Selenium is an essential trace mineral and functions as part of the antioxidant enzyme glutathione peroxidase. It is bonded to the essential sulfur amino acid, methionine is a naturally occurring form as found in the diet. Selenium is found most abundantly in Brazil Nuts, organ meats, seafood, and wheat germ.*

Question:

Someone recently told me that taking selenium supplements is beneficial. He made it sound like it could reduce the risk of some cancers by 50% or more, which sounds too good to be true. Is it?

Answer:

It may be true. A study published in the Journal of the American Medical Association in 1996 found that people taking 200 micrograms of selenium a day for over four years had a 46% lower risk of lung cancer, 63% lower risk of prostate cancer, and 58% reduction in colorectal cancer. Overall, the cancer risk dropped by 37% compared to people taking a placebo.

If a pharmaceutical company came out with a drug that could reduce the risk of cancer to this degree, then just about every doctor in the country would prescribe it. You would likely find full-page ads in newspapers and magazines: "Ask your doctor for this new drug." Sometimes, when I lecture, I'll ask people how many were prescribed selenium by their physicians, and very few raise their hands.

Any time a new therapy comes along, the most important questions to ask are, "What is the scientific evidence that it is effective? What are the potential side effects? How much does it cost?" Physicians sometimes refer to this as the "risk/benefit ratio." In the case of selenium, the potential benefit is great, the cost is very low, and the side effects and risks are very low. Although this study needs to be replicated, the potential benefits are so great and the risks and costs are so low, I now recommend selenium for most people. Selenium was first linked with reduced cancer risk in the 1960s. Theories about how the trace element could work to prevent tumors include the following: it may act as an antioxidant; it may be able to alter how the body processes carcinogens; it may have an effect on how proteins are made, or selenium may play a role in how the immune system functions.*

From the FDA's website:

"Selenium may reduce the risk of certain cancers. Some scientific evidence suggests that consumption of selenium may reduce the risk of certain forms of cancer. However, FDA has determined that this evidence is limited and should be revisited."

High antioxidant intake, including selenium and tocopherol, has been shown to protect against chronic diseases.

The research showed that nearly 40 percent of the sample population failed to reach the desired levels of serum selenium concentrations, (less than 1.1 micromoles per liter), despite eating healthily.

The study followed the diet of 178 women with an average age of 63 over a three-day period. Blood samples were taken to determine the serum levels of the antioxidants.

The results show that low serum alpha-tocopherol and selenium concentrations are highly prevalent even among well-educated and well-nourished German women,” said the scientists.

“This result indicates that...women with low selenium antioxidant levels would possibly benefit from the additional intake of selenium,” recommended the researchers.

It is believed that selenium and alpha-tocopherol work together to inhibit lipid peroxidation. “Insufficient status of one of these nutrients may elevate the risk of oxidative stress and possibly for associated diseases,” explained the researchers.

Results published in the Archives of Internal Medicine (2004, Vol. 164, pp. 2335-2342) indicated that supplementation of the diet with antioxidants may lower the risk of cancers. Another study, published in the American Journal of Clinical Nutrition (Vol. 80, pp. 154-162), reported that increased selenium intake could boost the immune system.

These reports add to the growing body of evidence for the health benefits of selenium intake. There have even been recommendations to enrich soil and fertilizers with selenium to boost public consumption.

Selenium and Health

This section focuses on four diseases and disorders in which selenium might play a role: cancer, cardiovascular disease, cognitive decline, and thyroid disease.

Cancer

Because of its effects on DNA repair, apoptosis, and the endocrine and immune systems as well as other mechanisms, including its antioxidant properties, selenium might play a role in the prevention of cancer.

Epidemiological studies have suggested an inverse association between selenium status and the risk of colorectal, prostate, lung, bladder, skin, esophageal, and gastric cancers. In a Cochrane review of selenium and cancer prevention studies, compared with the lowest category of selenium intake, the highest intake category had a 31% lower cancer risk and 45% lower cancer mortality risk as well as a 33% lower risk of bladder cancer and, in men, 22% lower risk of prostate cancer. The authors found no association between selenium intake and the risk of breast cancer. A meta-analysis of 20 epidemiologic studies showed a potential inverse association between toenail, serum, and plasma selenium levels and prostate cancer risk.

Randomized controlled trials of selenium supplementation for cancer prevention have yielded conflicting results. The authors of a Cochrane review concluded, based on nine randomized clinical trials, that selenium might help prevent gastrointestinal cancers but noted that these results need to be confirmed in more appropriately designed randomized clinical trials. A secondary analysis of the double-blind, randomized, controlled Nutritional Prevention of Cancer Trial in 1,312 U.S. adults with a history of basal cell or squamous cell carcinomas of the skin found that 200 mcg/day selenium as high-selenium baker’s yeast for 6 years was associated with a 52% to 65% lower risk of prostate cancer. This effect was strongest in men in the lowest tertile of selenium concentrations who had a baseline prostate-specific antigen (PSA) level of 4 ng/mL or lower. The Selenium and Vitamin E Cancer Prevention Trial (SELECT), a randomized, a controlled trial in 35,533 men aged 50 years or older from the United States, Canada, and Puerto Rico was discontinued after 5.5 years when analyses showed no association between supplementation with 200 mcg/day selenium with or without 400 international units (IU)/day vitamin E and prostate cancer risk. An additional 1.5 years of follow-up data on participants after they stopped taking the study supplements confirmed the lack of a significant association between selenium supplementation and prostate cancer risk.

In 2003, the FDA allowed a qualified health claim on foods and dietary supplements containing selenium to state that while "some scientific evidence suggests that consumption of selenium may reduce the risk of certain forms of cancer... FDA has determined that this evidence is limited and not conclusive". More research is needed to confirm the relationship between selenium concentrations and cancer risk and to determine whether selenium supplements can help prevent any form of cancer.

Cardiovascular disease

Selenoproteins help prevent the oxidative modification of lipids, reducing inflammation and preventing platelets from aggregating. For these reasons, experts have suggested that selenium supplements could reduce the risk of cardiovascular disease or deaths associated with cardiovascular disease.*

The epidemiological data on the role of selenium in cardiovascular disease have yielded conflicting conclusions. Some observational studies have found an inverse association between serum selenium concentrations and the risk of hypertension or coronary heart disease. A meta-analysis of 25 observational studies found that people with lower selenium concentrations had a higher risk of coronary heart disease. However, other observational studies failed to find statistically significant links between selenium concentrations and risk of heart disease or cardiac death, or they found that higher selenium concentrations are associated with an increased risk of cardiovascular disease.

Several clinical trials have examined whether selenium supplementation reduces the risk of cardiovascular disease. In one randomized, placebo-controlled study, for example, 474 healthy adults aged 60 to 74 years with a mean baseline plasma selenium concentration of 9.12 mcg/dL were supplemented with 100, 200, or 300 mcg selenium per day or placebo for 6 months. The supplements lowered levels of total plasma cholesterol and non–high-density-lipoprotein (HDL) plasma cholesterol (total cholesterol levels minus HDL levels) compared with the placebo group, whereas the 300 mcg/day dose significantly increased HDL levels. Other trials have provided evidence that selenium supplementation (200 mcg/day) or supplementation with a multivitamin / multimineral pill containing selenium (100 mcg/day) does not reduce the risk of cardiovascular disease or cardiac death. A review of trials of selenium-only supplementation for the primary prevention of cardiovascular disease found no statistically significant effects of selenium on fatal and nonfatal cardiovascular events. Almost all of the subjects in these clinical trials were well-nourished male adults in the United States.

The limited clinical-trial evidence to date does not support the use of selenium supplements for preventing heart disease, particularly in healthy people who already obtain sufficient selenium from food. Additional clinical trials are needed to better understand the contributions of selenium from food and dietary supplements to cardiovascular health.

Cognitive decline

Serum selenium concentrations decline with age. Marginal or deficient selenium concentrations might be associated with age-related declines in brain function, possibly due to decreases in selenium’s antioxidant activity.

The results of observational studies are mixed. In two large studies, participants with lower plasma selenium levels at baseline were more likely to experience cognitive decline over time, although whether the participants in these studies were selenium deficient is not clear. An analysis of NHANES data on 4,809 elderly people in the United States found no association between serum selenium levels (which ranged from lower than 11.3 to higher than 13.5 mcg/dL) and memory test scores.

Researchers have evaluated whether taking an antioxidant supplement containing selenium reduces the risk of cognitive impairment in elderly people. An analysis of data from the Supplémentation en Vitamines et Minéraux Antioxidants (SU.VI.MAX) study on 4,447 participants aged 45 to 60 years in France found that, compared with placebo, daily supplementation with 120 mg ascorbic acid, 30 mg vitamin E, 6 mg beta-carotene, 100 mcg selenium, and 20 mg zinc for 8 years was associated with higher episodic memory and semantic fluency test scores 6 years after the study ended. However, selenium’s independent contribution to the observed effects in this study cannot be determined. The authors of a systematic review that included nine placebo-controlled studies concluded that the available clinical evidence is insufficient to determine whether selenium supplements can prevent Alzheimer’s disease.

More evidence is required to determine whether selenium supplements might help prevent or treat cognitive decline in elderly people.

Thyroid disease

Selenium concentration is higher in the thyroid gland than in any other organ in the body, and, like iodine, selenium has important functions in thyroid hormone synthesis and metabolism.

Epidemiological evidence supporting a relationship between selenium levels and thyroid gland function includes an analysis of data on 1,900 participants in the SU.VI.MAX study indicates an inverse relationship between serum selenium concentrations and thyroid volume, risk of goiter, and risk of thyroid tissue damage in people with mild iodine deficiency. However, these results were statistically significant only in women. A cross-sectional study in 805 adults with mild iodine deficiency in Denmark also found a significant inverse association between serum selenium concentration and thyroid volume in women.

Randomized, controlled trials of selenium supplementation in patients with thyroid disease have had varied results. In one randomized, double-blind, placebo-controlled trial, 100, 200, or 300 mcg/day selenium for 6 months in 368 healthy adults aged 60 to 74 years had no effect on thyroid function, even though plasma selenium levels increased significantly. Another randomized, double-blind, placebo-controlled trial compared the effects of 200 mcg/day selenium (as sodium selenite), 1,200 mg/day pentoxifylline (an anti-inflammatory agent), or placebo for 6 months in 159 patients with mild Graves’ orbitopathy. Compared with patients treated with a placebo, those treated with selenium but not pentoxifylline reported a higher quality of life. Furthermore, ophthalmic outcomes improved in 61% of patients in the selenium group compared with 36% of those in the placebo group, and only 7% of the selenium group had a mild progression of the disease, compared with 26% of those in the placebo group.

Women with thyroid peroxidase antibodies tend to develop hypothyroxinemia while they are pregnant and thyroid dysfunction and hypothyroidism after giving birth. The authors of a Cochrane review of hypothyroidism interventions during pregnancy concluded, based on a trial that administered supplements containing 200 mcg selenium as selenomethionine daily to 151 pregnant women with thyroid peroxidase antibodies, that selenomethionine supplementation in this population is a promising strategy, especially for reducing postpartum thyroiditis. However, the authors called for large randomized clinical trials to provide high-quality evidence of this effect.

Additional research is needed to determine whether selenium supplements can help prevent or treat thyroid disease.

LifeSource Vitamins - Selenium Journal of the American Medical Association in 1996 found that people taking 200 mcg of selenium a day for over four years had a decrease of 46% lung cancer, 63% prostate cancer, and 58% colorectal cancer.*

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