Mara Ventura

Selenium and Thyroid Function

Selenium is an essential trace element embedded in several proteins. Most of the known selenoproteins are found in the thyroid gland and this is the organ with the highest amount of selenium per gram of tissue. Selenium levels in the body depend on the characteristics of the population and its diet, geographic area, and soil composition. In the thyroid, selenium is required for protection from oxidative damage and for the metabolism of thyroid hormones. The literature suggests that selenium intake is associated with autoimmune thyroid disorders and selenium supplementation in those patients is associated with a reduction in antithyroid antibody levels, improved thyroid ultrasound features, and improved quality of life. Selenium supplementation in Graves’ ophthalmopathy is associated with an improved quality of life, less eye involvement, and delayed orbitopathy progression. Supplementation with the organic form is more effective, and benefits in immunological mechanisms have been observed in patients with autoimmune thyroiditis.

The role of ablative treatment in differentiated thyroid cancer management

ABSTRACT Introduction: The role of ablative treatment in differentiated thyroid cancer management has been evolving over the years. After its introduction in clinical practice, the use of postsurgical radioiodine treatment was generalized to almost every patient with differentiated thyroid cancer, with the exception of unifocal microcarcinomas. However, in the last decade several studies questioned its benefit in low- and intermediate-risk patients. Areas covered: In this review we discuss the role of postsurgical radioiodine treatment at the present time. Expert commentary: Although there is general consensus about the recommendation for very low-risk (microcarcinomas) and high-risk patients – no indication for routine postoperative radioiodine and clear indication for radioiodine treatment, respectively, the recommendation for low- and intermediate-risk patients is still under debate. The most recent guidelines from the American Thyroid Association make a statement against routine postoperative radioiodine in both low- and intermediate-risk cases, recommending an individualized approach that takes into consideration the risk of disease persistence or recurrence after surgery. We consider that these recommendations are in accordance with the best evidence available today, and we would like to emphasize that radioiodine is generally favored for most intermediate-risk patients, especially in the presence of extensive lymph node disease or older age.