon! Thank you so much for freely sharing your knowledge and expertise Dr Wentz!
Dr. Izabella says
Barbara – thank you for so much for sharing your journey with me. <3 I am very hesitant in recommending iodine in Hashimoto's. Although iodine serves as fuel for our thyroid and is very important in iodine deficiency hypothyroidism, Hashimoto's is a different mechanism. It's like pouring gas into an engine that's on fire... that's essentially what's happening in Hashi's, thyroid inflammation. Adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, in animal and human studies.
I have spent 4 years researching about this issue, and have seen too many people suffering the consequences of adding iodine too soon. My approach is, let's fix the engine first (usually a gut issue), and then add the fuel once we know that the engine is no longer on fire. Hope that you will check out my books. I do have a chapter on the iodine controversy that references numerous studies as well as the work of Abraham and Brownstein.
IODINE AND HASHIMOTO'S
https://thyroidpharmacist.com/articles/iodine-hashimotos/
Kathy says
In this article you say to take the Pure Encapsulations selenium supplement with vitamin E on an empty stomach, but the Pure Encapsulations bottle directions say to take 1-2 capsules with meals. So which is better? empty stomach or with a meal?
Dr. Izabella says
Kathy – thank you so much for reaching out. I recommend taking them on an empty stomach to ensure absorption, but please consult your practitioner before taking. <3
Greta says
I was diagnosed with Hashimotos almost 3 years ago and after seeing a nutrutionist who ran tests including an iodine loading test for which I prepared by taking Selenium for a few weeks first to get to a good leveI. I was low in iodine and began taking recommended supplements including both iodine and Selenium, zinc, magnesium, B12, D3 and I had already gone gluten free. Within 3 months my TPO antibodies came down to 6 which was in the normal range and they have stayed low . I am reasonably happy with my regime but it niggles that I have been unable to shift the TgAb level down. It remains almost constant at over 500. Although I have read lots about how to deal with TPO there is next to nothing in the literature specifically on TgAb (Thyroglobulin Antibody) reduction.
As I have been taking 200mg Selenium from the outset should I try increasing the dose? Any thoughts would really be appreciated. One other factor which I am considering is the removal of 7 mercury fillings. A couple of times I have seen a mention that Mercury could be related to the presence of TgAb but without any factual evidence these seem just anecdotal. I’m at a loss to know how to tackle TgAb properly.
Thanks so much for the amazing books and other resources that you provide Izabella. You really are an inspiration.
Dr. Izabella says
Greta – thank you for reaching out. I am not able to advise you on what dosage of this supplement would be appropriate for you and your specific health needs without a comprehensive health assessment. Please discuss this with your personal doctor or pharmacist. Dental issues can be an issue with Hashimoto’s, have you seen these articles?
CARRIE’S DENTAL PROCEDURE TRIGGERED HER HASHIMOTO’S
https://thyroidpharmacist.com/articles/carries-dental-procedure-triggered-her-hashimotos/
PERIODONTITIS
https://thyroidpharmacist.com/articles/periodontitis-a-trigger-for-hashimotos
FLUORIDE
https://thyroidpharmacist.com/articles/fluoride-and-your-thyroid
Biological dentistry is a branch of dentistry that looks at the connection between oral care and the health status of the rest of the body. While most traditional dentists focus only on “rescue care” rather than prevention, biological dentists try to prevent health problems that may originate from exposure to certain procedures and materials.
To find a biological dentist in your area, visit the International Academy of Oral Medicine & Toxicology’s website at http://www.iaomt.org. I hope this helps!
Melissa says
Hi Dr. Izabella,
I currently have hypothyroidism (not Hashimotos–I have been tested for antibodies five separate times and always come back <1 IU/mL). That being said, my provider made a comment at my last appointment that I need to be taking adequate Iodine. I am not iodine deficient, but she said that supplementation is important with thyroid disorder. So I ordered an iodine supplement and took one pill. Then I read the dosage–10,000 mcg!!! This was 36 hours ago and I am very concerned. Have I just created Hashimotos? Is there anything I can do to reverse the possibly very severe consequences? Should I take therapeutic doses of Selenium? I am at a loss and would very much appreciate your input as soon as possible!
Thank you!
Melissa
Dr. Izabella says
Melissa – thank you for reaching out and sharing your journey. Most people with thyroid conditions are not deficient in iodine, and it’s important to note that excessive iodine intake can exacerbate Hashimoto’s. However, if your iodine levels are indeed low, I would recommend taking a multivitamin such as Nutrient 950 by Pure Encapsulations. A dose of up to 250 mcg of iodine per day (these levels are found in most multivitamins and prenatal vitamins) has been found to be helpful and beneficial in people with Hashimoto’s; however, doses above 300 mcg can be potentially inflammatory. Although iodine serves as fuel for our thyroid and is very important in iodine deficiency hypothyroidism, Hashimoto’s is a different mechanism. It’s like pouring gas into an engine that’s on fire… that’s essentially what’s happening in Hashi’s, thyroid inflammation. Adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, in animal and human studies.
I have spent 4 years researching about this issue, and have seen too many people suffering the consequences of adding iodine too soon. My approach is, let’s fix the engine first (usually a gut issue), and then add the fuel once we know that the engine is no longer on fire. Hope that you will check out my books. I do have a chapter on the iodine controversy that references numerous studies as well as the work of Abraham and Brownstein. Here are the links to my books :
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Marci says
I have been taking 200 mcg of Pure Encapsulations Selenium and discovered through your articles Vitamin E needed to be added. I purchased the Rootcology Vitamin E but am unsure as to how many to take a day. The bottle indicates Vitamin E 60 mg but also lists High-Gamma Mixed Tocopherols 450 mg and High-Gamma Mixed Tocotrienols 20 mg. So is that a total of 530 mg of Vitamin E? Want to make certain I don’t take too much Vit E. Also, I take 50 mcg of Levothyroxine at least 3 hours before breakfast. So should I take 1 200 mcg Selenium and 1 60 mg Vitamin E at the same time as the Levothyroxine?
Thanks for all you do for us folks with Thyroid issues.
Dr. Izabella says
Marci – thank you for reaching out. Please email my team at info@rootcology.com and they will be happy to help you with this. <3
Marci says
Thanks – I contacted them.
Dr. Izabella says
Marci – you are very welcome! <3
Jasmin says
Hello,
it’s me again, my other comment just didn’t show up? Anyway,
I take my t4 thyroid medication (levothyroxine) at bedtime? I would like to incorporate selenium in my supplement regimen – but now I wonder, when to take it? Does it help converting t4 better into t3 when taken with thyroid medication? Several studies say so.
The same goes with magnesium. Maybe two hours before taking levo at bedtime? Iron supplementing is with my schedule an issue now too.
Additionally, I take thybon (20), splitting it 4 times a day at 8 am, 11 am, 2 pm and 5 pm. So I wonder, I don’t want bad interactions …
I would love to hear from you!
Dr. Izabella says
Jasmin – thank you for reaching out. For questions about the supplements please email my team at info@thyroidpharmacist.com and they will be happy to help you. <3
Jasmin says
Thank you very much! 🙂
Dr. Izabella says
Jasmin – you are very welcome! <3
Shari says
Hello. Thank you for all you do for the thyroid community! I have hashimoto’s. I read your book and started on 200mg/day selenium in January 2018. At that time my TPA was over 4000!!! My homocysteine was a bit high at 12. I then started seeing a Functional medicine doctor. At my next bloodwork in February my TPA was 702! I don’t know if it was the selenium but I continued taking it until September 2018. At that time my TPA was 436 and my homocysteine was normal at 7.2. My functional medicine doctor told me to stop taking the selenium because she said my selenium levels were too high at 546. I didn’t stop but only took 1 per week. Fast forward to April 2019. I went to er with a 1 month history of nausea, loss of appetite shortness of breath. They found extremely high liver enzymes. After a million tests and weekly bloodwork I am told I have autoimmune hepatitis. Do you think it is possible that the selenium was so good for me that stopping it could have caused this drastic liver issue? I heard it is good for the liver (but could be toxic in high doses). My dr says something kicked off this attack on my liver. Thank you for your time!
Dr. Izabella says
Shari – thank you for following! <3 Please understand, It would not be legal or appropriate for me to give any type of medical advice here. I recommend that you discuss this with your Functional Medicine practitioner.
Helen Chen says
Hi Dr. Izabella
I was diagnosed Hashimotos in Jan. After reading your Hashimoto Procotal and Root Cause, I am intaking 50mcg of levothyroxine and Selenium 200mcg with diet rule as books. My ANTI TPO has been reduced from 801.9 IU/mL to 129 IU/mL after 4 months. Is it safe and ok to intake Selenium 200mcg for long time? Will the ANTI TPO bonuce back if I stop to take Selenium? Any test should I run to know if I am on right track of Selenium supplement?
I love to hear from you
Dr. Izabella says
Helen – thank you for reaching out. I am so happy to hear you are having great success with my protocols! <3 For question about the supplements please email my team at info@thyroidpharmacist.com and they will be happy to help. <3
Tugce says
Thank you very much for this through discussion. I was taking Selenium before. However a year ago unfortunately, my university clinic doctor who also has Hashimoto’s as she informed me, claimed I can just forget about this disease as long as I have my routine check-ups on thyroids about once a year or two years because my hormones are fine and I don’t have nodules. She just said, do whatever with iodine or Selenium, it does not matter at the moment. She said I’m not doing anything myself, and her hormones were in normal range but worse than me, and also her antibodies were higher than mine. SO I STOPPED SELENIUM, because it was convenient not to think about this disease and taking a pill everyday (even though I read good things about Selenium before about treating Hashimato’s). I should have known better than just listening to her, but she was a doctor and she insisted, so I trusted her. Couple of days back, when I mentioned what happened to another doctor, he got angry saying I should definitely take Selenium for my well being, it will definitely be good for me. So I read your article. I realize, it was just me being weak and try to ignore this annoying disease, I knew all along I should have taken the supplements, but it was so nice when a doctor said I can ignore it.
Dr. Izabella says
Tugce – thank you so much for sharing your journey. I am so sorry. I understand how hard this all is. <3 I believe that everyone needs to find a practitioner that will let him/her be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It's a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
COMPOUNDING PHARMACIES
https://thyroidpharmacist.com/database-recommended-compounding-pharmacies/
Sally says
Hi Dr. Izabella,
My daughter is 7 years old. Her doctor noticed her thyroid was mild enlarged during a normal annual check. The follow up blood shows her TSH is within the normal range but Thyroglobulin antibody is 100 IU/mL. Her TPO antibody shows <3IU/mL.
She is having leaky gut, dry skin, skinny, losing hair, sometimes hard to fall asleep. I searched online and found your info. I ordered your book the Root Cause book amazon and started to read it. I haven’t finished yet. Seems lots information on TPO antibody was covered in the book but not very much for Thyroglobulin antibody was mentioned. Can all the methods mentioned in the book be used to help reduce Thyroglobulin antibodies as well? Some previous comments left from other patients mentioned that they successfully reduced the TPO AB by doing things you recommended in your book, while meanwhile Tg AB still stays pretty consistent.
Would you please share more knowledge about how to help reducing the high Thyroglobulin antibodies?
Thanks,
Sally
Dr. Izabella says
Sally – thank you for reaching out and sharing your journey. <3 About 95% of people with Hashimoto's have elevated Thyroid Peroxidase Antibodies, while 80% will have elevated Thyroglobulin Antibodies. They can both be important in monitoring the autoimmune attack on the thyroid, and can both be used to monitor the effect of interventions. Some interventions will lower TPO antibodies more, while others will have a greater effect on TG antibodies. This can depend on the individual and their body's response.
I have written several articles about how to best decrease thyroid antibodies.
Here are some articles I think you might find helpful:
HASHIMOTO'S AND THYROID ANTIBODIES: PART 1
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-antibodies/
HASHIMOTO’S AND THYROID ANTIBODIES: PART 2
https://thyroidpharmacist.com/articles/part-2-mechanisms-reduce-thyroid-antibodies/
Jennifer Sargent says
Hello Izabella, diagnosed with Hashi’s about 4yrs ago when my antibodies were off the rails. I am also post menopause now 6yrs and 57. Have spent lots of time since then researching and working with an FD. I am a big believer in testing before taking certain supps. I was thinking about taking a selenium supplement back in 2016 but I took a test first to see my levels and surprisingly they came back high – Selenium – Whole blood * 154 ug/l (76 – 140) for obviously reasons I never took it due to possible toxicity. That was just over 3yrs ago and wondering whether to test again or take a low dose ie the one you recommended. As I am in the UK there is only one supplier https://www.amritanutrition.co.uk/selenium-60-vcapsules. Since my body crashed 4yrs ago the anxiety has been so bad every day and I can’t shake it and wondered whether Selenium would help but scared to try it in case my levels are still high. What would you recommend please
Dr. Izabella says
Jennifer – thank you so much for reaching out. Please understand, I am not able to advise on whether selenium would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend that you discuss this with your personal doctor. <3
Cathy says
I read this article through and I have the CBS gene mutation. You say that those of us with this should regularly monitor our selenium levels but then, farther down you say there isn’t specific testing you would recommend relating to measuring selenium levels. Well then how would we monitor selenium levels if there isn’t a test? And would it be in red blood cell or serum or what? Thank you, Cathy
Dr. Izabella says
Cathy – thank you so much for sharing. <3 I recommend a Comprehensive Urine Elements Genova Kit. You can self-order that from direct labs or request it from your Functional practitioner. Here is a link if you would like to check it out: https://www.directlabs.com/thyroidrx/OrderTests/tabid/29159/language/en-US/Default.aspx
Miwa Takahashi says
Hello,
Thank you for this article I started taking selenium after reading this and it has cleared my anxiety that I was experiencing completely.
I did want to ask should you stop taking selenium after 3months or is this something that you can continue to take?
If I have Hashimoto’s is it a given that my TPO antibodies will be elevated? I’ve just had a blood test where my TSH is 2.99 but I was feeling an increase in anxiety tiredness over the last month or so… I have not had my tpo antibodies tested.
Thank you,
Miwa
Dr. Izabella says
Miwa – thank yo uso much for reaching out and sharing your journey. <3 It's always best to discuss your supplements with your practitioner who's care you are under so that proper testing can be done if needed. If you have any other questions about the supplements please feel free to email my team at info@thyroidpharmacist.com and they will be happy to help.
Miwa says
Hello – I was wondering should you be supplementing this indefinitely or just for 3-4mths. I recently just started taking this and it has helped with my anxiety so much (thank you!!) but wasn’t sure if this was something I should use on a short term base only…
Thank you!!
Miwa
Dr. Izabella says
Miwa – thank you for reaching out and sharing. <3 I'm so glad you are finding the selenium supplement helpful. I recommend that you discuss the long term use with your doctor who's care you are under.
Raaya says
Hello, I didn’t see in the article any information about blood test to check Selenium levels in the body or what is the recommended range for Hashimoto.
I tested for Selenium Serum ICPMS and got a result of 96.11 μg/L. How do I know if I need to supplement or not?
Dr. Izabella says
Raaya – thank you so much for reaching out. For information about the supplements and testing please email my team at info@thyroidpharmacist.com and they will be happy to help you. <3
Amber says
Hello, I have gotten my TPO numbers down into the 30s from 900s by following your protocol. My T4, T3, Reverse T3 are all in good shape. The problem is my hair is still falling out and not regrowing much, and I am tired/anxious. My gut is in good order and I’m slowly lowering my caffeine intake (I drink two glasses of iced tea a day with honey). I’ve suspected iodine and selenium could be to blame for the remaining symptoms, even though I supplement with 200 mcg selenium a day. Up until now, I have avoided iodine because I don’t want to cause a flare, but I have a gut feeling my iodine levels could be to blame. My iodine and selenium test results just came back. Serum iodine is 52 (range 52-109 mcg/L), urine iodine is 54 (range 34-523 mcg/L), and selenium is 90 (range < 160 mcg/L). I just bought a multivitamin with iodine and selenium in it. The iodine is 225 mcg per serving and the selenium is 50 mcg. Is there an ideal ratio of iodine to selenium? And is there a best functional test range for iodine and selenium? Thank you!
Dr. Izabella Wentz says
Amber – thank you for reaching out and sharing your journey.<3 The dose range found in multivitamins (between 150 mcg–220 mcg) is generally safe for people with Hashimoto’s. I do recommend discussing the addition of supplements with your practitioner whose care you are under. Here is an article you may find interesting as well:
IODINE AND HASHIMOTO'S
https://thyroidpharmacist.com/articles/iodine-hashimotos/
Elizabeth Davis says
Dr. Wentz,
I just started taking Selenium Yeast – Free (as L-selenomethionine) 200 mcg about 1 week ago because I found your article. I also take vitamin E 800iu for stomach inflammation and burning ( I have been diagnosed with erosive gastritis as of Jan. 24, 2020 from an endoscopy with my GI doctor.) I take vitamin B1 for digestive issues and B12 to help with my energy. Plus I am taking a probiotic 50 billion for digestive balance that is made to resist stomach acid. And I have put myself on an alkaline food menu.
I take Levothyroxine 88 mcg for Hashimoto’s disease and Rabeprazole 20 mg for acid reflux, and Famotidine 40mg for Silent Reflux. I was taking Oxybutynin 15mg and recently stopped a month ago because one of the side affects is an acid stomach.
My questions are:
1. Do I take Selenium 200 mcg since I am on Levothyroxine 88 mcg?
2. If the answer is yes to taking Selenium, how long can I take Selenium while taking Levothyroxine?
I am 70 years old and I have been taking thyroid medicine since I was 52 and have recently (last 5 years) developed acid reflux and gastritis.
You have mentioned to your other readers that talking to their PC or Specialist would be the best answer since you don’t have a complete diagnosed report.
I go to a VERY well know clinic in Texas and there is not one doctor out of the 10 different doctors that I see (for other issues) that has ever mentioned or suggested taking any supplements to help with any of my ailments nor do they seem to pay attention to the side affects with medicines that might cause problems in the future with health issues that I am having. My go to help are ladies at a health food store that I have befriended after I do my research on line.
It’s unfortunate that one has to be their own advocate when it comes to maintaining a healthy life style when you have all of these doctors who can’t get on the same page.
Sincerely,
Elizabeth
Dr. Izabella says
Elizabeth – thank you so much for sharing your journey. I understand how frustrating and hard it is to find the right practitioner. I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and prevent serious chronic disease rather than treating individual disease symptoms. I believe that everyone needs to find a practitioner that will let him/her be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It’s a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! Here are some resources you might find helpful.
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
COMPOUNDING PHARMACIES
https://thyroidpharmacist.com/database-recommended-compounding-pharmacies/
I also suggest that you join one of the Hashimoto’s groups that are out there. Being able to share ideas of what has worked with one another and offer support for each other can be very helpful. A couple of years after my diagnosis, I found Hashimoto’s 411, a closed Facebook group run by Alice Berry McDonnell. This group is amazing! It is comprised of an army of highly motivated, smart, supportive women and men (now 50,000+ strong), and each of them sharing ideas of what worked for them, things they were planning to try, and offering support to one another.
https://www.facebook.com/groups/hashimotos411/
Lori B says
Thank you for this comprehensive article! For someone with a CBS mutation is there a supplemental form of selenium other than selenomethionine that uou recommend? I would judt eat brazil nuts but cannot digest them well. Thank you!
Dr. Izabella Wentz says
Lori – thank you so much! <3 Please understand, I am not able to advise on a selenium supplement that would be appropriate for you and your specific health needs without a comprehensive health assessment. I recommend you discuss this with your practitioner who's familiar with your health history.
Jayne says
I have been taking a multi that has a small amount of kelp iodine. I have hashimotos and multinodular goiter. In my facebook group they said the irritation i was feeling was post scarcity effect so i kept taking. It’s not going away and i can feel it clicking when i swallow and have to clear my throat sometimes from it and feel tired. I stopped it now. Will selenium help it go back to normal. I cant afford a naturopath and my GP wont do anything for it except give my ultrasounds and synthroid. I need to get it back to normal. Please Help however you can. i also heard that the different forms work better for different people senenite vs selenomethionine. Selenomethionine didnt help anything when i took it a few years ago antibodies stayed the same.
Dr. Izabella Wentz says
Jayne – thank you for reaching out. I’m so sorry you are struggling with all of this! <3 I am very hesitant in recommending iodine in Hashimoto's. Although iodine serves as fuel for our thyroid and is very important in iodine deficiency hypothyroidism, Hashimoto's is a different mechanism. It's like pouring gas into an engine that's on fire... that's essentially what's happening in Hashi's, thyroid inflammation. Adding iodine to the mix before putting out the fire and fixing the engine may result in further damage to the thyroid. In those with a predisposition to autoimmunity, this has been documented time and time again, in animal and human studies.
I have spent 4 years researching about this issue, and have seen too many people suffering the consequences of adding iodine too soon. My approach is, let's fix the engine first (usually a gut issue), and then add the fuel once we know that the engine is no longer on fire. Hope that you will check out my books. I do have a chapter on the iodine controversy that references numerous studies as well as the work of Abraham and Brownstein. Here are the links to my books :
Hashimoto’s Protocol
http://amzn.to/2B5J1mq
Hashimoto’s Root Cause
http://amzn.to/2DoeC80
Here is an article you may find helpful as well:
IODINE AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/iodine-hashimotos/
Jenny Keefer* says
Hello Dr Izabella, I live in South Africa I have had this Thyroid problem for many years now.. it is a very difficult thing to live with. I have swelling in my neck and collar bone area… Anxiety and shaking. I am so tired of not feeling normal. I will definitely try the Selenium and vitamin E… I’m hoping it will help. Thank you for all the info.
Regards Jenny
Dr. Izabella Wentz says
Jenny – thank you for sharing your journey. <3 I'm so osrry you are struggling with all of this. <3 Nodules and goiters are often the result of toxicity and/or the autoimmune process. So, doing interventions to reduce the autoimmune attack on the thyroid, and toxicity, can be helpful to reduce them. Here is an article you may find helpful.
THYROID NODULES
https://thyroidpharmacist.com/articles/hashimotos-and-thyroid-nodules/
I highly recommend that you work with a functional medicine clinician. It’s an entire medical specialty dedicated to finding and treating underlying causes and prevention of serious chronic diseases, rather than disease symptoms. If you cannot find a Functional Medicine practitioner in your area, it is possible to work with an overseas practitioner remotely via Skype or some other online video platform. Here’s a link which might help: https://thyroidpharmacist.com/database-recommended-clinicians/
Dagmara says
Hello Dr Izabella,
What if someone’s selenium keeps showing too high on blood tests? If I don’t take Selenium supplements it’s still showing high. If I take some supplements ( included in my NAC supplements) at dose of 75 mcg/ day, my Selenium levels are very high. The doctors don’t know why.
I used to take Diatomaceous earth for period of time. Do you think this contributed to increase in Selenium. I have MTHFR gene variations and I have 3 x hemangiomias on the liver. I also heard from one methylation expert that when Selenium is high and it’s not supplemented this means that we are not absorbing the selenium because glutathione is low. We need Glutathione for Selenium absorbtion. Do you agree with this? How would you check if your Glutathione is low?
Best regards
Dagmara
Dr. Izabella Wentz says
Dagmara – thank you for sharing. ❤️ Please understand I am not able to advise you on what would be appropriate for you and your specific health needs without a comprehensive health assessment. I highly recommend that you work with a functional medicine clinician to be a part of your own health care team. It’s an entire medical specialty dedicated to finding and treating underlying root causes and prevent serious chronic disease rather than treating individual disease symptoms.
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
FIND A FUNCTIONAL MEDICINE CLINICIAN
https://ifm.org/find-a-practitioner/
Dagmara says
Hi Izabella- Thank you for your comment. I know how Functional Medicine works as I have been following this for years. No problem- I will shortly be seeing ( lost the count how many I have seen already) a Functional Medicine Doctor.
Regards
Dr. Izabella Wentz says
Dagmara, I’m sorry you have not had an luck finding the right practitioner. My heart goes out to you. I understand how hard it is. <3 I believe that everyone needs to find a practitioner that will let you be a part of the healthcare team. You want someone that can guide you, that will also listen to you and your concerns. You want someone that’s open to thinking outside of the box and who understands that you may not fit in with the standard of care. It's a good idea to ask some standard questions when contacting a new doctor for the first time. Something else to consider is you can work with a functional doctor remotely, via Skype. You could also contact your local pharmacist or compounding pharmacy, who may be able to point you to a local doctor who has a natural functional approach. But I encourage you to keep looking for the right one for you! I hope that the practitioner you are seeing soon is the right one for you and that you will keep me posted on you progress.
Rebecca says
Do you recommend 200mcg selenium on top of a prenatal multivitamin?
Dr. Izabella Wentz says
Rebecca – thank you for reaching out. I recommend that you discuss this with your OB practitioner. ❤️
Yaminee says
Hi, I recently started taking the Megafood E & Selenium. Do you think this supplement is viable option or should I stick to Pure Encapsulations? Also, I have had systemic inflammation for 2 years – could the selenium deficiency be the root cause? Thanks!
Dr. Izabella Wentz says
Yaminee – thank you for reaching out. ❤️ I am not familiar with that specific supplement. Inflammation is always a factor with Hashimoto’s, as thyroid disease itself involves inflammation of the thyroid gland
In autoimmune disease, the body views part of its own body as a foreign invader and stages an attack, resulting in inflammation. In most cases of Hashimoto’s, where the body attacks its own thyroid cells, the inflammation is not limited to the thyroid gland, but can manifest anywhere in the body. Hashimoto’s is very much an individual condition. While there are root cause commonalities, each person will have their own or in some cases, more than one root cause. You will have to start with the simplest modifications, by removing triggers, followed by repairing the other broken systems to restore equilibrium, allowing the body to rebuild itself. You will need to dig down to why the immune system is imbalanced in the first place and this will tell you how you begin to finally feel better, reduce your thyroid antibodies and even take your condition into remission. You will have to create your own health timeline. Look back at your overall history as far back as you can remember. Look for infections, periods of severe stress, the use of medications (especially antibiotics, antacids, and oral contraceptives), accidents, and exposure to toxins. These are events that may have contributed to Hashimoto’s. Once you do, you will know what types of changes you need to implement to make yourself feel better.
If you need further support, please check out the list of lab tests inside the “Testing” chapter of my book, Hashimoto’s Root Cause. I also offer a 12-week program, Hashimoto’s Self Management Program. Here are some resources I hope you find helpful as well. ❤️
BUILDING YOUR OWN HEALTH TIMELINE
https://thyroidpharmacist.com/sample-health-timeline/
Hashimoto’s Self-Management Program
https://thyroidpharmacist.com/enroll-in-hashimotos-self-management/
ROOT CAUSE RESET
https://thyroidpharmacist.com/enroll-in-root-cause-reset/
April Bowen says
You say you recommend taking selenium on an empty stomach with vitamin E, which works in synergy with selenium, to ensure proper absorption. With so many things that must be taken on an empty stomach in the thyroid sufferer’s world (especially when you have to take multiple doses of T3 throughout the day) why is this? You are great at citing excellent sources and many times my questions are answered there but this is not the case for your recommendation to take selenium on an empty stomach.
Can this be consumed with coffee but no food? An hour after I take my first dose of thyroid medication? With all this “take with an empty stomach” and my digestion sluggish as it is it’s a wonder if I’ll ever eat again.
Dr. Izabella Wentz says
April – thank you for reaching out. ❤️ I understand how hard this all is! Selenium is usually best taken on an empty stomach. You can take it within 30 minutes of your thyroid hormones. Thyroid medication absorption can be impacted by many things, including food, other medications, and supplements. Thyroid medication should be taken on an empty stomach at least one hour before eating, taking other medications, supplements or coffee to ensure appropriate absorption. Antacids such as Tums, iron, magnesium, and calcium supplements can impair the absorption of thyroid medications. Thus, you need to have at least 4 hours of time in between your thyroid medications and these agents. Please be sure to read the directions provided with the medication.
I hope you find this free ebook helpful. https://thyroidpharmacist.com/meds-ebook/
Here is an article you may find helpful as well:
CONTROVERSY COFFEE AND YOUR THYROID
https://thyroidpharmacist.com/articles/controversy-coffee-bad-thyroid-myths-truths/
Jane says
I had taken selenium supplements in the past , 200 mcg . I did see a modest decrease of tpo antibodies, However, my endo tells me that I am insulin resistant and may develop diabetes. Apparently I have this GAD65 antibody that might indicate type 1 diabetes! He has me testing blood sugars etc, which are currently in the high range of normal as is my HbA1C. I have read some studies suggesting that selenium supplementation can increase the risk of diabetes. I am 63. My sig other tells me to stop watching the numbers and just eat healthy. Very frustrating, finding one thing that helps Hashimotos, but might create a whole new problem.
Dr. Izabella Wentz says
Jane – thank you for reaching out. ❤️ You could ask your practitioner to check your selenium levels if you are concerned. Blood sugar imbalances are a big contributor to Hashimoto’s. Balancing blood sugar levels should be one of the priorities for anyone who is hoping to overcome autoimmune thyroiditis and adrenal fatigue. Balancing my blood sugar made a big difference for me, helping with my anxiety levels and reducing my thyroid antibodies. I hope this article helps shed some light on the matter:
BLOOD SUGAR IMBALANCES AND HASHIMOTO’S
https://thyroidpharmacist.com/articles/blood-sugar-imbalances-and-hashimotos
Camille says
Is it possible to have an adverse reaction to selenium? The 2 times I tried taking a Natural Factors supplement of 100 mcg a day, I ended up with red patches appearing on my legs after how showers, itching all around my waist and lower back, and garlic-smelling sweat. One time, I also got all these symptoms while taking a balanced thyroid synergy that only contained 25 mcg of selenium. When I stop taking it, the red patches remain for days but eventually fade out. Could it be because I dont metabolize properly selenium? I never heard of these effects before.
Dr. Izabella Wentz says
Camille – thank you for reaching out. ❤️ Not all supplements are created equally and you may be using a brand that contains fillers and additional ingredients that could be causing a reaction. Selenium appears to be a supplement with a narrow therapeutic index. A minimum dose of 200 mcg was required to reduce TPO antibodies in clinical trials (100 mcg did not have an effect), and Selenium can be toxic at doses >800 mcg. Daily Selenium dose for adults should be between 200 mcg and 400 mcg. I recommend discussing your symptoms with your practitioner.
Jennifer says
I had my thyroid radiated 10 years ago because that was what I was told to do. My antibodies are high now, but my TSH, T3 and T4 are all normal. The endo said they won’t see me while I am at normal levels and to let my GP monitor my symptoms yearly. (Extreme hand and foot pain, hair loss, gritty eyes, exhaustion that comes and goes, heart palpitations, the list goes on.) Will these hints on your pages help even though my thyroid is fried? I bought Selenium, but then was nervous to take it.
I appreciate this article. It made me more confident. I will be taking it daily. Thank you for your time!
Dr. Izabella Wentz says
Jennifer – thank you for reaching out! I’m so sorry to hear you are struggling with all of this! ❤️ Most thyroid conditions result from the immune system attacking the thyroid because the immune system is out of balance. Even when the thyroid is taken out surgically or treated with radioactive iodine the autoimmunity still persists in most cases. Many people will have their thyroids removed, and will develop new autoimmune disorders such as Lupus, Rheumatoid arthritis, etc. The immune system just finds a different target.
We need to rebalance the immune system to prevent this. Sometimes the autoimmunity can be reversed as well! The gut determines your immune system. With the exception of discussing proper thyroid medication dosing, the majority of my website and my book focuses on balancing the immune system. The info I present is based on my own research and journey for overcoming my autoimmune thyroid condition.
IMPORTANCE OF GUT HEALTH
https://thyroidpharmacist.com/articles/importance-gut-health/
WHERE DO I START WITH HASHIMOTO’S
https://thyroidpharmacist.com/articles/where-do-i-start-with-hashimotos/
Rob says
I’m a 40 year old male with in range TSH/T3/T4 but found out I had elevated antibodies 3-4 years ago. Pure Encapsulations Selenium at 200 mcg dropped my antibodies by 50-60%, and even got my TPO into normal range, but how do I weigh the prostate cancer risk being a male? Is it worth taking selenium or too risky?
Dr. Izabella Wentz says
Rob – thank you for sharing! ❤️ I recommend discussing your concerns about selenium and your cancer risk with your practitioner who is familiar with your health history. They can help you decide if continuing to supplement is the best option for you and your health condition.
Almudena says
Thank you for sharing this information ❤️.
I wonder if selenium is recommended even if selenium levels are ok. I’m considering adding selenium to my supplements but in my last blood test the value was a little above the reference range. My antibodies are not negative but almost, however I need high doses of levothyroxine and I definetely have problems converting T4 in T3 🙁
Do you think selenium is recommended and can help in my case?
Thank you in advance. I love your books and all the stuff you share 🙂
Dr. Izabella Wentz says
Almudena – thank you for reaching out! I’m os glad to hear you are enjoying my books and research! ❤️ I’ve found that selenium supplementation at 200 mcg per day is generally safe for most people with Hashimoto’s and I have found toxicity problems to be very rare. I do recommend disussing with your practitioner to determine whether selenium supplementation may be right for you.
Marina says
Hello! Love your article. My 7yo daughter has Hashimoto. Can you tell me what dosage of selenium you recommend? Thank you
Dr. Izabella Wentz says
Marina – thank you for sharing. My heart goes out to you and your daughter. ❤️ Unfortunately dosing for children is different then for adults so I am not able to advise you. When it comes to children, as well as adults, I always recommend starting with the diet. Are they gluten, dairy, corn and soy free? Are they eating a nutrient dense diet with fermented foods? Most of the interventions recommended in my book can be done with children, with the exception of the dosing of supplements as I said. I do suggest that you work with a functional medicine doctor that is familiar in working with children (I only work with adults).
FUNCTIONAL MEDICINE APPROACH TO THE THYROID
https://thyroidpharmacist.com/articles/functional-medicine-approach-to-the-thyroid
CLINICIAN DATABASE
https://thyroidpharmacist.com/database-recommended-clinicians/
Sharon Benedict says
My doctor say I don’t have Hastimotos but have hypothyroid, insulin resistance/prediabetic, chronic fatigue, malabsorption over the years. I am 78 years old now. Doing well overall but have regressed the last 6 months. Still on compounded estradiol/estriol, progesterone, testosterone. They are trying to boost my T3 by using sublingual T3/T4 combination. They have been testing every 3 months as they continue to up the dosages. Their T3 goal is 4-4.4 and T4 1.2-1.5. The August 2022 test results showed T3 2.9 (up from 2.2), T4 .73 (dropped from 1.33). TSH .025 (drop from 1.62), SHBG 118. They don’t know why the T4 dropped to .73. TSH is now .025 and they want it <1.
TPO in 2020 was 14, Reverse T3 22.1, TgAb <1.0, SHBG 119. Been much more tired, brain fog, muscle aches all returned, sugar cravings again.
Is TSH .025 too low? Or are my doctors on the right track?
And maybe need to increase selenium? Currently taking 70mcg, iodine 150mcg, inositol 25mg, extra magnesium, pantothenic acid. Your input appreciated.
Dr. Izabella Wentz says
Sharon – thank you so much for sharing your journey. I’m so sorry you are struggling with this. I recommend discussing this recent regress and your symptoms with your practitioner so that they can help you determine your next steps. Most people do feel best with a TSH of around 1 or lower and with a Free T4 and Free T3 in the upper half of the range. It is expected that your TSH will be very suppressed when optimal on NDT medication. How much thyroid replacement therapy is needed is unique and different for each person, so it’s important to work with a functional medicine practitioner or a doctor, who can closely monitor your dosage and your progress. Every six weeks is usually a good schedule for testing your thyroid hormones. I have some articles on my website here that you may find helpful as well just search your symptoms in the search bar. I do hope you will continue to keep me posted on your progress.
Eleanor says
Fascinating article thanks. Note, is an error in the article. Should read Brazil instead of New Zealand as a source of brazil nuts with potentially high selenium levels.
Dr. Izabella Wentz says
Eleanor, Thank you so much for bringing that to my attention! I will have my team look into that and update.
Hollie Wanders says
This information has been really helpful. I have had hypothyroidism for over 25 years and have been on desiccated thyroid meds for years at the same dosage and for the most part my bloodwork has always remained stable. After drastically changing my diet to the Weston Price diet for the past year, my blood work came back with TSH of below .1 yet my T4 has come back normal (12). Is this a potential sign that I am healing my thyroid? I have been gradually reducing my meds and am wondering if introducing Selenium would be a good option for me to help encourage continual healing.
Dr. Izabella Wentz says
Hollie – thank you for sharing! I’m so glad you are seeing improvements after making dietary changes. Selenium is a great supplement to try, you will need to monitor thyroid function, as it can really improve to the point where you may eventually need to lower your dosage. Keep me posted on your progress.
Shannon says
I’ve been on an iodine protocol since 2020. I started this because i was hoping it would cure my endometriosis, which it did. I took iodine and all cofactors including selenium daily and two years later in 2022 my hair started falling out. I had a micro-nutrient test done and my selenium was in the toxic range. So I continued the protocol without selenium and eventually things leveled out because my hair was getting thicker. I’ve been afraid to take selenium since. Recently, I’ve started to feel unwell. My heart rate is resting at 110 for a week and a half and shoots up to 140 if I stand or walk. I think 2 years without selenium has caused me to go hyper. When I finally came to this conclusion yesterday, I stopped iodine and started taking selenium again. I’m wondering if I’ve messed myself up permanently or if it will resolve after stopping iodine. I haven’t had any blood work done yet to test my thyroid levels. My appointment with a GP is Thursday amd it will take me months to get to an endocrinologist. I’m hoping selenium will take me back to normal.
Dr. Izabella Wentz says
Shannon – thank you so much for sharing. Selenium can be very helpful for many with Hashimoto’s. It can reduce antibodies by about half, when taken at a dose of 200 mcg per day x 3 months. People generally report feeling less anxious and see less hair loss, in my experience. It is a goldilocks nutrient, so getting too much can be an issue, and even toxic. I recommend taking no more than 400 mcg per day (if adding to your regimen, please check your multivitamins as some may contain additional selenium, and avoid Brazil nuts. Brazil nuts can have anywhere from 100 mcg selenium per nut all the way up to 600 mcg). While it helps many people, it’s not right for everyone. If you feel worse after taking selenium, stop taking it and listen to your body. I also recommend discussing this with your practitioner. Please keep me posted on your progress. ❤️
Daisy says
What time of day should selenium be taken?
With or without food?
Dr. Izabella Wentz says
Daisy – Great question! I generally recommend taking selenium on an empty stomach along with Vitamin E, 30 minutes to one hour away from thyroid medications.