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Insufficient documentation for clinical efficacy of selenium supplementation in chronic autoimmune thyroiditis, based on a systematic review and meta-analysis.
Endocrine. 2017 Feb; 55(2):376-385.E

Abstract

By a systematic review and meta-analysis to investigate clinically relevant effects of selenium supplementation in patients with chronic autoimmune thyroiditis. Controlled trials in adults (≥18 years) with autoimmune thyroiditis, comparing selenium with or without levothyroxine substitution, versus placebo and/or levothyroxine substitution, were eligible for inclusion. Identified outcomes were serum thyrotropin (thyroid stimulating hormone) levels in LT4-untreated patients, thyroid ultrasound and health-related quality of life. Eleven publications, covering nine controlled trials, were included in the systematic review. Random effects model meta-analyses were performed in weighted mean difference for thyroid stimulating hormone, ultrasound and health-related quality of life. Quality of evidence was assessed per outcome, using GRADE. Meta-analyses showed no change in thyroid stimulating hormone, or improvements in health-related quality of life or thyroid echogenicity (ultrasound), between levothyroxine substitution-untreated patients assigned to selenium supplementation or placebo. Three trials found some improvement in wellbeing in patients receiving levothyroxine substitution, but could not be synthesized in a meta-analysis. The quality of evidence ranged from very low to low for thyroid stimulating hormone as well as ultrasound outcomes, and low to moderate for health-related quality of life, and was generally downgraded due to small sample sizes. We found no effect of selenium supplementation on thyroid stimulating hormone, health-related quality of life or thyroid ultrasound, in levothyroxine substitution-untreated individuals, and sporadic evaluation of clinically relevant outcomes in levothyroxine substitution-treated patients. Future well-powered RCTs, evaluating e.g. disease progression or health-related quality of life, are warranted before determining the relevance of selenium supplementation in autoimmune thyroiditis.

Authors+Show Affiliations

Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 10, 6th floor, Odense C, 5000, Denmark. kristian.winther@rsyd.dk. Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Winsløwparken 19, 3. Sal, Odense C, 5000, Denmark. kristian.winther@rsyd.dk.Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 10, 6th floor, Odense C, 5000, Denmark. Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Winsløwparken 19, 3. Sal, Odense C, 5000, Denmark.Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 10, 6th floor, Odense C, 5000, Denmark. Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Winsløwparken 19, 3. Sal, Odense C, 5000, Denmark.Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 10, 6th floor, Odense C, 5000, Denmark. Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Winsløwparken 19, 3. Sal, Odense C, 5000, Denmark.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27683225

Citation

Winther, Kristian Hillert, et al. "Insufficient Documentation for Clinical Efficacy of Selenium Supplementation in Chronic Autoimmune Thyroiditis, Based On a Systematic Review and Meta-analysis." Endocrine, vol. 55, no. 2, 2017, pp. 376-385.
Winther KH, Wichman JE, Bonnema SJ, et al. Insufficient documentation for clinical efficacy of selenium supplementation in chronic autoimmune thyroiditis, based on a systematic review and meta-analysis. Endocrine. 2017;55(2):376-385.
Winther, K. H., Wichman, J. E., Bonnema, S. J., & Hegedüs, L. (2017). Insufficient documentation for clinical efficacy of selenium supplementation in chronic autoimmune thyroiditis, based on a systematic review and meta-analysis. Endocrine, 55(2), 376-385. https://doi.org/10.1007/s12020-016-1098-z
Winther KH, et al. Insufficient Documentation for Clinical Efficacy of Selenium Supplementation in Chronic Autoimmune Thyroiditis, Based On a Systematic Review and Meta-analysis. Endocrine. 2017;55(2):376-385. PubMed PMID: 27683225.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insufficient documentation for clinical efficacy of selenium supplementation in chronic autoimmune thyroiditis, based on a systematic review and meta-analysis. AU - Winther,Kristian Hillert, AU - Wichman,Johanna Eva Märta, AU - Bonnema,Steen Joop, AU - Hegedüs,Laszlo, Y1 - 2016/09/28/ PY - 2016/05/17/received PY - 2016/08/17/accepted PY - 2016/9/30/pubmed PY - 2017/7/29/medline PY - 2016/9/30/entrez KW - Chronic autoimmune thyroiditis KW - Hashimoto’s thyroiditis KW - Meta-analysis KW - Quality of life KW - Selenium supplementation KW - Systematic review KW - Thyroid hormones KW - Thyroid ultrasound SP - 376 EP - 385 JF - Endocrine JO - Endocrine VL - 55 IS - 2 N2 - By a systematic review and meta-analysis to investigate clinically relevant effects of selenium supplementation in patients with chronic autoimmune thyroiditis. Controlled trials in adults (≥18 years) with autoimmune thyroiditis, comparing selenium with or without levothyroxine substitution, versus placebo and/or levothyroxine substitution, were eligible for inclusion. Identified outcomes were serum thyrotropin (thyroid stimulating hormone) levels in LT4-untreated patients, thyroid ultrasound and health-related quality of life. Eleven publications, covering nine controlled trials, were included in the systematic review. Random effects model meta-analyses were performed in weighted mean difference for thyroid stimulating hormone, ultrasound and health-related quality of life. Quality of evidence was assessed per outcome, using GRADE. Meta-analyses showed no change in thyroid stimulating hormone, or improvements in health-related quality of life or thyroid echogenicity (ultrasound), between levothyroxine substitution-untreated patients assigned to selenium supplementation or placebo. Three trials found some improvement in wellbeing in patients receiving levothyroxine substitution, but could not be synthesized in a meta-analysis. The quality of evidence ranged from very low to low for thyroid stimulating hormone as well as ultrasound outcomes, and low to moderate for health-related quality of life, and was generally downgraded due to small sample sizes. We found no effect of selenium supplementation on thyroid stimulating hormone, health-related quality of life or thyroid ultrasound, in levothyroxine substitution-untreated individuals, and sporadic evaluation of clinically relevant outcomes in levothyroxine substitution-treated patients. Future well-powered RCTs, evaluating e.g. disease progression or health-related quality of life, are warranted before determining the relevance of selenium supplementation in autoimmune thyroiditis. SN - 1559-0100 UR - https://www.unboundmedicine.com/medline/citation/27683225/Insufficient_documentation_for_clinical_efficacy_of_selenium_supplementation_in_chronic_autoimmune_thyroiditis_based_on_a_systematic_review_and_meta_analysis_ L2 - https://dx.doi.org/10.1007/s12020-016-1098-z DB - PRIME DP - Unbound Medicine ER -