Selenium Deficiency

What Is Selenium?

[dropcap]S[/dropcap]elenium is a mineral that is required by the body  in trace amounts for a healthy immune system, normal thyroid function, and antioxidant protection.

Selenium is absolutely required in the production of at least 30 selenoproteins in the body. First, selenium is joined to the amino acids cysteine as selenocysteine and to methionine as selenomethionine before being used as components for selenoproteins. Many selenoproteins are important antioxidant enzymes such as glutathione peroxidase.

Q: How does glutathione peroxidase work?

A: Glutathione peroxidase activity helps the recycling of vitamins C and E in optimizing the performance of the antioxidant system. The antioxidant properties of selenoproteins help prevent cellular damage from free radicals. Free radicals are natural by-products of oxygen metabolism that may contribute to the development of chronic diseases such as cancer and heart disease.

In the immune system, selenium stimulates immune properties of lymphocytes (white blood cells) by contributing to higher natural killer lymphocyte activity. Natural killer lymphocytes have the ability to destroy cancer cells and bacterial and viral agents.

Other selenoproteins help protect the thyroid gland from anti-oxidants and regulate thyroid function. Specifically, selenium plays an integral role in thyroid gland metabolism.¹ Functions are more fully described below.

According to the Food and Agriculture Organization, United Nations, approximately 30 percent of tissue selenium is contained in the liver, 15 percent in kidney, 30 percent in muscle, and 10 percent in blood plasma.

What Is Selenium Deficiency In Celiac Disease and/or Gluten Sensitivity?

• Relationship between selenium deficiency and celiac disease. Selenium deficiency is a classic symptom of celiac disease that results when the level within cells is too low to meet needs of the body for this mineral caused by malabsorption.

• Relationship between selenium deficiency and blood status. Blood levels of  selenium in children with celiac disease are especially low at the preliminary stage of diagnosis and following low compliance to the gluten free diet.²

• Relationship between selenium deficiency and villous atrophy. Serum levels of selenium in children with celiac disease having type 3 duodenal lesions are decreased, with and without diarrhea.³

• Relationship between selenium deficiency and signs. Selenium deficiency is characterized by impaired anti-oxidant protection making the body more susceptible to illnesses caused by nutritional, biochemical or infectious stresses, impaired immune system, impaired male fertility due to defective and non-mobile sperm, impaired DNA repair, impaired protective role against cancer, impaired production of prostaglandins that require selenium, and impaired thyroid hormone activation resulting in hypothyroidism (autoimmune thyroid disease).
• Relationship between selenium deficiency and thyroid. The thyroid is especially sensitive to selenium deficiency, because selenoproteins can modify thyreocytes function (thyroid cell that make thyroid hormone) by acting as antioxidants and modifying antioxidant status and thyroid hormone metabolism.⁴
• Relationship between selenium and inflammation. Low selenium levels negatively alter genes that regulate the inflammatory response to injury. Selenium deficiency promotes inflammation of blood vessels.
• Relationship between selenium deficiency and damaged cells. In celiac disease, and autoimmune thyroid disease as well, there is an over production of inflammatory interleukin-15 (IL-15) which inhibits the correct removal of damaged intraepithelial lymphocytes (white blood cells) caused by the reaction to gluten. On the reverse, selenium proteins promote the removal of damaged cells. Therefore, selenium deficiency is a key factor directly leading to thyroid AND intestinal damage because of the failure to remove cells affected by oxidative damage. Serum levels of IL-15 are directly correlated with the seriousness of tissue damage.⁵

How Prevalent Is Selenium Deficiency In Celiac Disease and/or Gluten Sensitivity?

Selenium levels were found decreased in individuals with celiac disease at diagnosis, due to impaired absorption. The frequency of deficiency was found increased in study subjects with untreated celiac disease.⁶,³

Note: in the general population, selenium deficiency is rare because it is efficiently absorbed.⁷

What Are The Symptoms Of Selenium Deficiency?

Selenium deficiency is is marked by these symptoms:

• Cardiomyopathy (damage to heart muscle).
• Elevated blood pressure.
• Fatigue after mild exertion.
• Muscle weakness and myalgia.
• Increased risk for cancer (especially prostate) in chronic low selenium.
• Inflammatory conditions.
• Loss of vitality.
• Lowered resistance to infection.
• Hypothyroidism.
• Male infertility due to defective sperm (non-mobile sperm) and poor production.
• Osteoporosis, contributes to.
• Testosterone deficiency.

How Does The Body Get Selenium?

• Selenium must be obtained from food and is readily absorbed in the upper segment of the small intestine (duodenum).⁸

What Does Selenium Do In The Body?

1. Repairs DNA (genetic material).
2. Activates thyroid hormone.
3. Enhances immune system and defense against infection.
4. Needed for production of prostaglandins.
5. Essential for production of the body’s master antioxidant enzyme, glutathione peroxidase.
6. Required for conversion of the essential omega-3 fatty acid alphal-linolenic acid (ALA) into eicosapentanoic acid (EPA) and docosahexaenoic acid (DHA), two other critical omega-3 fatty acids.
7. Required for structure and function of spermatozoa which is particularly dependent on glutathione peroxidase which is converted into a structural component in the midpiece of mature spermatozoa development of sperm production.

How Does Selenium Deficiency Develop In Celiac Disease and/or Gluten Sensitivity?

• Selenium deficiency results from malabsorption in celiac disease.⁹
• Inflammation contributes to selenium deficiency when the body uses selenoproteins as antioxidants to counteract inflammation caused by interleukin-15 activity in the small intestinal lining in active celiac disease.  Interleukin-15 is a cytokine (protein) that stimulates the production of T-lymphocytes, causing tissue damage.⁴

Does Selenium Deficiency Respond To Gluten-Free Diet?

Yes. Celiac disease related selenium deficiency responds to a gluten-free diet containing adequate selenium and may require supplementation based on laboratory testing of blood level (very important to know the blood status to avoid harmful overdose).

Institution of a gluten free diet at an early age may prevent the development of autoimmune thyroid disease.¹⁰

6 Steps To Correct Selenium Deficiency:

• [dropcap]1[/dropcap]Meet, or Exceed the RDA (Recommended Dietary Allowances) for Selenium in micrograms (mcg) per day:

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20 mcg for children 1-3 years;

30 mcg for children 4-8 years;

40 mcg for children 9-14 years;

40 mcg for adolescents 14-18 years

55 mcg for males and females over 19 years;

60 mcg for pregnancy; 70 mcg for breastfeeding women.[/box]

• [dropcap]2[/dropcap]Diet – Include Food Sources Richest in Selenium:

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Selected Food Sources of Selenium; first number is the food micrograms (mcg) and the second number is the Percent DV*

• Brazil nuts, unblanched, 1 ounce (6-8 nuts)……….544 mcg….777%
• Tuna, light, canned in water, drained, 3 ounces……68 mcg…..97%
• Cod fish, cooked, 3 ounces………………………………..32 mcg…..46%
• Turkey, light meat, roasted, 3 ounces…………………27 mcg…..39%
• Chicken breast, meat only, roasted, 3 ounces………24 mcg…..34%
• Beef chuck roast, lean only, roasted, 3 ounces……..23 mcg…..33%
• Sunflower seed kernels, dry roasted, 1 ounce………23 mcg…..33%
• Ground beef, cooked, broiled, 3 ounces……………….18 mcg…..26%
• Egg, whole, hard-boiled, 1 large………………………….15 mcg….21%

*DV = Daily Value. DVs are reference numbers developed by the Food and Drug Administration (FDA) to help consumers determine if a food contains a lot or a little of a specific nutrient.

Note: The content of selenium in food depends on the selenium content of the soil where plants are grown or animals are raised. Animals that eat grains or plants that were grown in selenium-rich soil have higher levels of selenium in their muscle, such as middle American states like Nebraska and the Dakotas. Low levels soils include the eastern seacoast, northern Atlantic and Pacific states and Florida.[/box]

• [dropcap]3[/dropcap] Diet – Avoid Eating At The Same Meal or Limit These Foods That Deplete or Interfere With Absorption:

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• Milk products.
• High fiber foods. [/box]

 

• [dropcap]4[/dropcap]Monitor Medications That Deplete or Interfere With Absorption:

Ask your doctor or pharmacist about possible interactions between selenium supplements and medications you’re taking to make sure you time the doses correctly.

[box type=”shadow” ]Here are common medications that deplete selenium. Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below. Do not stop prescribed medications without supervision.

This is not a complete listing.

• Anticonvulsants (Phenobarbital and Barbituates; and Dilantin®, Tegretol®, Mysoline®, Depakane/Depacon®).
• Corticosteroids (Prednisone, Medrol®, Aristocort®, Decadron®).
• Female oral contraceptives (Norinyl®, Ortho-Novum®, Triphasil®, and others). Correlation analysis shows significant association between some trace elements and the duration of contraception and body mass index of the study participants.¹¹.[/box]

• [dropcap]5[/dropcap]Manage Nutritional Supplements to Obtain Selenium:

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• A blood level concentration should be obtained to determine status before supplementing.
• Selenium is available in several different forms. Studies indicate that inorganic salts like sodium selenite are less effectively absorbed and not as biologically active as organic forms of selenium, such as selenomethionine or high-selenium content yeast.
• Selenium supplementation (100 mcg a day) increases the ratio of HDL to LDL cholesterol and inhibits platelet aggregation (clumping).
• Selenium is safe at the level generally used for supplementation (100-200 mcg a day).

Toxicity: Taking more than 750 mcg of selenium per day may cause toxicity reactions such as brittle, loose hair, diseased/loss of fingernails, skin rash (yellowish hue) and peripheral neuropathy.  

According to the Word Health Organization, the upper tolerable nutrient intake level (UL) for selenium should be set, provisionally, at 400 µg/day for adults.

Excessive intake of selenium has been linked to increased total cholesterol and may increase risk of developing type II diabetes mellitus because excessive selenium supplementation depletes chromium.¹²

Caution: In the presence of iodine deficiency goiter, selenium supplementation has been reported to make low thyroid function worse. [/box]

• [dropcap]6[/dropcap]Other Supplements That Interact With, Deplete or Interfere With Absorption:

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• Calcium supplements used for osteoporosis compete with selenium for absorption. Check with your pharmacist. Generally, take 2 hours before or after each other.
• Excessive selenium supplementation depletes chromium.

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Medical Research Findings On Selenium Deficiency In Celiac Disease and/or Gluten Sensitivity:

RESEARCH STUDY SUMMARIES

“Serum carnitine and selenium levels in children with celiac disease.” This study investigating serum levels of selenium in children with celiac disease having type 3 duodenal lesions demonstrated that selenuim and carnitine levels are decreased in children with celiac disease, with and without diarrhea.³

“Selenium plasma concentrations in children with celiac disease in different stages of diagnosis.” This study investigating plasma selenium levels in children with celiac disease demonstrated that in celiac disease low plasma selenium levels are especially marked at the preliminary stage of diagnosis and following low compliance to the gluten free diet. Researchers state, “Children with this sickness may need supplementation of their diet with selenium.”

The level of selenium was estimated by flame atomic absorptiometry method according to Whiteside. Celiac disease was diagnosed according to ESPGHAN criteria.²

“Body content of selenium in celiac disease.” This study investigating selenium in whole blood, plasma, and leukocytes (white blood cells) in patients with biopsy-confirmed celiac disease who were clinically well and on gluten free diet demonstrated significantly lower concentrations of selenium than healthy controls.¹³

Sources:

1. Stazi AV, Trinti B. Selenium status and over-expression of interleukin-15 in celiac disease and autoimmune thyroid diseases. Ann Ist Super Sanita. 2010;46(4):389-99.DOI: 10.4415/ANN_10_04_06. [↩]
2. Kalita B, Nowak P, Slimok M, Sikora A, Szkilnik R, Obuchowicz A, Sulej J, Sabat D. Selenium plasma concentrations in children with celiac disease in different stages of diagnosis. Pol Merkur Lekarski. 2002 Jan;12(67):43-4. [↩] [↩]
3. Yüce A, Demir H, Temizel IN, Kocak N. Serum carnitine and selenium levels in children with celiac disease. Indian Journal of Gastroenterology. May-Jun 2004; 23(3):87-8 [↩] [↩] [↩]
4. Stazi AV, Trinti B. Selenium deficiency in celiac disease: risk of autoimmune thyroid diseases. Minerva Med. 2008 Dec;99(6):643-53. [↩] [↩]
5. Stazi AV, Trinti B. Selenium status and over-expression of interleukin-15 in celiac disease and autoimmune thyroid diseases. Ann Ist Super Sanita. 2010;46(4):389-99.DOI: 10.4415/ANN_10_04_06. [↩]
6. Hinks LJ, Inwards KD, Lloyd B, Clayton BE. Body content of selenium in celiac disease. British Medical Journal. Jun 23, 1983; 288(6434):1862-3. [↩]
7. Mark Beers and Robert Berkow. The Merck Manual, 17th edition. Whitehouse Station, NJ, USA: Merck Research Laboratories, 1999. [↩]
8. Kathleen Mahan and Sylvia Escott-Stump, ed. Krause’s Food, Nutrition & Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000. [↩]
9. Yüce A, Demir H, Temizel IN, Kocak N. Serum carnitine and selenium levels in children with celiac disease. Indian Journal of Gastroenterology. May-Jun 2004; 23(3):87-8. [↩]
10. Stazi AV, Trinti B. Selenium status and over-expression of interleukin-15 in celiac disease and autoimmune thyroid diseases. Ann Ist Super Sanita. 2010;46(4):389-99.DOI: 10.4415/ANN_10_04_06. [↩]
11. Akinloye O1, Adebayo TO, Oguntibeju OO, Oparinde DP, Ogunyemi EO. Effects of contraceptives on serum trace elements, calcium and phosphorus levels. West Indian Med J. 2011 Jun;60(3):308-15. [↩]
12. Wang X, Zhang W, Chen H, Liao N, Wang Z, Zhang X, Hai C. High selenium impairs hepatic insulin sensitivity through opposite regulation of ROS. Toxicol Lett. 2014 Jan 3;224(1):16-23. doi: 10.1016/j.toxlet.2013.10.005. [↩]
13. Hinks LJ, Inwards KD, Lloyd B, Clayton BE. Body content of selenium in celiac disease. British Medical Journal. Jun 23, 1983; 288(6434):1862-3. [↩]