Human selenium deficiency is rare in the U.S. but is seen in other countries, most notably China, where soil concentration of selenium is low.¹ There is evidence that selenium deficiency may contribute to development of a form of heart disease, hypothyroidism, and a weakened immune system.²³ There is also evidence that selenium deficiency does not usually cause illness by itself. Rather, it can make the body more susceptible to illnesses caused by other nutritional, biochemical or infectious stresses.⁴

Three specific diseases have been associated with selenium deficiency:

• Keshan Disease, which results in an enlarged heart and poor heart function, occurs in selenium deficient children.
• Kashin-Beck Disease, which results in osteoarthropathy
• Myxedematous Endemic Cretinism, which results in mental retardation

Keshan disease was first described in the early 1930s in China, and is still seen in large areas of the Chinese countryside with selenium poor soil.⁵ Dietary intake in these areas is less than 19 micrograms per day for men and less than 13 micrograms per day for women, significantly lower than the current RDA for selenium.⁶ Researchers believe that selenium deficient people infected with a specific virus are most likely to develop Keshan disease.^7 8

Selenium deficiency has also been seen in people who rely on total parenteral nutrition (TPN) as their sole source of nutrition.^9 10 TPN is a method of feeding nutrients through an intravenous (IV) line to people whose digestive systems do not function. Forms of nutrients that do not require digestion are dissolved in liquid and infused through the IV line. It is important for TPN solutions to provide selenium in order to prevent a deficiency.¹¹ Physicians can monitor the selenium status of individuals receiving TPN to make sure they are receiving adequate amounts.

Severe gastrointestinal disorders may decrease the absorption of selenium, resulting in selenium depletion or deficiency.¹² Gastrointestinal problems that impair selenium absorption usually affect absorption of other nutrients as well, and require routine monitoring of nutritional status so that appropriate medical and nutritional treatment can be provided.

Related Links: What is selenium? | What foods provide selenium? | How much selenium do I need? | What happens if I do not get enough selenium? | Do I need extra selenium? | Can selenium be harmful? | What are some of the current issues and controversies about selenium? |

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Footnotes

1. Ellis DR and Salt DE. Plants, selenium and human health. Curr Opin Plant Biol 2003;6:273-9. [↩]
2. Combs GF. Food system-based approaches to improving micronutrient nutrition: the case for selenium. Biofactors 2000;12:39-43. [↩]
3. Zimmerman MB and Kohrle J. The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid 2002;12:867-78. [↩]
4. Beck MA, Levander O, Handy J. Selenium deficiency and viral infection. J of Nutr 2003;133:1463S-67S. [↩]
5. Beck MA, Levander O, Handy J. Selenium deficiency and viral infection. J of Nutr 2003;133:1463S-67S. [↩]
6. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: Vitamin C, Vitamin E, Selenium, and Carotenoids. National Academy Press, Washington, DC, 2000. [↩]
7. Beck MA, Levander O, Handy J. Selenium deficiency and viral infection. J of Nutr 2003;133:1463S-67S. [↩]
8. Levander OA and Beck MA. Interacting nutritional and infectious etiologies of Keshan disease. Insights from coxsackie virus B-induced myocarditis in mice deficient in selenium or vitamin E. Biol Trace Elem Res 1997;56:5-21. PubMed abstract [↩]
9. Levander OA. Scientific rationale for the 1989 recommended dietary allowance for selenium. J Am Diet Assoc 1991;91:1572-6. PubMed abstract [↩]
10. Gramm HJ, Kopf A, Bratter P. The necessity of selenium substitution in total parenteral nutrition and artificial alimentation. J Trace Elem Med Biol 1995;9:1-12. PubMed abstract [↩]
11. Abrams CK, Siram SM, Galsim C, Johnson-Hamilton H, Munford FL, Mezghebe H. Selenium deficiency in long-term total parenteral nutrition. Nutr Clin Pract 1992;7:175-8. PubMed abstract [↩]
12. Rannem T, Ladefoged K, Hylander E, Hegnhoj J, Staun M. Selenium depletion in patients with gastrointestinal diseases: Are there any predictive factors? Scand J Gastroenterol 1998;33:1057-61. PubMed abstract [↩]