Opthalmic consultant recommended selium. Is this the dose I should be taking?

[A1Amber]

I am already taking 200 ug selium. Yesterday I had an eye check to rule out Ted. After being referred initially by Specsavers to New Medica then on to a hospital to see a consultant. The consultant said she was uncertain and will check again in 3 months but recommended 250 mgs selenium and System Balance eye drops plus Flaxseed.Although I had taken my last thyroid test results she did not want to see them.

[PurpleNails Administrator]

Usual recommendation is Selenium 200ug, for up to 6 months.   Then reduce to 100ug.  Doctor has suggested a high dose, would not recommend it long term.  Should you eat any selenium in diet especially selenium rich food eg a few Brazil  nuts it might well take you to toxic levels.  Flaxseed good for omega 3.  System Balance eye drops are not preservative free.  I recommend preservative free drop / gels / wipe for long term use.  Hylosan is good option.  

[A1Amber in reply to PurpleNails]

Thank you

[SeasideSusie Remembering]

I would test selenium before increasing your dose.

[A1Amber in reply to SeasideSusie]

Thank you

[A1Amber in reply to SeasideSusie]

Ideally yes. But at £101 plus £30 blood draw! My budget just won't run to it! I have spent over £300 on two telephone consultations with an endocrinologist (recommended by a member on this site) and I guess another £155 to speak of my blood results that my Gp says are in range.

This week I have had 2 NHS appointments checking inside my throat (unexplained hoarseness - Gp says not thyroid related as I am sufficiently medicated) and an eye check with an ocupastic consultant to look at eyelid swelling and possible Ted.

These appointments were at a hospital 92 miles from where I live. Almost 400 miles on the two visits.

I respect and appreciate the advice you give and I wish I could follow it all the way!

[SeasideSusie Remembering in reply to A1Amber]

You could always ask your consultant if you can have the test on the NHS as she's recommending that you take selenium, explain that you already take the recommended dose and are concerned that taking more might be detrimental.

Or

£69 home fingerprick test

cerascreen.co.uk/products/s...

Includes zinc and magnesium as well (although the magnesium test is not reliable as it's a serum test rather than a red cell test).

Has to be sent to Germany so takes longer than any of the normal UK home tests.

[LAHs in reply to SeasideSusie]

Absolutely! I was just about to write that. The other thing which bothers me is that TED is associated with hyperthyroidism, i.e. plenty of T3 being generated, probably too much. Selenium is recommended for hypothyroidism so that it catalyses the T4 to T3 reaction. I think Se was altogether the wrong call in this case.

[helvella Administrator in reply to LAHs]

All three deiodinase enzymes are seleno-proteins.

Yes, they convert T4 to T3.

And what looks like the de-activating pathway to rT3.

And T3 to T2.

And rT3 to T2.

And other steps.

We need the right balance of these enzymes, and whatever controls their activity also needs to be working well. The amount of T3 we have is the result of a dynamic balance of activity - converting T4 to T3 increases T3, converting T3 to T2 reduces T3. Both are happening all the time.

While too much selenium is toxic, too little means we likely will not be making these enzymes in sufficient quantities to keep everything working adequately.

The diagram below is a simplified version just to give a flavour.

Diagram of thyroid hormone conversions

[LAHs in reply to helvella]

Oh geez, such a balancing act, no wonder not many medics want to specialise in thyroid endocrinology. It would take weeks of blood test measurements to get all that ticking over correctly.

[Buddy195 Administrator]

I like both HycoSan and Hyloforte preservative free drops; use liberally to alleviate dry eye. I certainly wouldn’t take more than 200ug selenium per day as in excess of 400ug has been shown to be toxic. I take a daily supplement of 100ug, but do increase to 200ug if I’m having a TED flare up.

I also take lutein and zeazanthin for overall eye health.

For me, getting FT3 higher in range definitely improved eye swelling, although dry eye& light sensitivity are still ongoing issues for me.