A pilot study on the beneficial effects of additional selenium supplementation to methimazole for treating patients with Graves’ disease

Bin Xu,Di Wu,Ying Zhang,Hong Ying

doi:10.3906/sag-1808-67

Abstract

Background/aim The aim of this study was to assess the effect of a combination use of methimazole (MMI) and selenium (Se) in the treatment of Graves’ disease (GD). Materials and methods A total of 103 newly diagnosed hyperthyroidism patients were randomized to MMI and MMI + Se combination groups. After treatment for 6 months, the levels of triiodothyronine (FT3), free thyroxine (FT4), thyrotropin receptor antibody (TRAb), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb) were observed. An in vitro culture model of thyroid cells was established and the protein expression and mRNA levels of TRAb, TPOAb, and TGAb were determined by western blot and RT-PCR.Results A significant decrease in the levels of FT3, FT4, TRAb, TPOAb, and TGAb were observed in both groups along with a marked increase in TSH levels. Furthermore, the in vitro experiments showed that the protein expression and mRNA levels of TRAb, TPOAb, and TGAb decreased significantly. Also, compared to the MMI group, there was a greater improvement of these indices in the MMI + Se group. Conclusion We suggest that the combined use of MMI and Se could improve the thyroid activity in patients, which may provide an effective therapy for the treatment of GD in clinical settings.

Highlights

Hyperthyroidism is an autoimmune disease that is frequently seen in the endocrinology department
A significant decrease in the levels of FT3, FT4, thyrotropin receptor antibody (TRAb), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb) were observed in both groups along with a marked increase in TSH levels
The in vitro experiments showed that the protein expression and mRNA levels of TRAb, TPOAb, and TGAb decreased significantly

Summary

Introduction

Hyperthyroidism is an autoimmune disease that is frequently seen in the endocrinology department. It is caused by the excess release of thyroid hormone through thyroid synthesis, resulting in hypermetabolism, sympathetic nerve excitability, and palpitations, sweating, increases in food intake and frequency of stools, and weight loss [1]. Graves’ disease (GD) is a common autoimmune disorder of the thyroid gland, resulting in thyrotoxicosis secondary to thyroid receptor autoantibodies, which accounts for 60% to 80% of the global incidence of thyrotoxicosis [3,4]. The treatment of hyperthyroidism mainly includes antithyroid drugs (ATDs) (e.g., methimazole or propylthiouracil), thyroidectomy, radioactive iodine (I131), and permanently reduced thyroid function [5]. Due to its less systemic adverse reaction to hyperthyroidism, it has been widely used as a first-line hyperthyroidism treatment in clinical settings [11,12]

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