title: EFFECT OF SELENIUM SUPPLEMENTATION VIA BRAZIL NUT (BERTHOLLETIA EXCELSA, HBK) ON THYROID HORMONES LEVELS IN HEMODIALYSIS PATIENTS: A PILOT STUDY.
abstract: BACKGROUND
  thyroid function depends on trace mineral selenium (Se), being at the active center of the iodothyronine deiodinase that catalyzes the conversion of the thyroxine (T4) to the active form of thyroid hormone, triiodothyronine (T3). Hemodialysis (HD) patients have reduced T3 levels partly due to impaired hormonal conversion that can be related to Se deficiency, a common feature in these patients. This study evaluated the effect of Brazil nuts (richest Se source) on thyroid hormone levels in HD patients.
  
  
  METHODS
  we performed an uncontrolled intervention with 40 HD patients (53.3 ± 16.1 yrs, dialysis vintage 62.0 (8.0 - 207.0) months) that received one nut (≈5g, average 58.1 μg Se/g) per day for three months. Se plasma levels were determined by atomic absorption spectrophotometry with hydride generation and, serum T3, free T4 (FT4), TSH as well as glutathione peroxidase (GPx) activity were measured by ELISA.
  
  
  RESULTS
  all patients were Se deficient and presented low T3 levels at baseline. After intervention, Se plasma levels (from 17.6 ± 11.6 to 153.4 ± 86.1 μg/L), GPx activity (from 33.7 ± 5.9 to 41.4 ± 11.2 nmol/min/mL), T3 (from 27.3 ± 8.8 to 50.2 ± 4.8ng/dL) and FT4 levels (0.87 ± 0.2 to 0.98 ± 0.4 ng/dL) were significantly increased (p < 0.05), while TSH levels were reduced (from 2.17 ± 1.3 to 1.96 ± 1.1 uUI/mL), but not significantly.
  
  
  CONCLUSIONS
  in conclusion, increasing Se levels via Brazil nut supplementation was associated with improvement in thyroid hormone levels in HD patients, although the amount of Se given was not able to restore T3 to normal levels.
authors.affiliation: Cardiovascular Sciences Graduate Program, Fluminense Federal University (UFF), Niterói-RJ, Brazil.. milbarcza@gmail.com.
authors.forename: Milena
authors.initials: M
authors.lastname: Barcza Stockler-Pinto
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.. milbarcza@gmail.com.
authors.forename: Juan Jesús
authors.initials: JJ
authors.lastname: Carrero
authors.affiliation: Medicine Faculty, Pathology Department, Federal University Fluminense (UFF), Niterói-RJ, Brazil.. milbarcza@gmail.com.
authors.forename: Luciene
authors.initials: L
authors.lastname: De Carvalho Cardoso Weide
authors.affiliation: University of São Paulo (USP), Faculty of Pharmaceutical Sciences, São Paulo, Brazil.. milbarcza@gmail.com.
authors.forename: Silvia Maria
authors.initials: SM
authors.lastname: Franciscato Cozzolino
authors.affiliation: Cardiovascular Sciences Graduate Program, Fluminense Federal University (UFF), Niterói-RJ, Brazil.. milbarcza@gmail.com.
authors.forename: Denise
authors.initials: D
authors.lastname: Mafra
mesh_terms: D000328:Adult; D000368:Aged; D031383:Bertholletia / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D006435:Renal Dialysis; D012643:Selenium / Q000097:blood / Q000172:deficiency / Q000494:pharmacology*; D013963:Thyroid Hormones / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood
chemical_list: D013963:Thyroid Hormones; D014284:Triiodothyronine; D012643:Selenium