Selenium deficiency
| Selenium deficiency | |
|---|---|
| Classification and external resources | |
 Selenium |
|
| ICD-10 | E59 |
| ICD-9 | 269.3 |
| DiseasesDB | 11941 |
Selenium deficiency is relatively rare in healthy well-nourished individuals. Few cases have been reported.
Contents |
[edit] Causes
It can occur in patients with severely compromised intestinal function, those undergoing total parenteral nutrition, those who have had gastrointestinal bypass surgery, and also[1] on advanced aged people (over 90).
Alternatively, people dependent on food grown from selenium-deficient soil are also at risk.
For some time now in medical literature it has been noted the pattern of side-effects associated with cholesterol lowering drugs statins resembles the pathology of selenium deficiency. [2] [3]
[edit] Reference ranges
In the USA, the Dietary Reference Intake for adults is 55 µg/day. In the UK it is 75 µg/day for adult males and 60 µg/day for adult females. 55 µg/day recommendation is based on full expression of plasma glutathione peroxidase. Selenoprotein P[4] is a better indicator of selenium nutritional status, and full expression of it would require more than 66 µg/day.[5]
[edit] Presentation
Selenium deficiency in combination with Coxsackievirus infection can lead to Keshan disease, which is potentially fatal. Selenium deficiency also contributes (along with iodine deficiency) to Kashin-Beck disease.[6] The primary symptom of Keshan disease is myocardial necrosis, leading to weakening of the heart. Kashin-Beck disease results in atrophy, degeneration and necrosis of cartilage tissue.[7] Keshan disease also makes the body more susceptible to illness caused by other nutritional, biochemical, or infectious diseases.
Selenium is also necessary for the conversion of the thyroid hormone thyroxine (T4) into its more active counterpart, triiodothyronine, and as such a deficiency can cause symptoms of hypothyroidism, including extreme fatigue, mental slowing, goitre, cretinism and recurrent miscarriage.[6]
[edit] Epidemiology and prevention
These diseases are most common in certain parts of China where the intake is low[8] because the soil is extremely deficient in selenium. Studies in Jiangsu Province of China have indicated a reduction in the prevalence of these diseases by taking selenium supplements.
[edit] References
- ^ Effect of micronutrient status on natural killer cell immune function in healthy free-living subjects aged >=90 y1 - Ravaglia et al. 71 (2): 590 - American Journal of Clinical...
- ^ Selenoprotein synthesis and side-effects of statins.
- ^ Selenoproteins, cholesterol-lowering drugs, and the consequences: revisiting of the mevalonate pathway.
- ^ Papp LV, Lu J, Holmgren A, Khanna KK (2007). "From selenium to selenoproteins: synthesis, identity, and their role in human health". Antioxid. Redox Signal. 9 (7): 775–806. doi:10.1089/ars.2007.1528. PMID 17508906.
- ^ Xia Y, Hill KE, Byrne DW, Xu J, Burk RF (2005). "Effectiveness of selenium supplements in a low-selenium area of China". Am. J. Clin. Nutr. 81 (4): 829–34. PMID 15817859.
- ^ a b DRAFT
- ^ NEJM - Kashin-Beck Osteoarthropathy in Rural Tibet in Relation to Selenium and Iodine Status
- ^ "Selenium: Mineral Deficiency and Toxicity: Merck Manual Professional". http://www.merck.com/mmpe/sec01/ch005/ch005i.html. Retrieved 2008-11-29.
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