Graves thyroid and eyed disease and selenium.

Graves’ disease and Selenium: my 2016  update
Selenium is a useful adjunct to help management or progression of bulging
Eyes, or orbitopathy in Graves disease. The thyroid stimulating antibodies of Graves’ disease produce oxidative stress, fibroblast (collagen-producing) cell proliferation and deposition of hyaluronic acid in the eye muscles. These events lead to eye muscles enlargement and produce changes in how the eyeball and muscles function within the orbit of the eye socket. As the muscles enlarge the eye ball is pushed forward producing the appearance of bulging eyes and creating double vision.  The worse scenerio is that at times enlargement of the muscles in the tight socket of the eye compromises the function of the optic nerve and vision. This is a medical emergency which requires surgical decompression by oculoplastic surgeons.  Improving the antioxidant balance with selenium helps protect the eye in patients with Graves’ disease. Selenium prevents proliferation of fibroblasts, prevents hyaluronic acid release, and prevents oxidative stress. One of the way that Selenium works is enhancing the function of many selenoproteins, some of which are enzymes involved with thyroid function and thyroid hormone synthesis, and others in antioxidant enzymes such as glutathione. Glutathione works with vitamin C and E to remove toxic oxidative stress.
The new Italian study, presented at the 2016 American Thyroid Association Meetings, confirms data published and referenced below.  Selenium 100 mg twice a day improved Graves’ eye disease and quality of life. No adverse events were seen with selenium. Based on this reassuring information we know that a 6 month trial can be offered safely to patients with eye complaints, in addition to lubricants, and thyroid supressive therapy with methimazole.  Please be aware that treatment of Graves’ disease with radioactive iodine can promote or worsen Graves’ eye disease, and that smoking also makes eye disease worse. If you and your doctor choose radioactive iodine for eye disease, then treatment steroids are also recommended at the same time to prevent eye problems after treatment.

Reference:  C Marcocci, at al. ‎Selenium and the course of mild Graves‘ orbitopathy. N Engl J Med. 2011 May 19;364(20):1920-31. doi: 10.1056/NEJMoa1012985. 
Posted in hyperthyroid and or Graves' disease, Thyroid, Wellness & Prevention