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Thyroid (Expert Forum)
hashimoto's and Selenium
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
hashimoto's and Selenium
by purplekedi, Nov 21, 2005 12:00AM
Hello, I've been diagnosed with hashi's about 3 years ago. It took me along time to start feeling good. Currently, I'm on Eltroxin 0.25 mg and taking Seleno-6 200mcg daily. About 3 months ago, I started taking Vit B12 shots of 1000mcg, currently per month. I felt great for the past 2 or 3 months. I had started Selenium and the B12 shots at the same time. Nowadays, I feel the returning regular symptoms of fatigue and discomfort in stomach. I know Selenium in the long run is not very healthy. What is your opinion on these? And would recommend any other supplements?
Thank you so much for your time
Thank you so much for your time
Doctor's Answer
by Mark Lupo, M.D., Nov 21, 2005 12:00AM
, Nov 21, 2005 12:00AM
Selenium at 200mcg per day is being looked at to improve immune system thyroid disease such as Hashi and Graves. There are limited data regarding long term use. Use the amino acid form (selenomethionine or selenocysteine) and not the salt form. Over 1000mcg/day may be toxic.
Take a multivitamin as well.
The B12 injections are appropriate if you were B12 deficient - if that's the case - ask your doctor why you are deficient (ie, pernicious anemia (PA) or celiac sprue which are more common in hashi patients). If not clearly deficient or having PA or sprue then most patients absorb oral B vitamins just fine.
Regarding fatigue - make sure the TSH is at target - 0.5-2.0. Regarding the stomach pain -- consider acid indigestion -- if persists then ask you doc for a referral to a stomach specialist. Before that however, stop the selenium supplements to make sure that is not the cause -- some people are sensitive to oral supplements (including multivitamins, calcium etc) and it may be best to take such supplements after a meal.
Take a multivitamin as well.
The B12 injections are appropriate if you were B12 deficient - if that's the case - ask your doctor why you are deficient (ie, pernicious anemia (PA) or celiac sprue which are more common in hashi patients). If not clearly deficient or having PA or sprue then most patients absorb oral B vitamins just fine.
Regarding fatigue - make sure the TSH is at target - 0.5-2.0. Regarding the stomach pain -- consider acid indigestion -- if persists then ask you doc for a referral to a stomach specialist. Before that however, stop the selenium supplements to make sure that is not the cause -- some people are sensitive to oral supplements (including multivitamins, calcium etc) and it may be best to take such supplements after a meal.
Having been through an "On again, off again" experience with Hashimito's (TSH swings from 4 to 8 fairly regularily, but my T4 and T3, T7 uptake have always been normal, though at one point in my history I did show for AB's. That was about ten years ago, so who's to say what's really been at work in my case, I suppose (I've been looking with interest at some of the newer caffeine/TSH connections).
But anyway, in the serum mineral panel that I had performed, the Selenium # was actually high, one point away from the upper cut off of the ref range. The copper level was perfectly in the middle of the reference range. Zinc, Manganese, Boron, Magnesium, and Molybdenum were all within ref range, but were found to be in the lower part of the ref range. The calcium level was within ref range, but on the higher end, too. Unfortunately, the test panel did not include testing for iodine or cobalt.
I'm 28 that's a Type 1 Diabetic too as you might remember. Last year, my doc ran a test last year on my B12 serum, which was in excess of 1800. Oddly enough, however, a WBC Lymphocyte measure revealed for a minor deficiency. The test was available from one of these "Cutting edge labs," of course. Though this lab's accredations are consistent with Lab One's requirements, you never know about these things, either, I suppose, you know. Magnesium serum was normal in a test at the clinic, but this same test that measured for the WBC Lymphocyte nutrition showed for a slight Magnesium deficiency.
If,and only if, every test mentioned here would have been "Fully accurate," and I know that might have been a long shot, but if that might have ever been the case, the red flags in my case would probably involve this scenario-
1)Adequate B12 absorption, but some type of problem in being able to get that into the cells.
2)The body is "Latching on" to Selenium. I eat a fairly balanced diet, and I doubt that I have been taking large amounts of Selenium by what I eat. Probably 50-60% of the RDA, on average, with another 29% of the RDA in my multi vitamin. That said, I don't see how I could have been over doing things on Selenium, which would lead me to believe that my system is either choosing to retain as much of it as possible, or I'm having a hard time excreting it. That is, once again, if this test was accurate.
3)Diabetics are supposed to retain higher amounts of zinc than copper, to my understanding. But that was not the case in my situation.
4)When comparing these results of having had a somewhat lower Moldybdenum level and that of a higher Thiamine level, according to the WBC Lympocyte reading, if there might ever be certain forces of nature from within that are making their own adjustments with the nutrition level, there might well be some room for consideration in the possibility that there might be an association of some sorts between Thiamine and Molybdenum (Thiamine's dependancy on Moly), as was suggested in the 1997 study of the Thiamine deficient pre natal formula/ lactic acidosis connection.
5)Might Magnesium be the darkhorse in all of this, than? The hypothesis that Thiamine tends to run higher among diabetics has been well established in previous studies, to my understanding. The Thiamine enzymes are largely dependant on Magnesium. Yet, outside of signifigant deficiency, in that scenario, might it ever be that diabetics may just simply not need "As much" magnesium as others, given the noted differences involved with the role of Thiamine in diabetes?
Bottomline is that nearly every diabetic I know has Hashimito's, and several with Hashimito's have Celiac Sprue. As a Type 1, I tested negative for Celiac Sprue in a thorough panel, but I have a type two diabetic with Celiac Sprue in the family. One way or the other, I'm convinced that all of this is the same process at work, one way or the other. And if you ask me, some of the trouble may well relate back to Glutamate. 45% of wheat gluten is glutamic acid. Half of our experts wonder whether or not this is really gliadin, or MSG, etc. Glutamate/Glutamic might be an interesting link to all of this, one way or the other, and it definitely wouldn't surprise me if Aldosterone/Renin come into play at somepoint thereafter.
Methathione itself, as well as Homocysteine (And the involvement of B12 and F Acid in this process), as well as B6 (Conversion of Homocysteine to Cysteine) are all open game at somepoint along the lines, too, I would imagine.
Celiac Sprue/Diabetes/Thyroid problems. They all have one thing in common. At a personal level, I believe they all have one very BIG THING in common that goes well beyond anything we're looking at here, if you know what I mean.
However, if the theory must stay within the merits of medicine itself, the liver itself becomes an intense area of focus, with a secondary desire to look at that Homocysteine level.
Thyroid patients are taking their Selenium, B6, iodine, FAcid, and B12 everyday in their multi's, though, and that's not doing much. What they're not taking, however, was something that was put on the back burner 30 years ago. TMG. Aka, betaine anhydrous. But I'm not going to be the guinea pig and start taking that one at this point, either, you know.
Regardless, it all starts with the brain, one way or the other, doc, I'm convinced of it, ie-stress.
For all of the others, I'm an amateur, so by all means do not get any ideas from what I've written down here. Talk to your docs, leave everything up to them, folks.