Selenium and Graves’ Disease: The Nutrient with the Strongest Clinical Evidence

Short answer

Selenium and Graves’ disease are often studied together, and selenium is the most well-studied nutrient in this condition, with consistent clinical evidence for improving Graves’ orbitopathy (eye disease) (Lanzolla et al., 2021)(Marcocci C et al., 2011). It may also reduce thyroid antibody activity in some cases, although effects on thyroid outcomes are less consistent. It should be considered a supportive, not standalone, treatment.

What is Graves’ disease?

Graves’ disease is an autoimmune condition where the immune system mistakenly attacks the thyroid gland, leading to overproduction of thyroid hormones (hyperthyroidism). While some people explore natural approaches, there is no good evidence that diet alone can treat the condition (Bhat et al., 2023) (see my full breakdown of Can Graves’ Disease Be Treated with Diet? What the Research Says). Graves’ can cause a range of symptoms, including anxiety, weight loss, and heart palpitations.

For some, it also leads to Graves’ orbitopathy (GO), an eye condition that can cause inflammation, bulging eyes, and vision changes.

Why selenium is studied in Graves’ disease

While there are established medical treatments for Graves’ disease, many people wonder about supportive therapies.

Selenium, an essential trace element, has emerged as a nutrient with promising, though sometimes varied, evidence for its role in managing the condition.

Does selenium help Graves’ disease?

For those with Graves’ orbitopathy, the evidence is the strongest. Selenium has some of the strongest clinical evidence among all nutrients studied in Graves’ disease (Lanzolla G et al., 2021), particularly for its impact on eye-related symptoms.

For Graves’ disease itself, the evidence is more mixed and less consistent.

What selenium may help with in Graves’ disease

1. Graves’ orbitopathy (eye disease)

This is where selenium shows the most consistent benefits. Studies suggest that selenium supplementation can significantly reduce eye inflammation, improve symptoms such as dryness, swelling, and discomfort, lower disease activity scores, and enhance overall quality of life.

Clinical guidance from the European Thyroid Association supports selenium use in mild Graves’ orbitopathy based on randomised controlled trial evidence.

2. Thyroid function and antibody outcomes

The effects on the thyroid itself are more varied, but still notable. Some research suggests that selenium may help reduce the activity of thyroid-stimulating hormone receptor antibodies (TRAb/TSI), which are central to Graves’ disease.

It may also support improvements in thyroid hormone levels (TSH, FT3, FT4) and, in some cases, a faster return to a normal thyroid state (euthyroidism), although findings are inconsistent across studies (Ventura M et al., 2017; Sharabati I et al., 2024).

3. Remission and relapse

Higher selenium status has been associated with improved outcomes in some studies, including higher remission rates and a reduced risk of relapse.

However, these findings are inconsistent, particularly in Graves’ disease without eye involvement (Ferrari SM et al., 2017).

How selenium may work in Graves’ disease (proposed mechanisms)

Selenium may support thyroid and immune function through several mechanisms:

• Antioxidant activity: It may help reduce oxidative stress in the thyroid and orbital tissues, which is often elevated in Graves’ disease (Hou et al., 2021)
• Immune modulation: Selenium plays a role in modulating immune signalling, which may help calm the overactive immune response (Checconi et al., 2020)
• Autoantibody reduction: It may contribute to a reduction in autoantibody activity, such as TRAb (Zheng et al., 2018)
• Tissue protection: It may help protect thyroid and orbital tissues from damage caused by inflammation (Duntas, 2012)

Should you take selenium for Graves’ disease?

Selenium can be helpful, especially for Graves’ eye disease. But it should be used alongside medical treatment, not as a replacement.

Selenium can be helpful, especially for Graves’ eye disease. But it should be used alongside medical treatment, not as a replacement (similar to other commonly discussed natural approaches like Can Bugleweed Help Graves’ Disease? What the Latest Research Says).

For a broader overview of how diet and lifestyle approaches fit into Graves’ disease management, see Diet and Lifestyle Approaches Studied in Graves’ Disease: What the Evidence Says.

Selenium dosage and safety

Typical doses used in research

• Around 100 µg twice daily (200 µg/day total) (Drutel et al., 2013)
• Often used for around 6 months, particularly in Graves’ orbitopathy

Forms used

• Selenium-enriched yeast
• Sodium selenite

Food sources of selenium

Brazil nuts are a rich natural source, with one nut containing approximately 50–90 µg of selenium.

• One nut per day provides a moderate intake
• Two nuts may approach amounts used in clinical studies

However, selenium content in Brazil nuts can vary widely. For consistent dosing – such as in studies on Graves’ orbitopathy, supplements are typically used.

For general intake, one Brazil nut per day is a simple option. For targeted dosing, supplements provide more consistent amounts.

Safety considerations

Selenium is essential, but too much can be harmful. EFSA sets an adult adequate intake of 70 µg/day and an adult tolerable upper intake level of 255 µg/day (EFSA NDA Panel, 2023).

Excess intake (selenosis) may cause:

• Hair loss
• Brittle nails
• Gastrointestinal upset
• Fatigue

If supplementing, avoid combining high-dose supplements with very high dietary intake unless advised by a healthcare professional.

In many cases, one Brazil nut per day may provide a moderate selenium intake, although levels can vary widely (Silva et al., 2017).

When is selenium most helpful in Graves’ disease?

The effectiveness of selenium can be very individual.

It appears to be more beneficial in:

• People with low baseline selenium status
• Those with Graves’ orbitopathy

Its impact is generally less consistent in Graves’ disease without eye involvement.

FAQs: Selenium and Graves’ Disease

Key takeaway

Selenium has one of the strongest evidence bases among nutrients studied in Graves’ disease, but its benefits are mainly limited to eye symptoms.

It may support thyroid and immune function in some cases, but it is not a replacement for medical treatment.

Medical disclaimer

Always consult with your doctor before starting any new supplement, especially if you have an existing medical condition like Graves’ disease. They can help determine if selenium supplementation is appropriate, guide dosing, and monitor your progress.

References

Marcocci C et al. (2011). Selenium and the course of mild Graves’ orbitopathy. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1012985

Lanzolla G et al. (2021). Selenium in the treatment of Graves’ hyperthyroidism and eye disease. Frontiers in Endocrinology. https://doi.org/10.3389/fendo.2020.608428

Ventura M et al. (2017). Selenium and thyroid disease: from pathophysiology to treatment. International Journal of Endocrinology. https://doi.org/10.1155/2017/1297658

Sharabati I et al. (2024). The efficacy and safety of selenium supplementation versus placebo in Graves’ orbitopathy: a systematic review and meta-analysis of randomised controlled trials. Clinical Endocrinology. https://doi.org/10.1111/cen.15128

Ferrari SM et al. (2017). Environmental issues in thyroid diseases. Frontiers in Endocrinology. https://doi.org/10.3389/fendo.2017.00050

Hou T-Y et al. (2021). The role of oxidative stress and therapeutic potential of antioxidants in Graves’ ophthalmopathy. Biomedicines. https://doi.org/10.3390/biomedicines9121871

Checconi P et al. (2020). Redox-modulating agents in the treatment of viral infections. International Journal of Molecular Sciences. https://doi.org/10.3390/ijms21114084

Zheng H et al. (2018). Effects of selenium supplementation on Graves’ disease: A systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine. https://doi.org/10.1155/2018/3763565

Duntas LH. (2012). The evolving role of selenium in the treatment of Graves’ disease and ophthalmopathy. Journal of Thyroid Research. https://doi.org/10.1155/2012/736161

Drutel A et al. (2013). Selenium and the thyroid gland: more good news for clinicians. Clinical Endocrinology. https://doi.org/10.1111/cen.12066

EFSA NDA Panel. (2023). Scientific opinion on the tolerable upper intake level for selenium. EFSA Journal. https://doi.org/10.2903/j.efsa.2023.7704

Silva EC da et al. (2017). Natural variation of selenium in Brazil nuts and soils from the Amazon region. Chemosphere. https://doi.org/10.1016/j.chemosphere.2017.08.158

Bhat JA et al. (2023). Therapeutic options in Graves’ hyperthyroidism. https://doi.org/10.5772/intechopen.106562

Lanzolla G et al. (2021). Selenium in the treatment of Graves’ hyperthyroidism and eye disease. Frontiers in Endocrinology. https://doi.org/10.3389/fendo.2020.608428