Selenium supplements as an adjuvant in the treatment of ulcerous colitis

The rate of inflammatory bowel diseases like ulcerous colitis is growing, and diet plays a major role. Even if you eat a healthy diet, it can be a challenge to get enough selenium because of the selenium-depleted soil in our part of the world. Apparently, selenium supplementation can lower the disease activity and improve quality of life in patients with ulcerous colitis.

Selenium supports well over 25 different selenium-dependent enzymes (selenoproteins) that are important for energy turnover, thyroid function, protective antioxidants, and many other functions. Selenium deficiency appears to be the cause of many diseases and can also worsen the prognosis. A study was conducted on 100 patients with mildly to moderately active ulcerous colitis. The patients were split into two groups, with one group receiving 200 micrograms of selenium daily, and the other group receiving matching placebo. The duration of the study was 10 weeks, and neither the participants nor the scientists knew who got what. At baseline and after the study, the disease activity was evaluated by using the SCCAI index (Simple Clinical Colitis Activity Index) that looks at variable such as frequency of bowel movements, diarrhea, bloody stool, and general well-being.
After 10 weeks, the SCCAI score was significantly reduced in the selenium group. Clinical improvement was observed in 19 patients (38%) in the selenium group, while only three patients (6%) in the placebo group improved. At the end of the study the researchers also noted that the quality of life in the placebo group had improved. Also, the selenium-treated patients’ low selenium status had increased, and they had lower levels of interleukin-17, which is a marker of inflammation. Based on their findings, the scientists concluded that selenium supplementation is useful as an adjuvant for patients suffering from mild to moderate ulcerous colitis.

How selenium benefits the gut flora and reduces inflammation

The study, which is published in the European Journal of Nutrition, supports an earlier review article published in Frontiers in Nutrition. Here, Chinese researchers describe selenium’s role in intestinal health. It is essential to have a balanced intestinal flora because it helps us digest our food and produce certain vitamins, neurotransmitters, and lactic acids. It also helps us metabolize indigestible carbohydrates (fibers). However, factors such as modern refined diets, antibiotic use, stress, and other things can easily disrupt the delicate gut flora, in which case potentially harmful bacteria and fungi can take over. This sets the stage for poor digestion and various inflammatory bowel diseases (IBD) such as ulcerous colitis. Selenium directly affects the gut flora by way of the following mechanisms:

• The enzyme functions of certain bacteria
• A selenium-rich lactic acid bacteria (Lactobacillus rhamnose SHA 113) counteracts damage to the intestine by producing a protective compound
• The intestinal immune defense that fights harmful microbes and toxins from food and potentially damaging microbes from the natural gut flora
• Prevents unwanted inflammatory processes in the intestines by regulating the activity of white blood cells from the immune defense
• Selenium-containing antioxidants such as GPX (glutathione peroxidase) protect intestinal cells and other cells against damage caused by free radicals and oxidative stress

In this review article, the authors conclude that selenium deficiency can damage the healthy gut flora and the immune defense, which can result in the development of inflammatory bowel diseases like ulcerous colitis.

Where do we get selenium – and why is selenium deficiency so common?

We get selenium from things like offal, meat, fish, and nuts (Brazil nuts in particular). However, the agricultural soil in large parts of the world, including Europe and large parts of China, is selenium-depleted. This is reflected throughout the food chain and explains why selenium intake varies so much from one place to another, in some cases by several hundred percent. It may be necessary to take a selenium supplement. Selenium yeast with a variety of different organic selenium types has better absorption and bioavailability in the body. Most studies where selenium has been tested use daily doses of 200 micrograms.

• Ulcerous colitis is an autoimmune disease characterized by chronic inflammation
• Part of the treatment is primarily to eat an anti-inflammatory diet
• Vitamin D and fish oil also help to reduce chronic inflammation

References:

Maryam Khazdouz et al. The effect of selenium supplementation on disease activity and immune-inflammatory biomarkers in patients with mild-to-moderate ulcerative colitis: a randomized, double-blind, placebo-controlled clinical trial. European Journal of Nutrition. 2023

Jinzhong Cai et al. Advances in the study of selenium and human intestinal bacteria. Frontiers in Nutrition. 2022.

Jill Hahn et al. Vitamin D and marine omega-3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial. The BMJ 26 January 2022