Selenium Supplementation in Graves’ Orbitopathy: Effects on Blood Concentrations and Clinical Outcomes

Mingkwan Lumyongsatien,1 Kittiphum Vejsitthangkul,1 Thitipon Treebuppachatsakul,1 Sunisa Sintuwong,1 Ornvenus Nimitwongsakul,1 Krit Pongpirul2 1Department of Ophthalmology, Metta Pracharak (Wat Rai Khing) Hospital, Nakhon Pathom, Thailand; 2Center of Excellence in Preventive and Integrative Medicine (CE-PIM), Chulalongkorn University, Bangkok, ThailandCorrespondence: Mingkwan Lumyongsatien, Department of Ophthalmology, Metta Pracharak (Wat Rai Khing) Hospital, 52 Moo 2 Rhikhing, Nakhon Pathom, 73210, Thailand, Email [email protected]: To evaluate changes in blood selenium concentrations and associated clinical outcomes following selenium supplementation in patients with Graves’ orbitopathy (GO) with varied severity.Study Design: A retrospective study.Patients and Methods: We retrospectively reviewed the medical records of patients with GO who received selenium supplementation with a total daily dose of 210 μg for six months at a single tertiary care center between January 2019 and January 2021. Clinical parameters, including visual acuity, exophthalmos, eyelid aperture, Clinical Activity Score (CAS), GO severity, Graves’ Ophthalmopathy Quality of Life (GO-QoL) scores, and selenium concentrations were assessed at baseline and post-treatment. Subgroup analysis was performed for patients who received no concurrent GO treatment.Results: Forty-eight patients (52.1% female, mean age 46.33± 11.47 years) were included, with disease severity classified as mild (22.9%), moderate-to-severe (70.8%), and sight-threatening (6.3%). The mean selenium concentrations increased from 90.46± 16.40 μg/L to 113.67± 19.64 μg/L (mean difference: 23.21± 24.75 μg/L; 95% CI: 16.02– 30.39, P< 0.001). Of 37 patients who did not receive other GO treatments, CAS improved significantly in 13 (35.13%; P=0.02), and the prevalence of eyelid edema decreased from 22.2% to 5.6% (P=0.03). GO-QoL appearance subscale scores significantly improved (mean change: 8.16± 23.14; 95% CI: 0.33– 15.99; P=0.04), while the changes in visual function scores were not statistically significant.Conclusion: Selenium supplementation was associated with a significant increase in selenium concentrations and clinically significant improvements in CAS, eyelid edema, and quality of life among patients with GO. These findings support the potential role of selenium therapy in GO management. However, larger randomized controlled trials are warranted to confirm these observations and guide dosage recommendations.Keywords: selenium supplementation, blood concentration, Graves’ orbitopathy