Selenium and its health
advantages
What is selenium? What are the health benefits of selenium?
Selenium is a trace mineral essential to good health [1.2]. Selenium
asserts its health benefits via the production of selenoproteins.
Selenium is incorporated into proteins to make selenoproteins.
Selenoproteins are antioxdants to 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 [2,3]. Selenoproteins help
regulate thyroid function and play a role in the immune system [4-7].
Selenium may provide important health benefits to people whose
oxidative stress loads are high, such as those with inflammatory or
infectious diseases like rheumatoid arthritis or human
immunodeficiency virus/acquired immunodeficiency syndrome, or who
are at high risk for cancers, particularly prostate cancer. [A2]
Therefore, some people consider selenium as a vitamin offering
multiple health benefits.
What are the food sources of selenium?
Plant foods are the major food sources of selenium. The content of
selenium in food depends on the selenium content of the soil where
plants are grown or animals are raised. For example, soils in northern
Nebraska and the Dakotas have very high levels of selenium. People
living in those regions generally have the highest selenium intakes in
the United States (U.S.) [8]. In the U.S., food distribution patterns
across the country help prevent people living in low-selenium
geographic areas from having selenium deficiency. Soils in some parts
of China and Russia have very low amounts of selenium. Selenium
deficiency is often reported in those regions because most food in
those areas is grown and eaten locally.
Other foods with selenium include some meats and seafood. Animals
that eat grains or plants that were grown in selenium-rich soil have
higher levels of selenium in their muscle. In the U.S., meats and bread
are common sources of dietary selenium [9,10] Some nuts are also
sources of selenium.
Selenium content of foods can vary. For example, Brazil nuts may
contain as much as 544 micrograms of selenium per ounce. They also
may contain far less selenium. It is wise to eat Brazil nuts only
occasionally because of their unusually high intake of selenium. Other
common food sources of selenium include tuna, beef, spaghetti, cod,
turkey, chicken, noodles, macaroni, egg, cottage cheese, oatmeal, rice,
bread and walnuts.
What is the recommended dosage for selenium?
Recommendations for selenium are provided in the Dietary Reference
Intakes developed by the Institute of Medicine [12]. The
Recommended Dietary Allowances (RDA) for selenium for healthy
adults is 55 ug/day.
When can selenium deficiency occur?
Human selenium deficiency is seen, where soil concentration of
selenium is low [15]. There is evidence that selenium deficiency may
contribute to development of a form of heart disease, hypothyroidism,
and a weakened immune system [16,17].
Selenium deficiency can also make the body more susceptible to
illnesses caused by other nutritional, biochemical or infectious stresses
[18].
Three specific diseases frequently associated with selenium deficiency
are Keshan Disease [enlarged heart and poor heart function],
Kashin-Beck Disease [osteoarthropathy] and Myxedematous Endemic
Cretinism [mental retardation].
Keshan disease was first described in the early 1930s in China, and is
still seen in large areas of the Chinese countryside with selenium poor
soil [18]. Dietary intake in these areas is less than 19 micrograms per
day for men and less than 13 micrograms per day for women,
significantly lower than the current RDA for selenium [12]. Researchers
believe that selenium deficient people infected with a specific virus are
most likely to develop Keshan disease [18,19].
Selenium deficiency has also been seen in people who rely on total
parenteral nutrition (TPN) as their sole source of nutrition [20,21]. TPN
is a method of feeding nutrients through an intravenous (IV) line to
people whose digestive systems do not function. Forms of nutrients
that do not require digestion are dissolved in liquid and infused
through the IV line. It is important for TPN solutions to provide
selenium in order to prevent a deficiency [22]. Physicians can monitor
the selenium status of individuals receiving TPN to make sure they are
receiving adequate amounts.
Severe gastrointestinal disorders may decrease the absorption of
selenium, resulting in selenium depletion or deficiency [23].
Gastrointestinal problems that impair selenium absorption usually
affect absorption of other nutrients as well, and require routine
monitoring of nutritional status so that appropriate medical and
nutritional treatment can be provided.
Who may need supplemental selenium?
In the U.S., most cases of selenium depletion or deficiency are
associated with severe gastrointestinal problems, such as Crohn's
disease, or with surgical removal of part of the stomach. These and
other gastrointestinal disorders can impair selenium absorption
[24-26]. People with acute severe illness who develop inflammation
and widespread infection often have decreased levels of selenium in
their blood [27]. Physicians will evaluate individuals who have
gastrointestinal disease or severe infection for depleted blood levels
of selenium to determine the need for supplementation.
People with iodine deficiency may also benefit from selenium
supplementation. Iodine deficiency is rare in the U.S., but is still
common in developing countries where access to iodine is limited [28].
Researchers believe that selenium deficiency may worsen the effects
of iodine deficiency on thyroid function, and that adequate selenium
nutritional status may help protect against some of the neurological
effects of iodine deficiency [6,7]. Researchers involved in the
Supplementation en Vitamines et Mineraux AntioXydants (SU.VI.MAX)
study in France, which was designed to assess the effect of vitamin
and mineral supplements on chronic disease risk, evaluated the
relationship between goiter and selenium in a subset of this research
population. Their findings suggest that selenium supplements may be
protective against goiter, which refers to enlargement of the thyroid
gland [29].
As noted above, selenium supplementation during TPN administration
is now routine [21,22]. While specific medical problems such as those
described above indicate a need for selenium supplementation,
evidence is lacking for recommending selenium supplements for
healthy children and adults.
Selenium supplements
Selenium occurs in staple foods such as corn, wheat, and soybean as
selenomethionine, the organic selenium analogue of the amino acid
methionine [30,31]. Selenomethionine can be incorporated into body
proteins in place of methionine, and serves as a vehicle for selenium
storage in organs and tissues. Selenium supplements may also
contain sodium selenite and sodium selenate, two inorganic forms of
selenium. Selenomethionine is generally considered to be the best
absorbed and utilized form of selenium.
Selenium is also available in 'high selenium yeasts', which may contain
as much as 1,000 to 2,000 micrograms of selenium per gram [30].
Most of the selenium in these yeasts is in the form of
selenomethionine. This form of selenium was used in the large scale
cancer prevention trial in 1983, which demonstrated that taking a daily
supplement [dosage: 200 micrograms of selenium per day] could
lower the risk of developing prostate, lung, and colorectal cancer [32].
However, some yeasts may contain inorganic forms of selenium, which
are not utilized as well as selenomethionine.
A study conducted in 1995 suggested that the organic forms of
selenium increased blood selenium concentration to a greater extent
than inorganic forms. However, it did not significantly improve the
activity of the selenium-dependent enzyme, glutathione peroxidase
[33].
Selenium and Cancer
Observational studies indicate that death from cancer, including lung,
colorectal, and prostate cancers, is lower among people with higher
blood levels or intake of selenium [34-40]. In addition, the incidence of
nonmelanoma skin cancer is significantly higher in areas of the United
States with low soil selenium content [37]. The effect of selenium
supplementation on the recurrence of different types of skin cancers
was studied in seven dermatology clinics in the U.S. from 1983
through the early 1990s. Taking a daily supplement with dosage of
200 ug of selenium did not affect recurrence of skin cancer, but
significantly reduced the occurrence and death from total cancers. The
incidence of prostate cancer, colorectal cancer, and lung cancer was
notably lower in the group given selenium supplements [41].
Research suggests that selenium affects cancer risk in two ways. As
an anti-oxidant, selenium can help protect the body from damaging
effects of free radicals. Selenium may also prevent or slow tumor
growth. Certain breakdown products of selenium are believed to
prevent tumor growth by enhancing immune cell activity and
suppressing development of blood vessels to the tumor [42].
Rayman MP from University of Surrey, Guildford, UK, suggested that
selenium is an unusual trace element in having its own codon in mRNA
that specifies its insertion into selenoproteins as selenocysteine
(SeCys), by means of a mechanism requiring a large SeCys-insertion
complex. This exacting insertion machinery for selenoprotein
production has implications for the selenium requirements for cancer
prevention. If selenium may protect against cancer, an adequate
intake of selenium is desirable. [A1]
However, not all studies have shown a relationship between selenium
status and cancer. In 1982, over 60,000 participants of the Nurse's
Health Study with no history of cancer submitted toenail clippings for
selenium analysis. Toenails are thought to reflect selenium status over
the previous year. After three and a half years of data collection,
researchers compared toenail selenium levels of nurses with and
without cancer. Those nurses with higher levels of selenium in their
toenails did not have a reduced risk of cancer [43]. Current primary
and secondary prevention trials of selenium are underway in the USA,
including the Selenium and Vitamin E Cancer Prevention Trial (SELECT)
relating to prostate cancer, [A1]
Selenium and heart disease
Some population surveys have suggested an association between
lower antioxidant intake and a greater incidence of heart disease [46].
Evidence also suggests that oxidative stress from free radicals, which
are natural by-products of oxygen metabolism, may promote heart
disease [47-49]. For example, it is the oxidized form of low-density
lipoproteins (LDL, often called "bad" cholesterol) that promotes plaque
build-up in coronary arteries [48]. Selenium is one of a group of
antioxidants that may help limit the oxidation of LDL cholesterol and
thereby help to prevent coronary artery disease [47-49]..
Selenium and arthritis
Surveys indicate that individuals with rheumatoid arthritis, a chronic
disease that causes pain, stiffness, swelling, and loss of function in
joints, have reduced selenium levels in their blood [50-51]. In addition,
some individuals with arthritis have a low selenium intake [52].
The body's immune system naturally makes free radicals that can help
destroy invading organisms and damaged tissue, but that can also
harm healthy tissue [53]. Selenium, as an antioxidant, may help to
relieve symptoms of arthritis by controlling levels of free radicals [54].
Selenium and HIV
HIV/AIDS malabsorption can deplete levels of many nutrients, including
selenium. Selenium deficiency is associated with decreased immune
cell counts, increased disease progression, and high risk of death in
the HIV/AIDS population [55,56]. HIV/AIDS gradually destroys the
immune system, and oxidative stress may contribute to further
damage of immune cells. Antioxidant nutrients such as selenium help
protect cells from oxidative stress, thus potentially slowing
progression of the disease [57]. Selenium also may be needed for the
replication of the HIV virus, which could further deplete levels of
selenium [58].
An examination of 125 HIV-positive men and women linked selenium
deficiency with a higher rate of death from HIV [59]. In a small study of
24 children with HIV who were observed for five years, those with low
selenium levels died at a younger age, which may indicate faster
disease progression [60]. Results of research studies have led experts
to suggest that selenium status may be a significant predictor of
survival for those infected with HIV [61].
What are the side effects of selenium? Is high dose of selenium
poisoning?
Within the recommended daily allowance, selenium appears to be
safe. However, high blood levels of selenium (greater than 100 ug/dL)
can lead to a side effect called selenosis [62]. Symptoms of selenosis
include gastrointestinal upsets, hair loss, white blotchy nails, garlic
breath odor, fatigue, irritability, and mild nerve damage [2].
Selenium toxicity is rare. The few reported cases have been
associated with industrial accidents and a manufacturing error that led
to an excessively high dose of selenium in a supplement [63,64]. The
Institute of Medicine of the National Academy of Sciences has set a
tolerable upper intake level (UL) for selenium at 400 micrograms per
day for adults to prevent the risk of developing the side effect, i.e.
selenosis [12].
Reasonable care has been taken in preparing this document and the information provided herein
is believed to be accurate. The information is not intended to be a substitute for professional
medical advice. It is important to seek the advice of a physician about any medical condition or
symptom. It is also important to seek the advice of a physician, registered dietitian, pharmacist,
or other qualified health professional about the appropriateness of taking dietary supplements
and their potential interactions with medications. ALL RIGHTS RESERVED 2008
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Walnut is a good source of selenium.
Selenium may benefit people at cancer risk; some research suggested.