Thyroid eye disease (TED), also known as Graves’ ophthalmopathy or Graves’ orbitopathy, is an autoimmune condition that affects the tissues around the eyes. TED primarily affects individuals with overactive thyroids, particularly those with Graves’ disease. Common symptoms include bulging eyes, double vision, pain, and, in severe cases, vision loss. Managing TED can be challenging, and people often look for alternative or complementary treatments to alleviate symptoms.

One potential complementary treatment is selenium, a trace element that has gained attention for its antioxidant properties. But can selenium truly help those with TED? In this article, we’ll explore what selenium is, why it might be beneficial for TED, what current research says, and how to safely incorporate it into your health routine.

What Is Selenium?

Selenium is an essential mineral that our bodies need in small amounts for proper functioning. It plays a key role in metabolism and overall health by assisting in various processes, such as thyroid hormone production and immune system regulation. It is also a potent antioxidant, meaning it helps protect cells from oxidative damage caused by free radicals (unstable molecules that can damage cells). Oxidative stress, which occurs when free radicals outnumber antioxidants, has been linked to many diseases, including autoimmune conditions like TED.

Because the body cannot produce selenium, it must be obtained through diet or supplements. Foods rich in selenium include:

• Brazil nuts
• Mushrooms
• Seafood
• Chicken
• Whole grains

Brazil nuts, in particular, are known to contain some of the highest natural levels of selenium, with just one or two nuts providing more than the daily recommended intake.

How Does Selenium Help With TED?

Selenium is considered a potential treatment for TED, primarily because of its ability to reduce oxidative stress. In TED, inflammation damages the muscles and tissues around the eyes. This inflammation can lead to a buildup of free radicals, which worsens the damage. As an antioxidant, selenium helps neutralize these free radicals, reducing inflammation and potentially slowing the progression of the disease.

Moreover, selenium plays a crucial role in the proper functioning of the thyroid gland, which regulates many body functions through hormone production. In Graves’ disease, the immune system mistakenly attacks the thyroid, leading to hyperthyroidism (overactive thyroid). By promoting healthy thyroid function, selenium may help reduce the severity of autoimmune attacks on the tissues surrounding the eyes.

Research on Selenium and TED

Several studies have explored the effectiveness of selenium for treating TED, with the earliest notable being a randomized controlled trial in 2011. In this study, participants with mild active TED were given either a placebo (an inactive treatment), a medication called pentoxifylline, or 200 micrograms of selenium daily for six months. The results were promising: Those who took selenium reported significant improvements in their quality of life and a reduction in TED symptoms, including reduced eye bulging, pain, and discomfort.

Another key finding from the study was that selenium seemed to slow disease progression. Participants who took selenium had fewer instances of TED worsening compared to those who took a placebo. Given that TED can be unpredictable, with flare-ups (periods when symptoms worsen) and remissions (periods when symptoms improve or subside), this was an encouraging outcome.

However, it’s important to note that the study focused on individuals with mild TED. While selenium may be beneficials for those with early-stage TED, its effectiveness in moderate to severe cases is less certain. More research is needed to determine its role in advanced TED, but many health care providers already recommend selenium for people with mild TED as part of a broader treatment plan.

Potential Benefits of Selenium for TED

In addition to reducing inflammation and oxidative stress, selenium supplementation may offer other benefits for people with TED. For example, it has been shown to improve eye health by reducing the severity of symptoms like redness, dryness, and swelling.

Moreover, selenium may also enhance the body’s response to other TED treatments, such as steroids or biologics like teprotumumab-trbw (Tepezza). By supporting thyroid function and modulating the immune system, selenium could potentially boost the effectiveness of these treatments, though more research is needed in this area.

How To Take Selenium for TED

If you have TED and are considering selenium supplements, the recommended dosage based on research is 200 micrograms per day. Selenium is widely available over-the-counter in supplement form, making it easy to incorporate into your daily routine. However, it is important to consult with your doctor before starting any new supplement, especially if you have underlying health conditions or are taking medications.

For those who prefer food sources of selenium, eating selenium-rich foods like Brazil nuts, mushrooms, tuna, and whole grains can also boost your intake. However, reaching the therapeutic dose of 200 micrograms per day through diet alone can be difficult. For example, while Brazil nuts are an excellent source of selenium, relying solely on food to meet the recommended intake may not be practical for everyone.

Is Selenium Safe? Potential Side Effects and Risks

Although selenium is generally safe when taken in appropriate doses, it’s possible to consume too much. Selenium toxicity, also known as selenosis, can occur if a person exceeds 400 micrograms per day. Symptoms of selenium toxicity can include:

• Bad breath
• Nausea
• Fatigue
• Hair loss
• Brittle nails

In severe cases, long-term excessive selenium intake can lead to more serious issues, such as cardiovascular (heart) problems or neurological (nerve) damage.

For this reason, it’s essential to stick to the recommended dose of 200 micrograms per day and consult your health care provider if you have any concerns about the right amount for your situation. You should also consider your overall dietary intake when taking selenium supplements, as many common foods contain small amounts of the mineral.

Is Selenium Right for You?

Selenium supplementation shows promise for people with mild TED, especially for those looking to manage symptoms like eye discomfort and swelling. Its antioxidant properties may help reduce inflammation and oxidative stress, potentially slowing the progression of the disease. For individuals with early-stage TED, selenium may be a valuable addition to their treatment regimen.

However, for those with moderate to severe TED, selenium may not be as effective as other treatment options, such as steroids or biologic drugs. Additionally, more research is needed to fully understand selenium’s long-term benefits and potential risks, especially for those who take it over extended periods.

Ultimately, whether selenium is right for you depends on your individual condition and treatment plan. Be sure to consult with your health care provider before starting selenium or any new supplement, as they can help you determine the appropriate dosage and monitor your progress.

Talk With Others Who Understand

TEDhealthteam is the social network for people with thyroid eye disease and their loved ones. On TEDhealthteam, members come together to ask questions, give advice, and share their stories with others who understand life with TED.

Are you living with TED and thinking of supplementing with selenium? Share your experience in the comments below, or start a conversation by posting on your Activities page.