The Effect of Levothyroxine and Selenium versus Levothyroxine Alone on Reducing the Level of Anti-thyroid Peroxidase Antibody in Autoimmune Hypothyroid Patients

Document Type : Original Article


1 Isfahan Endocrinology and Metabolism Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Internal Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Due to the prevalence of autoimmune hypothyroidism and its effects on physical and mental health it is necessary to provide a treatment which is also effective in preventing the progression of sub-clinical hypothyroidism in these patients. This study aims to investigate the effect of selenium supplementation on of anti-thyroid hormone antibodies in these patients.
Materials and Methods: In a randomized clinical trial, 70 patients with autoimmune hypothyroidism randomly divided into two groups of 35 each, the first group was treated with oral selenium treatment with levothyroxine (LT4) and to the second group along with LT4, placebo was also prescribed. Serum selenium level, thyroid hormones and anti-thyroid hormone antibodies before and after 3 months of treatment in both groups, were determined, and the results were analyzed using SPSS software.
Results: The mean of the serum anti-thyroid peroxidase serum level in the intervention group before and after treatment was 682.18 ± 87.25 and 522.96 ± 47.21 and the difference before and after treatment was statistically significant (P = 0.021). The level of this antibody before and after treatment in the control group was 441 ± 53.54 and 501.18 ± 77.68, and no significant differences between two groups were observed before and after treatment (P = 0.42).
Conclusion: Selenium supplementation may help to reduce the levels of antibodies in patients with autoimmune hypothyroidis


Baretic M. 100 years of Hashimoto thyroiditis, still an intriguing disease. Acta Med Croatica 2011;65:453-7.  Back to cited text no. 1
Fink H, Hintze G. Autoimmune thyroiditis (Hashimoto's thyroiditis): Current diagnostics and therapy. Med Klin (Munich) 2010;105:485-93.  Back to cited text no. 2
van Zuuren EJ, Albusta AY, Fedorowicz Z, Carter B, Pijl H. Selenium supplementation for Hashimoto's thyroiditis. Cochrane Database Syst Rev 2013;6:CD010223.  Back to cited text no. 3
Trbojevic B, Djurica S. Diagnosis of autoimmune thyroid disease. Srp Arh Celok Lek 2005;133 Suppl 1:25-33.  Back to cited text no. 4
Schomburg L. Selenium, selenoproteins and the thyroid gland: Interactions in health and disease. Nat Rev Endocrinol 2011;8:160-71.  Back to cited text no. 5
Köhrle J. The trace element selenium and the thyroid gland. Biochimie 1999;81:527-33.  Back to cited text no. 6
Köhrle J. Selenium and the control of thyroid hormone metabolism. Thyroid 2005;15:841-53.  Back to cited text no. 7
Duntas LH. Selenium and the thyroid: A close-knit connection. J Clin Endocrinol Metab 2010;95:5180-8.  Back to cited text no. 8
Köhrle J, Gärtner R. Selenium and thyroid. Best Pract Res Clin Endocrinol Metab 2009;23:815-27.  Back to cited text no. 9
Duntas LH. The role of selenium in thyroid autoimmunity and cancer. Thyroid 2006;16:455-60.  Back to cited text no. 10
Duntas LH, Mantzou E, Koutras DA. Effects of a six month treatment with selenomethionine in patients with autoimmune thyroiditis. Eur J Endocrinol 2003;148:389-93.  Back to cited text no. 11
Krysiak R, Okopien B. The effect of levothyroxine and selenomethionine on lymphocyte and monocyte cytokine release in women with Hashimoto's thyroiditis. J Clin Endocrinol Metab 2011;96:2206-15.  Back to cited text no. 12
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;87:1687-91.  Back to cited text no. 13
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. J Clin Endocrinol Metab 2007;92:1263-8.  Back to cited text no. 14
Toulis KA, Anastasilakis AD, Tzellos TG, Goulis DG, Kouvelas D. Selenium supplementation in the treatment of Hashimoto's thyroiditis: A systematic review and a meta-analysis. Thyroid 2010;20:1163-73.  Back to cited text no. 15
Mazokopakis EE, Papadakis JA, Papadomanolaki MG, Batistakis AG, Giannakopoulos TG, Protopapadakis EE, et al. Effects of 12 months treatment with L-selenomethionine on serum anti-TPO levels in patients with Hashimoto's thyroiditis. Thyroid 2007;17:609-12.  Back to cited text no. 16
Turker O, Kumanlioglu K, Karapolat I, Dogan I. Selenium treatment in autoimmune thyroiditis: 9-month follow-up with variable doses. J Endocrinol 2006;190:151-6.  Back to cited text no. 17
Negro R. Selenium and thyroid autoimmunity. Biologics 2008;2:265-73.  Back to cited text no. 18
Onal H, Keskindemirci G, Adal E, Ersen A, Korkmaz O. Effects of selenium supplementation in the early stage of autoimmune thyroiditis in childhood: An open-label pilot study. J Pediatr Endocrinol Metab 2012;25:639-44.  Back to cited text no. 19
Karanikas G, Schuetz M, Kontur S, Duan H, Kommata S, Schoen R, et al. No immunological benefit of selenium in consecutive patients with autoimmune thyroiditis. Thyroid 2008;18:7-12.  Back to cited text no. 20
Anastasilakis AD, Toulis KA, Nisianakis P, Goulis DG, Kampas L, Valeri RM, et al. Selenomethionine treatment in patients with autoimmune thyroiditis: A prospective, quasi-randomised trial. Int J Clin Pract 2012;66:378-83.  Back to cited text no. 21