Influence of selenium supplements on the post-traumatic alterations of thethyroid axis: a placebo-controlled trial

Objective:To investigate whether early selenium (Se) supplementation can mo dify the post-traumatic alterations of thyroid hormone metabolism, since th e first week after trauma is characterised by low plasma Se and negative Se balances. Design: Prospective, placebo-controlled randomised supplementation trial. Setting: Surgical ICU in a tertiary university hospital. Patients: Thirty-one critically ill trauma patients aged 42 +/- 16 years (m ean +/- SD), with severe multiple injury (Injury Severity Score 30 +/- 7). Intervention: Supplementation during the first 5 days after injury with eit her Se or placebo. The selenium group was further randomised to receive dai ly 500 mug Se, with or without 150 mg alpha -tocopherol (AT) and 13 mg zinc supplements. The placebo group received the vehicle. Circulating Se, AT, z inc, and thyroid hormones were determined on D0 (= day 0, admission), D1, D 2, D5, D10, and D20. Results: Plasma Se, low on DO, normalised from D1 in the selenium group; to tal T4 and T3 increased more and faster after D2 (P = 0.04 and 0.08), rever se T3 rising less between D0 and D2 (P = 0.05). Conclusions: Selenium supplements increased the circulating Se levels. Supp lementation was associated with modest changes in thyroid hormones, with an earlier normalisation of T4 and reverse T3 plasma levels. The addition of AT and zinc did not produce any additional change.