title: Effects of selenium on short-term control of hyperthyroidism due to Graves' disease treated with methimazole: results of a randomized clinical trial.
abstract: OBJECTIVE
  In spite of previous conflicting results, an adjuvant role of selenium in the treatment of Graves' disease (GD) hyperthyroidism has been proposed. To address this issue, a randomized clinical trial was carried out aimed at investigating whether selenium is beneficial on the short-term control of GD hyperthyroidism treated with methimazole (MMI).
  
  
  METHODS
  Thirty newly diagnosed hyperthyroid GD patients were randomly assigned to treatment with: (i) MMI or (ii) MMI plus selenium. Primary outcomes were: control of hyperthyroidism and clinical and biochemical manifestations of hyperthyroidism [heart rate, cholesterol, sex hormone-binding globulin (SHBG), hyperthyroidism symptoms] at 90 days.
  
  
  RESULTS
  Baseline features of the two groups did not differ. Serum selenium at baseline was similar in the two groups and within the recommended range to define selenium sufficiency. Selenium increased with treatment in the MMI-selenium group and became significantly higher than in the MMI group. Serum malondialdehyde, a marker of oxidative stress, was similar in the two groups and decreased significantly with treatment, with no difference between groups. Administration of MMI was followed by a reduction of FT3and FT4, with no difference between groups. Heart rate, SHBG and symptoms of hyperthyroidism decreased, whereas total cholesterol increased in both groups with no difference between groups.
  
  
  CONCLUSIONS
  Our study, carried out in a selenium-sufficient cohort of GD patients, failed to show an adjuvant role of selenium in the short-term control of hyperthyroidism. However, selenium might be beneficial in patients from selenium-deficient areas, as well as in the long-term outcome of antithyroid treatment.
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Leo
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit, University of Insubria, Viale Borri 57, 21100, Varese, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bartalena
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rotondo Dottore
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Piantanida
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit, University of Insubria, Viale Borri 57, 21100, Varese, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Premoli
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Ionni
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit, University of Insubria, Viale Borri 57, 21100, Varese, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Di Cera
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit, University of Insubria, Viale Borri 57, 21100, Varese, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Masiello
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit, University of Insubria, Viale Borri 57, 21100, Varese, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Sassi
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: Tanda
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Latrofa
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Vitti
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Marcocci
authors.affiliation: Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy. michele.marino@med.unipi.it.
authors.forename: M
authors.initials: M
authors.lastname: Marinò
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000627:therapeutic use*; D013956:Antithyroid Agents / Q000009:adverse effects*; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy*; D008297:Male; D008713:Methimazole / Q000009:adverse effects*; D012643:Selenium / Q000627:therapeutic use*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013974:Thyroxine / Q000097:blood; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000097:blood
chemical_list: D000975:Antioxidants; D013956:Antithyroid Agents; D012738:Sex Hormone-Binding Globulin; D014284:Triiodothyronine; D008713:Methimazole; D012643:Selenium; D013974:Thyroxine
keywords: Autoimmunity; Graves’ disease; Hyperthyroidism; Selenium; Thyroid