Iodine and selenium deficiency in northern Zaire

The interactions between selenium and iodine deficiencies in man and animals

Up to one billion people live in areas where they may be at risk from I deficiency. Many of the debilitating effects of the deficiency may be irreversible, consequently it is essential to understand the mechanisms whereby lack of I can cause disease through decreased thyroxine and 3, 3',5-triiodothyronine (T3) synthesis. Since Se has an essential role in thyroid hormone metabolism, it has the potential to play a major part in the outcome of I deficiency. These effects of Se derive from two aspects of its biological function. First, three Se-containing deiodinases regulate the synthesis and degradation of the biologically active thyroid hormone, T3. Second, selenoperoxidases and possibly thioredoxin reductase (EC1.6.4.5) protect the thyroid gland from H2O2produced during the synthesis of thyroid hormones. The mechanisms whereby Se deficiency exacerbates the hypothyroidism due to I deficiency have been elucidated in animals. In contrast to these adverse effects, concurrent Se deficiency may also cause changes in deiodinase activities which can protect the brain from low T3concentrations in I deficiency. Animals with Se and I deficiency have changes in serum thyroid hormone concentrations that are similar to those observed in patients with I deficiency disease. However such animal models show no thyroid involution, a feature which is characteristic of myxoedematous cretinism in man. These observations imply that if Se deficiency is involved in the outcome of I deficiency in human populations it is likely that other interacting factors such as goitrogens are also implicated. Nevertheless the protection of the thyroid gland from H2O2and the regulation of tissue T3levels are the functions of Se that are most likely to underlie the interactions of Se and I.

Selenium and thyroid function in infants, children and adolescents

Selenium is an integral component of the enzymes glutathione peroxidase (GPx) and iodothyronine deiodinases. Although selenium nutrition could conceivably affect thyroid function in infants, children and adolescents, available data suggest that the effect of selenium deficiency on thyroid function is relatively modest. In patients with isolated selenium deficiency (such as patients with phenylketonuria receiving a low-protein diet), peripheral thyroid hormone metabolism is impaired but there are no changes in thyrotropin (TSH) or clinical signs of hypothyroidism, suggesting that these patients are euthyroid. Selenium supplementation may be advisable to optimize tissue GPx activity and prevent potential oxidative stress damage. In areas where combined selenium and iodine deficiencies are present (such as endemic goiter areas in Central Africa), selenium deficiency may be responsible for the destruction of the thyroid gland in myxoedematous cretins but may also play a protective role by mitigating fetal hypothyroidism. In these areas, selenium supplementation should only be advocated at the same time or after iodine supplementation. In patients with absent or decreased production of thyroid hormones and who rely solely on deiodination of exogenous L-thyroxine for generation of the active triiodothyronine (such as patients with congenital hypothyroidism), selenium supplementation may optimize thyroid hormone feedback at the pituitary level and decrease stimulation of the residual thyroid tissue.

Analysis of iodine and selenium trace elements in umbilical cord blood in cretinous regions in northwest China in 1999

Shaanxi Province located at Midwest inland of China was a typical iodine deficient disorders region. To investigate iodine and selenium levels of neonates in the Shaanxi sub-clinical cretinism region of China after supplement of iodine salt for nearly twenty years. We collected 56 umbilical cord blood samples from cretinous regions of Yijun County (a selenium deficient region) north of Shaanxi Province and Ziyang County (a selenium-enriched region) south of the province and from Lintong in Xi'an (a non-cretinous region for control). Among these samples 17 were collected from Ziyang, 20 from Lintong and 19 from Yijun. Seven trace elements of iodine, selenium, zinc, copper, iron, calcium and magnesium in the umbilical cord blood samples were measured and the results were processed statistically. There were no significant differences in the levels of iodine among all three counties. However, the level of selenium in Ziyang was the highest and in Yijun it was the lowest. The other trace elements such as Cu Zn Fe and Mg showed no significant difference among the three counties except for the Ca level which was lower in Yijun.The regression equation was established with the backward method of multiple regression was: Se=0.180+0.00006654 Fe-0.006 Cu-0.005956 Mg+0.1.

Selenium: recent clinical advances

Selenium is an essential trace element that serves a number of metabolic functions. Its recommended dietary allowance has been set at 55 µg per day for adults. Selenium deficiency has not been reported to occur in healthy persons in the United States and Canada. However, many people in the world have suboptimal intakes of the element and may suffer clinical consequences. Certain viruses become more virulent by being passed through selenium-deficient animals. This might have public health consequences because viruses of clinical significance infect selenium-deficient populations in China and elsewhere. Selenium has also been promoted as a cancer chemopreventive agent when given at supranutritional levels. Studies are underway to evaluate this use of the element.