Selenium counteracts bulging eyes caused by the thyroid disorder named Graves’ disease

Graves’ disease, also known as Basedow’s disease, is caused by hyperthyroidism and is associated with a number of different symptoms. A lot of patients also develop Graves’ ophthalmology, a disorder that can result in bulging eyes and impaired vision in severe cases. Apparently, daily supplementation with 200 micrograms of selenium has a positive impact on the eyes and their appearance, according to a Thai study that is published in Orbit.

Graves’ disease is an autoimmune disorder that is characterized by inflammation and the production of antibodies that stimulate the thyroid gland and causes it to step up its production of thyroid hormones. This results in hyperthyroidism and heart palpitations, inner unrest, diarrhea, sweating, and several other symptoms. In some cases, the eyelids may recede, and the eyes may look bloodshot. In the later stages, the eyes may protrude and look bulgy and staring. In severe cases, the vision is affected by the local swelling, and the impaired mobility of the eyeballs can cause double vision. People with extremely protruding eyes may also have problems with blinking, which can dry out the cornea and make it more vulnerable to infections. They may also have local irritation, pain, and stinging. These changes of the eyes can alter a person’s looks to the point where it becomes a cosmetic challenge.
Multiple studies have shown that selenium supplementation may have a positive impact on the thyroid function in patients with Graves’ disease, so the researchers behind the new study wanted to investigate if this was also the case with Graves’ ophthalmology.
They included 25 patients with inactive, moderate-to-severe Graves’ ophthalmology in their study. Thirteen of the patients were given 200 micrograms of selenium daily for six months, while 12 other patients got matching placebo during the same period. Using the so-called Clinical Activity Score (CAS) and eye examinations, the researchers evaluated the severity of the patients’ eye disease. Also, the patients’ quality of life was assessed by means of the Graves’ Ophthalmology Quality of Life Questionnaire (GO-QOL), and the scientists used the Fisher’s Exact Test to compare different variables during the course of the study.
Selenium levels in the blood of the participants were measured at baseline and upon the completion of the study after six months. At study start, both groups had enough selenium in their blood with levels averaging 100 mcg/L.
After six months, participants in the selenium group had less protruding eyes because of less eyelid retraction compared with the placebo group. Also, there were five participants (42 percent) in the placebo group whose eyes became more bulging. There were no differences between the two groups with regard to eyeball movement or other soft tissue changes, and there was no statistical difference between the two groups with regard to CAS score and GO-QOL score.
Based on these findings, the researchers concluded that selenium supplementation has a positive effect on eye appearance, even in those patients with inactive and moderate-to-severe Graves’ ophthalmology, who have sufficient blood levels of selenium.

Selenium’s effect on Graves’ and other thyroid diseases

Thyroid hormones are produced in the thyroid gland. One hormone is called T4 (it has four iodine atoms) and is passive, while the other, T3 (it has three iodine atoms), is active. The thyroid gland is the gland in the body that contains the most selenium in relation to its size. This is because selenium is required by an enzyme that works by removing an iodine atom from the passive T4 hormone, thereby converting it into active T3. Selenium also supports some very powerful antioxidants that protect the thyroid gland against free radicals and oxidative stress. Selenium has even been reported to counteract inflammatory processes through its role in regulating proinflammatory cytokines. This is the case with inflammatory processes in both the thyroid gland itself and in the muscle tissue of the eyelids.
Today, medical science primarily focuses on iodine in the prevention of goiter and thyroid disorders, and that is why iodine is added to table salt. However, selenium is also important, especially because so many people don’t get enough of this essential micronutrient.

• We get selenium from fish, shellfish, meat, offal, eggs, and grains
• The bioavailability of selenium depends on the agricultural soil
• The selenium content in farmlands in Europe and many other parts of the world is very low
• Around one billion people worldwide are believed to lack selenium

Selenium deficiency and thyroid diseases

According to the study, the participants had normal blood levels of selenium with an average of around 100 mcg/L. Nonetheless, other studies suggest that the optimal selenium level is around 120 mcg/L. It is worth noting that the average level among Europeans is 70-85 mcg/L. This is partly due to the low selenium content in the soil, but it is also due to the fact that we don’t eat the same diet as Thai people and get less fish and offal, which are good selenium sources. That is why many Europeans lack selenium and have an increased risk of thyroid disorders and other diseases.

References:

Panida Potita et al. Selenium supplementation in inactive moderate to severe Graves´ orbitopathy patients: a randomized controlled trial. Orbit 2024

Fei Wang et al. Selenium and thyroid diseases. Frontiers in Nutrition. 2023

Amra Jujic et al. Selenoprotein P deficiency is associated with higher risk of incident heart failure. Free Radical Biology and Medicine. 2023

Puze Wang et al. Selenium intake and multiple health-related outcomes: an umbrella review of meta-analysis. Frontiers in Nutrition. 13 Sep. 2023