Selenium: Important New Review of Health Findings
July 28, 2000
Selenium is a mineral which is essential in human nutrition in very small amounts (larger amounts are toxic). New research, much in the last five years, is finding that selenium deficiency may be involved in many important diseases, including HIV. The fact that this mineral has been the subject of irresponsible promotion as a cure-all must not blind us to the real possibilities that proper supplementation may have value in disease prevention and treatment.
A major literature review (1) published this month in the Lancet offers a credible overview of what is known and not known at this time on selenium and human health. We were surprised by the strength of the case for more attention to supplementation as a possible treatment -- a medical intervention which would cost essentially nothing, so it could be available anywhere in the world.
Here are some quotes from the review (we did not include the references from the original). Note that all measurements are in micrograms, because of the very small amounts of selenium used in human nutrition -- about a thousand times less than the dose of most AIDS drugs.
Other research has found effects of correcting selenium deficiency on mental status, tiredness, and mood -- and possibly on cardiovascular disease, although findings here have been mixed, perhaps because some of the trials included very few people with selenium deficiency.
Persons considering supplementation should note that the multivitamins they are taking may already include selenium -- in addition to their dietary intake, which tends to be higher in the U.S. than in many countries.
There is no clear agreement on how to supplement with selenium -- exactly who should use it, how much, or in what form. (In the research, selenium has been supplied both as inorganic forms such as selenate or selenite, and organic forms such as selenomethionine, or as selenium yeast.) Trials are ongoing, including at least two in HIV. But major uncertainties will remain.
We need more attention on rational ways to make decisions based on the incomplete information available now. Most professionals like to have definite proof, and are reluctant to prepare guidelines or recommendations based in part on reasonable guess. The frequent result is recommendations which are much too conservative, or none at all -- leaving the field to self-medication and a few self-taught experts, or to medical promoters or cultists. There should be widely discussed nutritional guidelines for persons with HIV, updated at least once a year -- as with guidelines for antiretroviral drug therapy.
Selenium levels in diet vary greatly by geography, because of the different amounts of the mineral in the soil where crops are grown. For example, diets are deficient in many areas of Western Europe, and of Africa. (Finland was especially deficient, and supplemented its food supply by adding selenium to fertilizer starting in 1984). It seems possible that region-specific, sophisticated recommendations on nutritional and other low-cost interventions could make major, cost-effective contributions both to treatment and prevention, benefiting those already infected and slowing the spread of the epidemic.
Copyright 2000 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.
This article was provided by AIDS Treatment News. It is a part of the publication AIDS Treatment News.