Don’t forget selenium

March 8, 2021

With the headline, we are entering the vital minerals, and selenium is one of the most important, because it is the gateway to 25 different selenoproteins, which control a wide range of processes in the body.

Selenium is a substance that we prefer not to lack, and numerous studies have over the years confirmed that selenium deficiency can lead to, among other things. heart failure, cancer, metabolic disorders, arthritis, infertility, atherosclerosis, increased inflammation, and a variety of immunological failures that are particularly relevant in this corona age.

Did you know, for example, that a vaccine will not work as intended if the vaccinated person lacks selenium and vitamin D. These two nutrients are necessary to activate the T cells, which must be able to recognize the infection the next time you encounter it (1,2,3). And they are also needed to moderate any vaccine-triggered cytokine storm.

There are thousands of articles cementing heavy research into selenium, and most recently, two months ago, an interesting study of selenium deficiency related to cardiovascular disease and inflammatory conditions was published (4). Since cardiovascular disease is also initiated by inflammation, it is natural to examine this collectively.

Previous studies have also shown that low selenium in the blood was the cause of increased inflammation, increased risk of cardiovascular disease and premature death (5,6).

Selenium dampens cytokine storms

The study included 858 healthy elderly and 606 cardiovascular patients of the same age.
The researchers examined the degree of inflammation by measuring the ratio of white blood cells (neutrophil / lymphocyte ratio), CRP and a wide range of cytokines, interleukins and chemokines.

They found a clear link between the lack of selenium and the incidence of cardiovascular disease as well as, not surprisingly, increased chronic, inflammatory load on the body, especially in the cardiovascular disease.

Selenium deficiency was associated with elevated values of circulating inflammation markers such as cytokines, interleukins and chemokines that are precisely characteristic of the scourge of our time, namely the risk of a cytokine storm at Covid-19.

Selenium is included as a moderator on an equal term with vitamin D, so that the formation and control of cytokines is formed and controlled, but to avoid the violent production called a cytokine storm, which triggers the damage that makes Covid-19 dangerous for individuals, weak people.

The researchers concluded that people with plasma selenium below 60 µg / l had almost twice the risk of cardiovascular disease compared to those who had a normal selenium content in the blood.

The result was convincing and statistically significant and corresponds very well to previous studies showing that the selenium-dependent glutathione peroxidase achieves its maximum activity in the blood when the concentration of selenium in plasma is between 70 and 90 µg / l (7).

In previous newsletters from May 2020, there are several references related to infections updated by Covid-19, and back in 2005 we wrote newsletters about cancer risk due to selenium deficiency. So selenium has been on the light board for many years, i.a. because there are so few who are aware that it is something we must not lack.

Daily intake (in Europe) should be around 100µg, and naturally it is found in fish, meat and certain nuts.
So remember selenium every day.

Take care of yourself and others.

Claus Hancke MD
Specialist in general medicine


  1. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study. Piroth L et al, Dec.2020, Lancet.
  2. Geisler C, Ødum N et al. 2010, Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nature Immunology 2010;11:344-349.
  5. Alberto Boretti, Bimal Krishna Banik (2020) Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome PharmaNutrition. 2020 Jun;12:100190.  Published online 2020 Apr 21.
  6. Caly L et al, 2020, Antiviral Research, 178, june 2020, 104787.

Update on Corona virus

August 26, 2020

Since the last newsletter from May 28, things have gone well here in Denmark.
On the other hand, viruses have become widespread, especially in those countries that have not taken the spreading of infection seriously.
In the past month, however, localized infection clusters have emerged in various places here in Denmark as well, especially in immigrant communities.
The reasons for this have been mentioned in the previous newsletters, whose advice is still valid, so I will not repeat it here, but instead focus on what has happened in the last 3 months.

In a literature study(1) from Norwegian, Russian and Swedish public health institutes six researchers have concluded that early intervention with Zinc, Selenium and Vitamin-D can alleviate the course of the disease, and virtually prevent the cytokine storm, which is the process responsible for the destruction of tissues, microthromboses, inflammation, etc. -the whole cascade that can take the life of the Covid-19 sick persons.

An almost simultaneous study(2) from Germany analyzed Serum-Selenium and Serum-Selenoprotein P, and both values were significantly lower in those who did not survive Covid-19.
(Selenium: 53.3 ± 16.2 vs. 40.8 ± 8.1 μg / l, Selenoprotein-P: 3.3 ± 1.3 vs. 2.1 ± 0.9 mg / L p<0.001). These results must be said to be highly relevant in our country, where we consume so little selenium. This study falls nicely in line with the former study.

On August 3, an article was published in the Lancet(3) which strongly calls for increased intake of vitamin D based on solid literature reviews.
This also falls in line with the first study mentioned above.

And, finally, there is a meta-analysis(4) of the role of vitamin D in the development of acute respiratory infection. It includes 30,000 people in controlled trials (RCTs), and has shown significantly reduced risk of acute respiratory infection already at 10-25 µg of vitamin D daily.
This confirms a previous meta-analysis(5), which also found a significant inverse correlation between the risk of acute respiratory infection and the vitamin D content in the blood.
All of the above studies are nicely in line with the advice mentioned in the five newsletters from May.

Authorities distribute vitamins
Azerbaijan has registered 35,000 Covid-19 cases in a population of 10 million. Of these, 1,800 were hospitalized and 508 died.
Here, the Ministry of Health has provided more than 3,500 Covid-19 patients with a free “medicine package” containing: Vitamin C, Vitamin D, Magnesium, Selenium, Zinc and Paracetamol.
The idea is then that the patients stay at home and treat themselves there.
Every day they are then contacted by the local hospital clinic and have to answer a series of questions, just as the doctor checks that they are taking their pills.
So far, a significant reduction in the number of hospitalizations in this group has been observed(6).

You can only shout cheers when you see authorities who can think outside the box and dare to start such a project. My guess is that the trend will continue and that home treatment will continue to reduce hospital admissions in Azerbaijan.

The idea is not bad because you initiate a completely harmless treatment of a, for some people, -dangerous disease.
But why wait until they get sick?

With timely care, one can improve the immune system of the entire population if one simply provides information about these supplements and their significance.

What could be done here in Denmark is to provide subsidies to the vulnerable groups, especially residents of the country’s nursing homes, who are completely dependent on the public perception of vitamins and minerals. If their own doctor does not prescribe a vitamin supplement, then residents are often denied help to get the supplements, despite their own desire. They are completely dependent upon the doctor’s knowledge or lack thereof. I think Danish authorities and medical staff would be shocked if we measured the level of vitamin D in the country’s nursing home residents.
If you do not want to use public funds to donate these subsidies to the residents, then you can at least make sure that both residents and their relatives are informed.

These newsletters on Covid-19 are unfortunately necessary as this knowledge and the scientific back-up are neglected in the public advice to the Danish population.

Take care of yourself and others

Claus Hancke MD
Specialist in general medicine


  1. Alexander J, Alehagen U et al. (2020) Early Nutritional Interventions with Zinc, Selenium and Vitamin D for Raising Anti-Viral Resistance Against Progressive COVID-19. Nutrients 2020, 12, 2358.
  2. Moghaddam A, Heller R et al. (2020) Selenium Deficiency Is Associated with Mortality Risk from COVID-19. Nutrients 2020, 12, 2098.
  3. Martineau A, Forouhi N (2020) Vitamin-D for Covid-19: a case to answer. Lancet 2020;8:735-6.
  4. Joliffe D, Martineau A, Damsgaard Camilla et al. (2020) Vitamin D supplementation to prevent acute respiratory infections: Systematic review and meta-analysis of aggregate data from randomised controlled trials. medRxiv BMJ (endnu ikke peer reviewed) 17.juli 2020.
  5. Martineau A et al. (2017) Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data.
    BMJ 2017;356:i6585.
  6. lmahamad A, (2020) 3.500 covid-19 patients provided with free medication. Azernews 18.august 2020.

Be prepared for the next Corona epidemic

The population is not

May 29, 2020

The Corona is spreading more slowly now, and, here in Denmark, Covid-19 is gradually infecting fewer and fewer people and we are more aware of protecting ourselves against it.

There have been good effects from keeping our distance and from maintaining good hygiene in which we have all been well instructed.

Much to the surprise of the Danish Serum Institute, less than 2% of the Danish population has had the disease, and only a few of these individuals may have obtained immunity to SARS-CoV-2, which the virus is called.
This means that more than 98% have not been infected and are completely without immunity. So forget about herd immunity.

The Danish population is just as vulnerable it was were in March when it all started.

Let’s try to summarize what we know and what we can do about it.

What do we know now?
SARS-CoV-2, which is the virus responsible for the current Covid-19 pandemic, is characterized in that it – like the influenza virus – triggers a reaction with the release of a number of signaling molecules such as interleukins, interferons, and lymphokines.

When this release is powerful, it is called a “cytokine storm”, and with Covid-19, it is so powerful that immune cells begin to damage the tissues where the process is taking place, and, in this case, it is primarily the lung tissue that is damaged.

During the cytokine storm, a violent inflammatory response and increased release of free oxygen radicals are created, which further damages the lung tissue due to the subsequent inflammatory microcoagulation seen in the pulmonary vessels. Adding too much oxygen at this stage will only aggravate the situation, which several anesthesiologists have experienced when Covid-19 patients’ conditions worsen when they are put on a respirator.

What can we do about it
Thus, it is primarily about attenuating the fatal cytokine storm.
Here vitamin D, magnesium, selenium, and vitamin C are particularly important as they specifically inhibit this cytokine storm and the subsequent inflammatory microcoagulation in the pulmonary vessels.
If the level of these essential substances in the body is high enough then you will have a subdued cytokine storm and thus attenuated symptoms, as seen during influenza infection. Fresh extract of Coneflower (Echinacea) has also been documented in several scientific studies to effectively inhibit this cytokine storm.

It should be obvious to protect ourselves by promoting such harmless and inexpensive remedies, but unfortunately in the medical and pharmaceutical world, one tends to stare blindly at the most expensive solutions.
Medical professionals were first intrigued by the antiviral drug Remdesivir, which could shorten the disease period of Covid-19 from 15 to 11 days. This fascination has now been replaced by a new one, another drug, an experimental cancer drug, Bemcentinib that may prevent viruses from entering the cells. A phase II trial is underway for 120 people, and we hope we will be able to get the result in a few months.

Well, it is excellent that medical professionals try to find a medicine that can help in this situation, but is it absolutely necessary to find a new, expensive medicine with side effects, when there are other far cheaper options without side effects?

The long awaited vaccine
While all this is going on, the pharmaceutical industry is working full speed on a vaccine. A vaccine against an RNA virus is very difficult to make, and using a vaccine is especially problematic because viruses constantly mutate and thereby often change the immune response.

No vaccine has ever been safety-tested, in the same way that medicine is tested, and this is a bit problematic because in recent years, the industry has started to add substances whose purpose is to stimulate the immune system for effective antibody formation. And stimulating antibody formation is good enough, too, but the safety of these substances has never been investigated. In Denmark, the use of mercury (thimerosal or thiomersal) in childhood vaccines was stopped from 1992 and in influenza vaccines from 2004, with the exception of the vaccine in 2009, which was an embarrassing exception. The toxic mercury should never be used again for human use – neither in the teeth, for that matter.

But in recent years aluminum has been added in the form of nanoparticles as well as squalene emulsions. These adjuvants have not been safety tested. It has just been noted (WHO has noted) that the number of side effects is not greater than is usually seen with vaccination. Aluminum is a neurotoxin, but it has been used in vaccines in the form of various aluminum salts since 1930, so in that form it probably isn’t particularly harmful. The problem is that nanoparticles are now being used that cannot be stopped by a cell membrane. They can penetrate all tissues.
It cannot be ruled out that it is safe to use these additives. It’s just never been investigated.

It should be a simple task to make a study with each of these ingredients against a real placebo such as brine.
We have many excellent vaccines, so let’s not be vaccine deniers. Let’s welcome a SARS-CoV-2 vaccine when it arrives, and then just hope it is properly safety tested. Of course, this hope becomes a requirement if we are to be mandatory vaccinated.

Of course, the Coronavirus will return
When and how bad we do not know, but it will come.
As mentioned in the Vitamin C newsletter, one of Europe’s experts in Covid-19, Professor Christian Drosten from the University of Berlin, has stated that the second wave could be tougher than the current one.
And since more than 98% of the Danish population is without immunity against it, we should not sit with our hands in our laps and wait for a vaccine.

We need to be proactive.
We need to make sure that we have enough of the nutrients that can reduce the risk of our getting sick, and especially the nutrients that can dampen the cytokine storms, so that we get a mild course of illness if we get sick anyway.

Especially old people and people who eat only very little, who may also be weakened by chronic disease, will do well by supplementing the diet in order to be well equipped with an optimally functioning immune system as the next virus threat approaches.

An appropriate daily dose for a normal-weight adult will typically be:

  • Vitamin A: 1-2 mg
  • Vitamin B6: 4-5 mg
  • Vitamin C: 2-3,000 mg
  • Vitamin D3: 75-100 µg
  • Selenium: 100-200 µg
  • Zinc: 20-30 mg
  • Magnesium: 200-300 mg

Note: The low dose is for those weighing less than 70 kg (155 pounds / 11 stones).

If you start now, you will be prepared in the fall. This is an obvious strategy for the country’s nursing homes.

This is the fifth and final Covid-19 newsletter.

Unfortunately, the five newsletters are necessary as this knowledge and scientific back-up are neglected in the public counseling of the population.

Take care of yourself and others,

Claus Hancke, MD,
Specialist in general medicine


  • McGonagle D et al. (2020) Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia. Lancet May 7, 2020:1-9
  • Zhang Y, Leung D, Richers B, et al. (2012) Vitamin D Inhibits Monocyte/Macrophage Proinflammatory Cytokine Production by Targeting MAPK Phosphatase-1. Journal of Immunology. 2012;188(5):2127-2135.
  • Alberto Boretti, Bimal Krishna Banik (2020) Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome PharmaNutrition.
    2020 Jun;12:100190. Published online 2020 Apr 21.
  • Sharma M, Anderson A et al.(2009) Induction of multiple pro-inflammatory cytokines by respiratory viruses and reversal by standardized Echinacea, a potent antiviral herbal extract. Antiviral Research, 2009;83(2):165-170.
  • Cannell JJ, Zasloff M, Garland CF et al. (2008) On the epidemiology of influenza.
    Virol J. 2008;5:29.
  • Gorton HC, Jarvis K (1999) The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manip Physiol Ther, 22:8, 530-533
  • Hemilä H (2003) Vitamin C and SARS coronavirus Journal of Antimicrobial Chemotherapy, Volume 52, Issue 6, December 2003, Pages 1049–1050
  • WHO Global advisory committee on vaccine safety 2020 (ikke ændret siden 2006).

Selenium attenuates Covid-19 disease

But we don’t hear about it

May 11, 2020

At this time, new research is emerging, newly published, especially about SARS-CoV-2, which has shut down the world with its follow-up Covid-19. This disease specifically affects the lungs, which is why people with lung disease are at special risk of serious illness.

One of the world’s most respected selenium researchers, Margaret Rayman, together with a team of researchers, has just published an important letter in the American Journal for Clinical Nutrition that shows a significantly (P <0.0001) higher cure rate for Covid-19 patients with higher selenium levels in the body.

An interesting study from 2004 (Beck) showed that if a virus like corona passes through a host animal with selenium deficiency, the viral virulence will increase. The host animal lacks selenium to produce glutathione peroxidase for its own protection, thus allowing the virus to mutate freely to a more virulent form. Such selenium-deficient host animals are found in large selenium-poor areas of China, and could, for example, be a bat, or more likely a civet, which is a Chinese cat-like animal resembling a mongoose a little bit. It is eminent for adapting to urban environments and can be a nuisance near human housing where the cats’ excrements make a mess and carry diseases – especially if the animals lack selenium.

Rayman mentions a number of diseases that are improved by optimizing selenium supplementation via the immunomodulatory effect of selenium, in particular selenium’s ability to attenuate the virus’s ability to mutate in a more virulent direction.

Along with the above zoological observation, this led Rayman and colleagues to assume that selenium status and Covid-19 disease had a relationship, and they wanted to find it.

In a retrospective population-based analysis, daily reports (from a credible, non-governmental source) were collected from each province, municipality and city on confirmed cases, cured and deceased Covid-19 patients.

From previous studies, data on selenium levels in individual small districts were reported as selenium concentration in hair. Hair selenium concentrations have shown strong correlation with selenium intake in the different Chinese districts.

By the term “cured” is meant more than three days of fever-free lung function and lung symptoms clearly improved pulmonary x-ray or scan normal, and negative immunological test for the lung pathogen in question in two subsequent tests at least one day apart.

The recovery was significantly lower in Hubei Province (13.2%) compared to all other provinces (40.6%), and mortality in Hubei Province higher (3% – sick) than in all other provinces (0.6 %). Both differences are highly significant (P <0.0001).

However, one of the cities of Hubei Province showed remarkably higher recovery rates than the rest of the cities of Hubei, and it was Enshi (36.4%), which is known for high selenium intake and high selenium status.
The reason China is so thoroughly researched for selenium, is because there are areas in China with both the world’s lowest – and the world’s highest occurrences of selenium in the soil and in the food.

An area of very low selenium status is Keshan in northeastern Heilongjiang Province. We know Keshan disease, which is a cardiomyopathy / heart failure due to selenium deficiency. In Keshan, the mortality rate was 2.4% compared to the other province’s 0.5%.

The Rayman study has significant weaknesses in confounding factors and the use of old selenium data. It was also published as a “facilitator” so that the news can come out as quickly as possible at a time when any whistleblow is welcome and every stone must be turned over.
The Vitality Council has emphasized that the research does come from a serious researcher, Margaret Rayman.

Furthermore, when we can link her new data with a large number of heavy scientific studies, all of which point to selenium as a key ingredient in our immune system, the Vitality Council will conclude that selenium is necessary to optimize our immune system, so we won’t get so sick from Covid-19.

Take care of yourself and others,

Claus Hancke; MD,
Specialist in general medicine


  • Rayman Margaret et al, 2020, Association between regional selenium status and reported outcome of COVID-19 cases in China Am J Clin Nutr 2020; 00: 1–3
  • Beck MA, Handy J, Levander OA. Host nutritional status: The neglected virulence factor. Trends Microbiol 2004; 12: 417–23.
  • Rayman Margaret. Selenium and human health. Lancet 2012; 379: 1256–68.
  • Harthill M. 2011, Micronutrient selenium deficiency influences evolution of some viral infectious diseases. Biol Trace Elem Res. 2011 Dec; 143 (3): 1325-36.
  • Huang Z, Rose AH, Hoffmann PR. The role of selenium in inflammation and immunity: from molecular mechanisms to therapeutic opportunities.
    Antiox Redox Signal. 2012 Apr 1; 16 (7): 705-43.
  • Beck MA, Nelson HK, Shi Q, Van Dael P, Schiffrin EJ, Blum S, Barclay D, Levander OA. Selenium deficiency increases the pathology of an influenza virus infection. FASEB J. 2001 Jun; 15 (8): 1481-3.
  • Steinbrenner H et al. 2015, Dietary Selenium in Adjuvant Therapy of Viral and Bacterial Infections. Adv Nutr 2015; 6: 73–82.

Latest news on selenium

January 12, 2010

Intensive research is going on in utilization of selenium against cancer.
The public in Denmark do not hear much of it, but here is a selection of recent news.

The lack of television and newspaper information may give the impression that there is quiet on the antioxidant front concerning disease control. This is not the case. The news shortage is chiefly due to the censorship that has been introduced. Regarding selenium alone, being one of the major antioxidants, there were in 2009 published more than 900 scientific articles. Here we will mention a selection of recent articles about selenium in the fight against cancer.

A famous attempt to demonstrate whether antioxidants protect against cancer were performed in the years 1985-91 in the Chinese Linxian province. Nearly 30.000 participated in the study, which showed a strong decrease in cancer risk among those who received a supplement of selenium (50 micrograms) and Vitamin E and Beta Carotene (respectively 30 and 15 mg). Now it has been determined, what had happened to the participants 10 years later (2001). Even after so long a time, there were relatively more survivors in this group than among those who received other supplements (eg. Vitamin A + zinc, was of no benefit). In particular, the group had reduced incidence of cancer of the stomach, but it was the participants under 55 years of age who experienced the greatest gain – you must avoid lacking vital nutrients already from the youth.

Apparently this result is contradicted by another famous study, the SELECT trial conducted in the U.S. Here it appeared that you could not prevent prostate cancer using selenium, vitamin E or a combination of both. This study was in large scale and the result a huge disappointment.

One of the world’s leading selenium specialists, Margaret Rayman, did point out however, a few months ago what really is obvious: Supplementation with selenium is of no benefit if you already get enough! As a general rule you get enough in the U.S., where you typically get 3-4 times as much selenium in the diet as in Denmark. Sufficient selenium is essential for the body to form enough of the enzymes which we presume protects against cancer. Amongst others Rayman refer to another U.S. cancer trial where you just saw a massive impact in those who received the least amount of selenium, but no effect in those who got the most.

Heavy metals neutralized
One of the veterans in selenium research is Gerhard Schrauzer from San Diego University of California. He has been involved more than 20 years. Now he points out that selenium is able to detoxify numerous toxic metals that somehow during our civilized environment ends up in our bodies. This applies to lead, mercury, copper, cadmium, arsenic, etc. Selenium inactivates these metals by forming insoluble compounds with them. But, says Schrauzer, one must remember that at the same time selenium is used up, so we for that reason are less protected against cancer. In Europe we already get too little selenium, but heavy metals etc. increases the demand.

Taylor and associates have written an article on new advances in selenium research. They write that the renewed interest in selenium is linked to the fact that the anti-cancer effect is now very well documented in animal studies. This is worth noticing.

And precisely on animals a research team from San Diego University have demonstrated that the effect of chemotherapy (cisplatin) against cancer of the colon is reinforced considerably by large supplements of antioxidants (A and vitamin E and selenium) combined with fish oil. The group believes their achievement justifies that research is made with people. The result is very exciting because cancer doctors in this country often discourages in strong terms their patients from combining antioxidants with chemotherapy. The reason for this warning has hitherto been unclear.

Selenium and chemotherapy
Researchers from The Karolinska Hospital in Stockholm state without hesitation that it is well documented that selenium prevents cancer. They describe several experiments which have shown that selenium has strong anti cancer effects – especially against cancer, which no longer responds to chemotherapy. Normal cells will not be harmed by the selenium doses needed for this!

Italian researchers, however, stresses that people can get too much selenium (but living in Denmark you have take approx. two selenium tablets a day in order to get the same amount as a typical American). They argue that high doses may increase the risk of diabetes, an assertion, however, that is controversial.

In the Netherlands, like in China there has been an interest in selenium and cancer of the esophagus. More than 120,000 persons who was 55-69 years old in 1968, delivered at that time, a portion nail clips from their big toes. 16 years later it was found who and how many have got cancer of the esophagus or stomach in the meantime. Then the selenium levels in their nails was measured and compared with the levels in healthy subjects. It was found that the risk of both cancers was significantly higher among those who only had small amounts of selenium in their nails, and hence their body.

A curious study has been conducted in Japan. Here researchers cultivated broccoli-sprouts in a selenium-rich environment, so the sprouts got an extra high content of selenium. In a laboratory study the sprouts was investigated for their impact on prostate cancer tissue. The enriched sprouts inhibited cancer growth clearly better than normal sprouts. Now the Japanese suggests, that men eat that kind of sprouts to prevent cancer of the prostate.

Finally other Japanese mention, that it is well known that selenium can kill cancer cells from humans, but but precisely how this happens is still unclear. They have reached the conclusion that at least part of the effect is due to selenium starts off a cancer cell death process using the same mechanism (apoptosis) as when normal cells must be replaced and die. Such a mechanism is of course necessary, since almost all normal cells divide continuously. There would soon be twice as many, and we would grow indefinitely, if not worn-out cells were put out.

As you can see, the research is really alive. Much of our understanding of selenium is achieved in very recent years. More will undoubtly follow.

By: Niels Hertz, M.D.

1. Qiao YL et al. Total and cancer mortality after supplementation with vitamins and minerals: follow-up of the Linxian General Population Nutrition Intervention Trial. J Natl Cancer Inst. 2009 Apr 1;101(7):507-18. Epub 2009 Mar 24.
2. Lippman SM et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2009 Jan 7;301(1):39-51. Epub 2008 Dec 9.
3. Rayman MP. Selenoproteins and human health: insights from epidemiological data.
Biochim Biophys Acta. 2009 Nov;1790(11):1533-40. Epub 2009 Mar 25.
4. Schrauzer GN Selenium and selenium-antagonistic elements in nutritional cancer prevention.
Crit Rev Biotechnol. 2009;29(1):10-7.
5. Taylor D. Recent developments in selenium research. Br J Biomed Sci. 2009;66(2):107-16; quiz 129.
6. Ma H. Bi Efficacy of dietary antioxidants combined with a chemotherapeutic agent on human colon cancer progression in a fluorescent orthotopic mouse model. Anticancer Res. 2009 Jul;29(7):2421-6.
7. Selenius M. Selenium and selenoproteins in the treatment and diagnostics of cancer.
Antioxid Redox Signal. 2009 Sep 21. [Epub ahead of print]
8. Vinceti M. Risk of chronic low-dose selenium overexposure in humans: insights from epidemiology and biochemistry Rev Environ Health. 2009 Jul-Sep;24(3):231-48.
9. Steevens J. Selenium status and the risk of esophageal and gastric cancer subtypes: the Netherlands cohort study. Gastroenterology.. [Epub ahead of print]
10. Abdulah R. Selenium enrichment of broccoli sprout extract increases chemosensitivity and apoptosis of LNCaP prostate cancer cells. BMC Cancer. 2009 Nov 30;9:414.

Selenium still helps preventing cancer

January 26, 2009

A huge U.S. study showed that supplementation of selenium do not prevent cancer of the prostate. But this result is only valid if you get plenty of selenium in advance.

12 years ago it aroused hope and optimism when American Larry Clark could tell that the mineral selenium prevents cancer, particularly prostate cancer, the second most common cause of death from cancer in men. He had to stop his trial before expiry when he learned that far fewer selenium-treated than placebo-treated patients (placebo: Inert tablets) got cancer.

Now a second, much larger, selenium trial has been stopped prematurely. Also in this case the focus of interest was the effect against prostate cancer. This was also an American study. But SELECT, as the trial was named, unfortunately showed that selenium had no effect. One could even not exclude an, admittedly very little, harmful effect. So, it was stopped.

In the meantime, Clark’s trial has been studied more closely. Was it really as convincing as was first believed? With 1.312 participants it was not nearly as large as SELECT where 35.000 attended. Very important was that the final report which came in 2003 showed that the benefit was smaller than first believed. Some cases of prostate cancer among selenium treated had for various reasons been overlooked.

What was left was a statistically significant benefit among those who at the beginning of the experiment had the least selenium in the blood and with most certainty did not have incipient cancer of the prostate. The latter could be concluded from the very low values of PSA (Prostate-Specific Antigen) in the blood of these people. In this group, while the trial was in progress, the incidence of cancer of the prostate was three times less than in the placebo group.

More selenium in the U.S.
Now the question is whether the much larger SELECT trial cancels Clark’s trial. It seems to be the general opinion as for example reflected in the leading article of the same issue of the American medical journal, JAMA, where SELECT was published. So far physicians should not recommend selenium as a prevention against prostate cancer, it says.

And yet one can rightly come to the diametrically opposite conclusion: There is every reason to believe that selenium prevents cancer of the prostate, and presumably also other kinds of cancer.

The fact is that Americans, but not all Americans, get far more selenium in their diet than we Scandinavians. In Clark’s study, participants were selected on the basis of consistently having relatively little selenium in their diet for U.S. standards. Two-thirds had less than 122 micrograms of selenium per. liter of serum. In the SELECT study only one in five had that low values. In other words, it is conceivable that most of the SELECT participants already got plenty of selenium so that additional supplementation would not benefit them. In Denmark almost everybody get less selenium than the participants of both the first and the second study mentioned. Our values are typically 80 micrograms per liter.

This is in excellent compliance with the fact that incredible few participants died from prostate cancer during the SELECT study. Statistically one would have expected 75 to 100 deaths for this reason, during the 5.6 years duration of the study. But only one died (!).

A contributory cause may have been that the vast majority of participants in the SELECT study on their own underwent PSA measurement annually. Possible prostate cancer was therefore detected and treated early. On the other hand, other studies have shown that annual PSA measurement does not reduce mortality. Therefore it is not recommended in Denmark.

Despite the termination of the SELECT study, as a Dane you should still remember that the research that involves us – as opposed to Americans we get very little selenium in our diet – suggests that supplementation with selenium in the order of 1-2 tablets (100-200 micrograms) per day seems to reduce the risk of prostate cancer to a third.

By: Niels Hertz, M.D.

1. Lippman SM et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers. JAMA online December 9, 2008: E1-E13
2. Gann PH. Randomized trials of antioxidant supplementation for cancer prevention. JAMA online December 9, 2008: E1-E2.
3. Selenium supplementation, baseline plasma selenium status and incidence of prostate cancer: An analysis of the complete treatment of the Nutritional Prevention of Cancer Trial. BJU Int. 2003;91:608-12.

Selenium, A Potent Substance Against Cancer

January 18, 2006

Studies from all angles support the idea that selenium works against cancer. Even though there is need for more research, an optimal dose can be suggested.

Selenium prevents cancer. This is common knowledge which is only awaiting conclusive confirmation. It received recognition when, in 1996, an American researcher (Clark) showed in a randomised study that the frequency of cancer fell by 38%, and that the fatality rate of those with cancer fell by 50%, in participants who received daily supplement of 200 micrograms selenium.

The supposition that selenium is preventative for cancer is in fact much more extensively backed. This has been shown by a leading selenium expert, Margret Rayman from the University of Surrey in England, in a thorough, but also complicated, summary. She has also illuminated who selenium prevents cancer and, even more importantly, how much is needed.

Rayman reviews the many geographical studies that have, since the 1960’s, consistently shown that the populations who received the least amount of selenium also had the highest cancer rates. Animal studies are also discussed. If one gives selenium to a male dog, not only is there less damage to the DNA of prostate cells, but the damaged cells that remain also die normally instead of living on as cancer cells.

A certain pattern emerges when one looks at studies where the blood concentration of selenium is compared to the cancer rate in groups of people. In a French study of this type from 2005, the death rate from cancer after nine years was four times greater in the 25% of the study-group who received the least selenium than in those who received the most selenium. Typically the French receive as little selenium in their diets as the British. Many studies from many countries have shown similar results for lung cancer (a 26% lower risk of cancer was reported in those with diets rich in selenium), oesophagus cancer, stomach cancer, and not in the least, prostate cancer as well as possibly cancer of the large intestine.

How much is enough
The best evidence can always be found in randomised studies where neither the patients nor the doctors know who receives what. A Chinese study of this type has shown that selenium has an especially effective against liver cancer. As mentioned before, Clark’s study had similar results. It is intriguing that, even though Americans receive an average of 200 micrograms more selenium daily than us, an additional 200 micrograms was beneficial to most. The effects were nevertheless minimal in those who received the most selenium beforehand. These individuals already received close to the optimal dose. But third of the population who received the least beforehand, had their cancer risk halved, and their prostate cancer risk decreased by 86%, after taking supplementary selenium.

Typical Europeans receive too little selenium while Americans receive double as much and Japanese receive almost three times as much. It has become apparent that 70 micrograms of selenium is needed in the daily diet to maintain levels of the selenium based antioxidant GSHpx in the body. The Japanese and most Americans receive this amount in their diets while we do not. But why is their cancer risk reduced when they receive supplementary selenium? The reason cannot be GSHpx and may not even be the anti-oxidizing effects alone.

Rayman examines many possible explanations. One is that high doses of selenium lead to the formation of the simple selenium compound methylselenol; which can kill cancer cells, counteract the formation of blood vessels (which the cancer cells need to survive) and can inhibit cancer in other ways. But selenium is naturally an antioxidant, an immune system stimulant, an activator for cancer inhibiting genes, an inhibitor for growth factors, etc. There is not one, but many, mechanisms of action.

Unchecked amounts of selenium should not be taken. Studies indicate that sufficiently high doses of selenium can increase the risk of cancer as much as insufficient amounts. Clark’s study, as well as others, suggests that a daily supplement of 200 micrograms is optimal.

The reward can be large, but more research is needed. Currently a large clinical trail (called SELECT) is being undertaken in the U.S.A., but a study in the more selenium poor Europe would be better. Rayman believes that such a study should be undertaken. But who wants the placebo!?

By: Vitality Council

1. Rayman M P. Selenium in cancer prevention: A review of the evidence and mechanism of action. Proceedings of the nutrition society. 2005;64:527-42.
2. Clark LC et al. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional Prevention of Cancer study group. JAMA 1996;276:1957-63.
3. Akbaraly NT et al. Selenium and mortality in the elderly: Results from the EVA study. Clin Chem. 2005;51:2117-23.

Selenium May Prevent Degenerative Joint Disease

November 24, 2005

For the first time ever, researchers have studied the correlation between selenium deficiency and osteoarthritis, which correlation is surprisingly strong and indicates that selenium supplementation may prevent the Western World’s most common cause of mobility-impairment.

There is a general agreement that selenium is a mineral which western Europeans get less and less of through their diets. Modern agricultural methods and the acidification of the soil has have caused a lowered amount of this vital antioxidant I crops, and thereby a lowered amount of selenium in our bodies. The deficiency is severe enough that, as early as the 1980’s, it widespread problems in Danish pigs so severe that, after some political tug-of-war, supplements were added to their feed. But does this deficiency mean anything for people?

So far the only answer is “probably.” Large population studies in Finland etc. have shown that members of the group which gets the least selenium via diet have the greatest risk of getting cancer.

Just as importantly, in an American randomised study with 1,300 participants undertake nine years ago, it was found that supplements of selenium halved the frequency of new cancer cases. The less selenium presents in the blood beforehand, the greater the positive effect with the supplement. The result was so certain that the study was stopped early for ethical reasons and is being repeated on a larger scale. If selenium prevents cancer so effectively, we should be absolutely certain of its effects.

Meanwhile, researchers from North Carolina’s university in cooperation with the American Center for Disease Control (CDC) discovered another relationship: Selenium deficiency causes an increased risk of arthritis of the knees. The risk of arthritis of the knees increases by 15-20% every time that the body’s selenium content is reduced by 10 micrograms (per kilo body weight). For comparison, the blood of the average Dane contains about 80 microgram/litre while the blood of the average American contains 110.

Among the nearly 900 people who were followed for 15 years, the risk was 40% lower in the third who received the most selenium. If they developed arthritis anyway, there was a tendency that it was to a lesser degree.

This is just a statistical relationship. It has not yet been published in the press, but has been presented in a congress (15.11.05) in San Diego for American arthritis doctors and can be read in an official press release from North Carolina’s university.

Nevertheless, the study’s leader, professor Joanne Jordan, has declared that the group is very excited about their findings. It could indicate that there is a possibility of preventing arthritis in the knee and possibly in other joints. In other words, it might be possible to prevent the most common reason for activity reduction in the western world. In China it is known that extreme selenium deficiency can cause severe cartilage injury in joints as early as during childhood. Does this point in the same direction?

Maybe, but it is not known for certain. According to Joanne Jordan, the next step in to study selenium’s effect on cartilage in the laboratory. The obvious hypothesis is that this effect is due to selenium’s function as an antioxidant. Clinical studies, in other words randomised studies, should be undertaken to find out whether selenium supplements effect pain and the level of function in people with arthritis.

The new finds are not final, but it is the first time that anyone has studied the correlation between arthritis and selenium. It is very surprising that the relationship is so apparent.

By: Vitality Council

1. Rayman M. The importance of selenium to human health. The Lancet 2000:;356:233-41.
2. News Release. Study links low selenium levels with higher risk of osteoarthritis. The University of North Carolina at Chapel Hill:
3. Clark LC. et al. Effect of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. JAMA 1996;276:1957-63.

Perhaps selenium can prevent hereditary breast cancer

May 30, 2005

Women with a genetic tendency towards breast cancer have unstable chromosomes. Studies now show that these chromosomes can be stabilized by taking selenium supplements.
About every twenty cases of breast cancer are due to inheritance. Most often, the cause is an innate mutation in the so-called BRCA1 gene, which, under normal circumstances, repairs damage to chromosomes.

If you carry this mutation, you already have a high risk of breast cancer: Approximately 60% will get the disease before they reach 50, and approximately 85% will get it before they reach 70. At the same time, the risk of ovarian cancer is no less than 60%.

By: Vitality Council

Kowalska E. et al. Increased rates of chromosome breakage in BRCA1 carriers are normalised by oral selenium supplementation. Cancer Epidem Biomarkers Prev 2005;14(5):1302-6.

Depressed Due to Vitamin Deficiency?

April 11, 2005

Several reports show a connection between depression and Vitamin E deficiency. There is a similar relation between depression and lack of Vitamin C and selenium. So far this gives food for thought.

Could it be that lack of vitamin E plays a role in depression? Something in that direction according to a preliminary Australian survey.

By: Vitality Council

1. Owen AJ et al. Low plasma vitamin E levels in major depression: Diet or disease? Eur J Clin Nutr 2005;59:304-6.
2. Tiemeier H et al. Vitamin E and depressive symptoms are not related. The Rotterdam Study. J Affect Disord 2002;72:79-83.
3. Maes M et al. Lower seriúm vitamin E concentration in major depression. Another marker of lowered antioxidant defense in that disease. J Affect Disord 2000;58:241-6.
4. Benton D et al. The impact of selenium supplementation on mood. Biol Psychiatry 1991;29:1092-8.