From the Guidelines
Selenium deficiency should be addressed with supplementation, with a recommended dose of 7 mg/kg/day in preterm infants and 2-3 mg/kg/day in term infants and children, up to a maximum dose of 100 mg/day, as supported by the most recent guidelines 1. To address selenium deficiency, it is essential to understand the importance of selenium in the body, particularly in its role as an antioxidant and its incorporation into selenoproteins that protect cells from oxidative damage. Selenium deficiency can lead to various health issues, including muscle weakness, fatigue, hair loss, and weakened immune function, and in severe cases, Keshan disease or Kashin-Beck disease.
Key Considerations
- Selenium supplementation should be approached cautiously, as excessive intake can cause toxicity, with symptoms including garlic breath odor, nausea, and nerve damage 1.
- The recommended dose of selenium supplementation varies depending on the individual's age, health status, and other factors, with preterm infants requiring a higher dose than term infants and children 1.
- Selenium can also be obtained through dietary sources, such as Brazil nuts, seafood, organ meats, and whole grains, although the bioavailability of selenium from these sources may vary 1.
Monitoring and Maintenance
- Selenium status should be monitored regularly in individuals receiving long-term parenteral nutrition, particularly in those with renal failure, to prevent deficiency and toxicity 1.
- Plasma selenium concentrations and glutathione peroxidase activity can be used to assess selenium status, although the latter may not be a reliable marker in preterm infants due to immaturity and oxygen exposure 1.
Special Considerations
- Certain groups, such as patients with burns, major trauma, or cardiac surgery, may require higher doses of selenium supplementation due to increased losses and oxidative stress 1.
- Genetic polymorphisms in selenoproteins may also affect selenium requirements and increase the risk of various diseases, including cancer and diabetes 1.
From the Research
Selenium Deficiency Overview
- Selenium deficiency can cause various health problems, including cardiomyopathy, arrhythmias, and increased susceptibility to infection 2
- A sufficiently high selenium status is essential for adequate immune response, and preventable endemic diseases are known from areas with selenium deficiency 3
Health Risks Associated with Selenium Deficiency
- Selenium deficiency is associated with an increased risk of autoimmune disease, including rheumatoid arthritis and type 1 diabetes mellitus 3
- Modest selenium deficiency may increase the risk of diseases of aging, such as cancer, heart disease, and immune dysfunction 4
- Systemic selenoprotein deficiency can result in a complex, multifactorial disorder, reflecting loss of selenoprotein function in specific tissues and/or long-term impaired selenoenzyme-mediated defence against oxidative and endoplasmic reticulum stress 5
Relationship between Selenium Deficiency and COVID-19
- Several studies have indicated that selenium deficiency may be detrimental in the context of COVID-19, with lower serum selenium levels associated with worse outcomes 6
- Selenium deficiency was associated with worse outcomes in most cases, and selenium levels in COVID-19 patients were lower than in healthy individuals 6
Potential Benefits of Selenium Supplementation
- Positive effects on the immune system are observed with selenium supplementation in pregnancy, autoimmune thyroid disease, and recovery from severe illness 3
- Cautious selenium supplementation in COVID-19 patients may be helpful to prevent disease progression, although randomized clinical trials are needed to confirm this 6
- Improved dietary choices or supplemental selenium are efficient ways to avoid severe selenium deficiency, thereby decreasing autoimmune disease risk and improving disease course 3