Selenium Transport Impairment - A Novel Form of Hypothyroidism

[jimh111]

This new paper, not yet peer reviewed describes a form of hypothyroidism I have not seen before papers.ssrn.com/sol3/papers... .

"Autoantibodies to Selenoprotein P in Patients with Chronic Fatigue Syndrome Suggest Selenium Transport Impairment and Acquired Resistance to Thyroid Hormone"

First a pedantic correction. Technically it is not "resistance to thyroid hormone (RTH)". RTH refers to impaired T3 binding to receptors or receptors to the DNA Response Elements. This paper describes "Impaired Sensitivity to Thyroid Hofmone (ISTH)". I'm sure we will see a lot more of this in future as the terminology was set up to describe existing conditions with little thought given to future discoveries.

The paper is difficult to follow, especially as I have no knowledge of the role of selenium! It describes "selenoprotein P (SELENOP)" which is a protein that transports selenium into cells. The study reveals that an antibody to selenoprotein P called "SELENOP-aAb" inhibits the entry of selenium into cells. Since the deiodinase enzymes are selenium based this results in impaired T4 to T3 conversion with reduced fT3 / fT4 ratios and no effect on TSH.

SELENOP-aAb +ve subjects had increased thyroidal secretion as measured by "SPINA GT". This is probably due to reduced T4 to T3 conversion in the pituitary. And as we might expect they showed reduced deiodinase as measured by "SPINA GD". I think the SPINA GT and SPINA GD caculations were developed by  diogenes ' team.

I believe this study is important because it's yet another form of hypothyroidism that isn't due to reduced thyroidal secretion, and can't be detected by a thyroid function test. About 6% of people with Hashimoto's have elevated antibodies. It presents with low urine iodine.

I believe impaired deiodinase (D2) presents a special problem because it regulates local T3 levels near the cell nucleus, T3 saturation at receptors. Simply restoring circulating T3 to normal will not fully restore T3 levels in tissues dependent on D2 such as the brain and skeletal muscles.

Lastly, the researchers are not independent, they have a company that specialises in selenium diagnostics selenomed.com/ . I don't have a problem with this, researchers need to promote their research so that benefits can be realised. As far as I know they are the only organisation providing a test for these antibodies and it is for reasearch purposes only.

Edited: I forgot to point out that over two decades ago Dr Gordon Skinner found that many cases of Chronic Fatigue were caused by undiagnosed hypothyroidism.

[Delgor]

Thank you jim for this which is highly interesting! Firstly I was one of those patients diagnosed with CFS around 30 years ago but was fortunate enough to find Dr Skinner who prescribed NDT and effectively gave me my life back again. Unfortunately all that changed around 4 years ago because of the interference of the group pharmacist and once again I find myself with CFS but have been focusing on my thyroid and vitamins before I felt I could rule them out.

Interestingly, although I had bought selenium a long time ago it stayed in the cupboard because I never got around to testing for it but around 3 months ago I decided to take 100 mcg daily to see if I felt any difference. Amazingly the scalp psoriasis I had had for over 20 years completely cleared and I did some further digging and found that psoriasis patients had a higher incidence of hypothyroidism and were commonly deficient in selenium as well as vit D and supposedly had abnormal levels of zinc and copper. I've literally just been blood tested for these minerals and awaiting results but meanwhile I did put up a post on HU's Beyond Psoriasis just in case it may help anyone else.

Thank you again for this article as who knows where it may lead!

[jimh111 in reply to Delgor]

It seems selenium deficiency causes a number of problems. These antibodies are associated with slightly higher blood selenium levels so we can't spot who has the antibodies.

[arTistapple in reply to Delgor]

I have already passed on your information to my son-in-law! He seems perfect for selenium treatment and told him to get out in the sunshine too. So many jobs where people are tucked away all day. COVID I think might have made this worse too. Another unexpected side effect still to be fully recognised.

[Delgor in reply to arTistapple]

I hope it works for him in some way - everything has got to be worth trying😊

[arTistapple in reply to Delgor]

At least I have a number of research papers to refer to. He is very anal about that. Just as a side issue I looked up what selenium is used for in homeopathy. It needs a different viewpoint to read that stuff and depends on where you read it. However hair loss and skin issues are big in that form of treatment too. It’s very much a ‘male’ remedy but with jimh111 discovery in mind about female issues with reproduction etc it’s very interesting. However both sexes are made from the same cloth really and what’s good for one can be good for the other with different emphases. As I say a complete aside. Thanks Delgor.

[tattybogle]

Very interesting Jim , thanks .

like you, i'm struggling to get my head round some of it , but it's heartening to see this sort of thinking / research going on .

Interesting to see 'pregnancy' listed here among causes of Acute Phase Response :

"A bacterial or viral infection causes hepatocytes to launch an acute phase response (APR),

involving strong alterations in hepatic selenoprotein biosynthesis pattern that finally compromise

full body Se status.

Upon prolonged APR, serum Se and SELENOP concentrations decline continuously, as observed in

critical disease, infections, poly-trauma, pregnancy, COVID-19 or severe liver disease [43, 52].

Under these conditions, SELENOP variants with reduced Sec content and altered primary

structure are generated that may serve as novel autoantigens provoking SELENOP-aAb.

It can be hypothesized that the stronger an inflammation, infection or APR, the lower the degree

of correct Sec insertion and the higher the immunogenicity of the newly synthesized SELENOP

variants [43] "

[jimh111 in reply to tattybogle]

I don't know anything about 'acute phase response'. Sarah Myhill explained the effects of pregnancy in immunity succintly. She said the baby is half alien, i.e. half its genes are from the father. Hence, the mother's immune system has to be toned down and this leads to increased immune system problems.

[tattybogle in reply to jimh111]

yes . i must admit that has always been my gut feeling about why women get autoimmune hypo / hyper so much more then than fella's do .. female immune system needs to be able to accommodate 'other ' without killing it ,,... therefore more complex , therefore more likely to get confused /go wrong.

[arTistapple in reply to tattybogle]

Your gut feeling I agree is on the correct lines. I read this forty six years ago when pregnant. So this info has been accepted (at least by some medics) for a very long time. I gave that book to someone else when they were pregnant and I never got it back, so can’t say who the author was. My memory is that it was ‘mainstream’ information.

[Alanna012 in reply to tattybogle]

I noticed that pregnancy seemed to cause a significant worsening of autoimmune issues. I never had eczema, hives or gastric reflux but developed eczema during my first pregnancy then all the other symptoms following my second. Because I didn't have a clue what was going on, I kept wondering why everything wasn't going back to normal like the maternity books said it should.

Years later I was still having disturbed sleep, skin, scalp, hair, gut anf allergy issues. And each time I went to the GP they told me I was stressed and depressed, young mum etc etc.

I don't know why post pregnancy malaise isn't given more medical attention. It seems only PMD is worthy of investigation and my thyroid status was never investigated once.

[Delgor in reply to Alanna012]

tattybogle Oh we've definitely had a discussion on this before Alanna as this was the first part of my thyroid journey. I was told by my GP I had post natal depression after the birth of my first son which I didn't totally accept as I wasn't at all depressed but I was very anxious and hot wired and unable to sleep with weight just dropping off me. I couldn't believe it when it happened again after the birth of my second son but once again didn't know any better - so many others like me must have had post partum thyroiditis but were never checked out for same. Personally I feel it should be standard testing for all pregnant mums after birth as it would save years of ill health for so many women.

[tattybogle in reply to Delgor]

me too ... it makes absolutely no sense ~ a thyroid blood test should be routine for ANY problems in the post natal period , before jumping to the conclusion of 'post natal depression ' ... it took 5 yrs before anyone thought to check my thyroid , and with hindsight it was bleedin obvious thyroid was the problem all along .. classic 'hyper' phase / weight loss /bit nutty ~ followed by slow decline into 'freezing cold sloth' ......

it's not like it's a rare disease .... mostly women / very frequently goes wonky post partum.... Duh !

[Delgor in reply to tattybogle]

So sorry Tatty for late reply - you post has only just shown up in my mail box (obviously sluggish like me)! It's hard to believe that new mums are still not getting the help they deserve all for the sake of a blood test but I'm now even wondering if things may get even worse with the shortage of GP's and not enough Health Visitors to go around. Perhaps it's time for you to write a humerous book that can be published and given out to new mums at clinics and surgeries - just a thought😉

[arTistapple in reply to Delgor]

One of my daughter’s friends has been showing signs of thyroid problems. We were just discussing it on Sunday. Her wee boy is now three. She was told her thyroid was compromised (that’s definitely new) but no follow up. So her hair is falling out, fatigue, nails, slow etc Aagh! It’s not occurred to her that it’s her thyroid. So she has been advised now (by us). Unfortunately she will not thank me when she gets medicated. She will likely go through this hope for help and be disappointed. Oh well maybe I can help a bit. Get her on the forum for a start!

[Delgor in reply to arTistapple]

Yes there always seems to be someone who has symptoms and is in need of help but isn't it sad that we can't direct them to a GP or endo in the full knowledge that they will get that help. Even my hairdresser's cat has had better treatment than a lot of people on this forum - maybe it's time that VETs were employed to help humans too😁😁😁

[greygoose in reply to Delgor]

I wouldn't want my dog's vet treating me! She made a right pig's ear of it. I'm sure he'd be alive now if she hadn't messed around with his dose.

[Delgor in reply to greygoose]

Oh I'm very sorry to hear that greygoose😢 However, the person I was referring to had some splendid results from her vet because her cat was proved to have a thyroid problem and seemingly the cat has had more tests and care than I could ever hope to have from the hospital endo. Have given up on him after him asking that I come off all meds for the 4th time to see what is happening - over my dead body, hence a vet sounded as if he could be a better bet☹️

[TSH110 in reply to jimh111]

Robert Baker’s Sperm Wars is quite a read, it touches on this. It’s quite old and it left me rather speechless when I read it long ago, but it is very fascinating a long way from the normal trollop that’s trotted out about reproduction.

[arTistapple]

Further information to support the gene issues with the De-iodineses, particularly D2 and the inability to convert T4/T3. Selenium is needed for that de-iodines gene? to process/transport to ‘whole body’ as opposed to just the thyroid itself and pituitary. I can see that even using chemical hormones to prevent pregnancy could disrupt the female body through creating the ‘pretence’ of a pregnancy. I hope I have this correct as I have been reading about it elsewhere all morning so far. Unfortunately taking selenium has not made any noticeable difference to my conversion and I don’t have enough years to crank it up. I feel I must short cut it with T3.

[Alanna012 in reply to arTistapple]

That's interesting. You've made me think something that should be obvious, which is that humans aren't supposed to be pregnant month after month, continually for years. What effect could a pretend pregnancy have? And even in a pregnancy if I remember correctly the hormone levels change according to gestation period.

Then there is also the fact that synthetic progestins aren't exactly progesterone. I don't know what effect that might be having.

That said with the exception of one short period of a few months on the progesterone only pill, I have never taken any birth control. Anecdotally though, I have friends who have (including the coil which is kept in for years) and I have to say they are each better health-wise than I am. I'm just unlucky.

[arTistapple in reply to Alanna012]

Well Alanna012 I don’t know what age you are but your name makes me think you are a lot younger than me. I looked after myself, took exercise (even when it became difficult) ate well but still ended up here. I am a lot older now and I see friends who smoked, drank, no exercise, years on the pill etc. I might have this awful condition but otherwise I look about 15 years younger than they do. My neighbour was the opposite, did all the jogging thing etc whilst I was already showing signs of difficulties we might normally associate with age. However he is dead and gone. People can look or appear healthy but no-one knows what the heck is going on underneath!

[Alanna012 in reply to arTistapple]

Oh very true! You make a valid point. No one indeed knows what's going on on the inside until it suddenly reveals itself.I'm heading towards late 40's. I do get told I look young by strangers who don't know me, but that's only if I'm wearing a wig, as my hair aged virtually overnight in my twenties and the best part of it fell out and it has never returned. Hypothyroid joys!

[arTistapple in reply to Alanna012]

I looked at some of your posts and I see it has been really difficult for you. Goodness Alanna I hope for better for us. It’s ironic that we can look ok considering how we feel. It’s a strange society where we feel ashamed almost of how we look and it adds to our problems!

[Alanna012 in reply to arTistapple]

Thank you for such a lovely reply, needless to say I agree with you, absolutely... as if being ill isn't enough! We've all have it so hard yet feel beholden to society and ourselves to still look well and/or youthful! x

[nightingale-56]

It makes perfect sense to me as selenium has been insufficient in our soil for many years. My old Endocrinologist asked me if I thought pregnancy caused Thyroid problems (in my case Graves). It seems to have been the catalyst for me. So pregnancy broke the Camel's back! It has done in my case.