Se

Selenium/Drug Interactions:

  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: In human research, selenium supplementation increased platelet GSH-peroxidase activity; however, no effects were observed on platelet aggregation (473).
  • Antidiabetic agentsAntidiabetic agents: Based on human research, selenium supplementation may increase risk for type 2 diabetes (424; 469). However, the research is not consistent, as other research has found high plasma selenium concentrations to be associated with late occurrence of dysglycemia (470).
  • Anti-inflammatory agentsAnti-inflammatory agents: Both in vitro and animal experiments have shown that selenium may modulate the inflammatory response in a variety of diseases (474).
  • Antilipemic agentsAntilipemic agents: Taking selenium in combination with beta-carotene and vitamins C and E appears to decrease the effectiveness of the combination of simvastatin (Zocor?) and niacin (43), although long-term effects are not known. Theoretically, selenium could reduce the effectiveness of other HMG-CoA reductase inhibitors such as atorvastatin (Lipitor?), fluvastatin (Lescol?), lovastatin (Mevacor?), and pravastatin (Pravachol?). Based on human research, high serum selenium concentrations may be associated with increased total and LDL cholesterol (411).
  • Antineoplastic agentsAntineoplastic agents: In human research, selenium in conjunction with CPT-11, SN-38, or SN-38G has produced gastrointestinal toxicity (33).
  • BarbituratesBarbiturates: In animal research, selenium was found to inhibit hepatic metabolism of barbiturates and prolong the sedative effect (475; 476).
  • CisplatinCisplatin: In human research, cisplatin has been reported to reduce serum selenium concentrations in patients being treated for testicular cancer (477).
  • ClozapineClozapine: It has been suggested that cardiac side effects associated with clozapine use may be related to low selenium concentrations. It is not clear if assessment of selenium levels or selenium supplementation should be routine in patients taking this drug.
  • CorticosteroidsCorticosteroids: In human research, increased selenium levels were noted in patients using corticosteroids (478). In human research, selenium supplementation has been shown to reduce the need for corticosteroids in corticosteroid-dependent asthmatic patients (479). However, in other human research, high-dose corticosteroid therapy (specifically 20-60mg of prednisolone daily) lowered plasma selenium levels (419).
  • Erythropoietin (EPO)Erythropoietin (EPO): In human research, selenium increased the effects of EPO in patients on hemodialysis (408).
  • EstrogensEstrogens: Selenium levels may be decreased in patients taking oral contraceptives, as estrogens have been shown to upregulate selenium-dependent glutathione peroxidase (GPx) (420).
  • Gastric acid-reducing agents and antiulcer agentsGastric acid-reducing agents and antiulcer agents: Based on anecdotal information, agents that increase the pH of the stomach (e.g., proton pump inhibitors, H-2 blockers, and antacids) may decrease absorption of selenium.
  • Growth hormonesGrowth hormones: Based on animal studies, selenium may reduce serum levels of somatotropin (growth hormone) and insulin-like growth factor-1 (IGF-1), followed by growth retardation. However, in humans, wheat Se and selenomethionine supplementation had no effect on somatotropin and IGF-1 (465).
  • ImmunosuppressantsImmunosuppressants: In in vitro, animal, and human research, selenium has been shown to stimulate the immune system via cellular and humoral immunity (412; 413; 414; 415; 416; 417; 418).
  • Iron saltsIron salts: Based on human research, serum selenium levels may be affected by iron supplementation (422).
  • Thyroid hormonesThyroid hormones: Selenium may affect thyroid function (480).
  • Valproic acidValproic acid: Decreased selenium levels have been reported in humans and animals after valproic acid administration (481).

    • Selenium/Herb/Supplement Interactions:

  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: In human research, selenium supplementation increased platelet GSH-peroxidase activity; however, no effects were observed on platelet aggregation (473).
  • Anti-inflammatory herbs and supplementsAnti-inflammatory herbs and supplements: Both in vitro and animal experiments have shown that selenium may modulate the inflammatory response in a variety of diseases (474).
  • AntilipemicsAntilipemics: Taking selenium in combination with beta-carotene and vitamins C and E appears to decrease the effectiveness of the combination of simvastatin (Zocor?) and niacin (43), although long-term effects are not known. Theoretically, selenium could reduce the effectiveness of other HMG-CoA reductase inhibitors such as atorvastatin (Lipitor?), fluvastatin (Lescol?), lovastatin (Mevacor?), and pravastatin (Pravachol?). Based on human research, high serum selenium concentrations may be associated with increased total and LDL cholesterol (411).
  • AntineoplasticsAntineoplastics: In human research, selenium in conjunction with CPT-11, SN-38, or SN-38G has produced gastrointestinal toxicity (33).
  • AntioxidantsAntioxidants: In human research, sodium selenite supplementation has been shown to increase glutathione peroxidase 1 (GPx-1) activity in endothelial cells and in coronary artery disease (CAD) patients (482; 483). Serum concentrations of selenium have been increased after antioxidant supplementation in humans when selenium was included in the supplement (28).
  • AstragalusAstragalus: Based on research, astragalus may cause selenium to accumulate (421). Theoretically, concurrent use of astragalus with selenium may increase the risk of selenium toxicity.
  • CalciumCalcium: In human research, calcium supplementation of 1,000mg daily did not have a negative impact on selenium parameters (484). Beard calcium concentration has been used as a marker for coronary heart disease and has been shown to be affected by supplementation with micronutrients, including selenium (485).
  • ChromiumChromium: In human research, combined zinc (Zn) and chromium (Cr) supplementation had no apparent effects on selenium plasma levels or Se glutathione peroxidase (GPx) in red blood cells (486).
  • Coenzyme Q10Coenzyme Q10: Supplementation with coenzyme Q10, vitamins, and selenium has been shown to raise blood concentrations of coenzyme Q10 (487).
  • Gastric acid-reducing and antiulcer herbs and supplementsGastric acid-reducing and antiulcer herbs and supplements: Based on anecdotal information, agents that increase the pH of the stomach (e.g., proton pump inhibitors, H-2 blockers, and antacids) may decrease absorption of selenium.
  • HypoglycemicsHypoglycemics: Based on human research, selenium supplementation may increase risk for type 2 diabetes (424; 469). However, the research is not consistent, as other research has found high plasma selenium concentrations to be associated with late occurrence of dysglycemia (470).
  • ImmunosuppressantsImmunosuppressants: In in vitro, animal, and human research, selenium has been shown to stimulate the immune system via cellular and humoral immunity (412; 413; 414; 415; 416; 417; 418).
  • IodineIodine: Consumption of an iodine brine concentrate resulted in increases in Se-independent and total glutathione peroxidase (GSH-PX) in plasma (488).
  • IronIron: Based on human research, serum selenium levels may be affected by iron supplementation (422).
  • Omega-3 fatty acidsOmega-3 fatty acids: In human research, n-3 polyunsaturated fatty acids (PUFA) modified the effect of Se supplementation (i.e., increased serum Se concentration), whereas Se seemed to lower the peroxidative effects of n-3 PUFA (489).
  • PhytoestrogensPhytoestrogens: Selenium levels may be decreased in patients taking oral contraceptives, as estrogens have been shown to upregulate selenium-dependent glutathione peroxidase (GPx) (420).
  • Vitamin CVitamin C: Based on anecdotal information, vitamin C may be necessary for maintaining selenium levels in the body. Ascorbic acid has been shown to not affect the availability of the supplemental sodium selenate (490).
  • ZincZinc: In human research, combined zinc (Zn) and chromium (Cr) supplementation had no apparent effects on selenium plasma levels or Se glutathione peroxidase (GPx) in red blood cells (486).

    • Selenium/Food Interactions:

  • Designer eggsDesigner eggs: Consumption of designer eggs enriched in vitamin E, lutein, Se, and DHA significantly increased the levels of alpha-tocopherol, lutein, and DHA in plasma; however, egg consumption did not change Se concentration in plasma (491).
  • Diets (e.g., ketogenic diet, vegetarian diet, diets high in refined foods)Diets (e.g., ketogenic diet, vegetarian diet, diets high in refined foods): Certain diets (e.g., ketogenic diet, vegetarian diet, and diets high in refined foods) can lead to selenium deficiency (492; 493; 494; 495; 496).
  • FishFish: Fish consumption has been shown to be positively correlated with plasma selenium and glutathione peroxidase (497).
  • GarlicGarlic: Supplementation with selenium in patients with diabetes has been shown to potentiate the anticarcinogenic potential of garlic (498).
  • Vegetarian dietVegetarian diet: Selenium status has been shown to be significantly lower in vegetarians when compared to nonvegetarians (499).

    • Selenium/Lab Interactions:

  • Albumin excretionAlbumin excretion: Supplementation with selenium in patients with diabetes has been shown to diminish urinary albumin excretion rates (500).
  • CadmiumCadmium: Supplementation with selenium in patients with diabetes has been shown to produce a marked decrease of RBC cadmium (Cd) (501).
  • CopperCopper: Supplementation with selenium in patients with diabetes has been shown to increase copper metabolism (502; 503).
  • Lipid profileLipid profile: In human research, higher selenium status (>1.20mcM/L) was associated with increased total and non-HDL cholesterol levels (504).
  • Serum glutathione levelsSerum glutathione levels: Supplementation with combinations of vitamins and minerals, including selenium, has been shown to increase serum and red blood cell glutathione levels in humans (505; 506). In human research, Se supplementation raised platelet selenoglutathione peroxidase (Se-GSHPx) and also Se and Se-GSHPx in whole blood and plasma (507); however, activities of glutathione-S-transferase, superoxide dismutase, and catalase were not changed after Se supplementation (507). In human research, thrombocyte glutathione peroxidase GPX was specifically increased by short-term selenate supplementation, but not by short-term supplementation with organic Se (508). Selenomethionine supplementation has been shown to produce transient and acute changes in lymphocyte, granulocyte, and platelet phospholipid-hydroperoxide glutathione peroxidase (GPx4) activity, possibly affecting the normal function of the cell (509).
  • Sperm motilitySperm motility: The effect of selenium supplementation on semen parameters is unclear. Based on human research, selenium supplementation may reduce sperm motility (466); however, follow-up research reported no effect on sperm motility or any other semen quality parameter (467). When combined with vitamin E (468) or N-acetyl cysteine (434), semen quality improved in infertile men.
  • Thiobarbituric acid reactive substancesThiobarbituric acid reactive substances: Supplementation with selenium in patients with diabetes has been shown to diminish serum concentrations of thiobarbituric acid reactive substances (500).