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What a hopeful piece of study!
Checks all the boxes-
1. Both FT4 and FT3 decreased more at 2 months in the selenium group than the controls
2. The TSH level increased more in patients receiving selenium supplementation (p<0.05)
3. The TRAb level was significantly lower in patients receiving selenium supplementation (2.4 IU/l vs. 5.6 IU/l, p=0.04)
4. The percentages of patients with normal TRAb level at 6 months was also significantly higher in the selenium group (19.0 vs. 0%, p=0.016)
5. Kaplan-Meier survival curve showed patients receiving selenium supplementation had a significantly higher rate of remission than controls
IMPORTANT NOTES- Randomized trials with large number of participants are needed to validate the finding above.
From the full study
ncbi.nlm.nih.gov/pubmed/273...
There are several limitations in this prospective pilot study.
First, there was a greater risk of selection bias owing to the quasi-random in the allocation of patients. There was no statistical difference in gender, age, and the levels of serum FT4, FT3, TSH, and
TRAb between the 2 groups at baseline (●▶ Table 1), the finding need to be validated in future randomized clinical trials.
Second, the number of recruited patients was also limited. The small sample size may have led to insufficient statistical power to detect a slight effect, which is a major limitation to the reliability
of the study. To get a more adequate assessment of the effect of selenium administration in patients with recurrent Graves’ disease, future clinical trials are needed recruiting enough number of patients.
Third, the effect of selenium supplementation may be more profound in patients with selenium deficiency, which has not been analyzed in the present study [11,13].
Fourth, there is conflicting data on the dose and form of selenium used for supplementation [12,37,38]. More clinical trials are still
needed to find the best dose or form of selenium used for treatment in recurrent Graves’ disease. In addition, owing to the pilot design of this study, we were able to assess the role of duration of selenium administration in the efficacy of treatment. Further studies are needed to assess the impact of the duration of sele- nium administration in the efficacy of treatment.
Finally, the mechanism underling the efficacy of selenium therapy in recur
rent Graves’ disease has not been adequately explained, which also need further studies
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