The selenium (Se) content in 1 g of thyroid tissue is higher than in other organs [1]. For the normal functioning of the thyroid gland and maintaining thyroid homeostasis, not only iodine is needed, but also Se. In regions with severe iodine deficiency, selenium deficiency aggravates hypothyroidism and leads to myxedema and cretinism [2]. In autoimmune thyroiditis under conditions of selenium deficiency, an inverse relationship was observed between the level of selenium in the blood and the volume of the thyroid gland, as well as the severity of hypoechogenicity of the thyroid gland [3,4]. Thus, selenium status may play a role in the development of thyroid pathology.
Objective - to study thyroid function in patients with tuberculosis (TB) and attempts of its regulation.
Materials and methods. 60 patients with tuberculosis and subclinical hypothyroidism (SH) were monitoring during 2 first months of chemotherapy. 30 patients of observations, received sodium selenite during the first 2 months of chemotherapy, and 30 control patients - chemotherapy only. The levels of selenium (Se), free thyroxine (Tfree ), thyroid stimulating hormone (TSH), were determined in the serum of blood in all patients before and at 2 months therapy after its beginning. Biochemical parameters were compared between the groups of monitoring and control.
Results and discussion. In patients with TB and SH with low-normal level of Tfree (11.12 pmol/l) and increased TSH level (4.30 μIU/ml) a reduced average level of Se in the blood serum is observed (66 μg/l) with a normal level of 74-130 μg/l. The low-normal mean value of Tfree (11.12 pmol/l) and increased TSH levels (4.30 μIU/ml) in this group indicate the development of SH. At the end of the intensive therapy phase after 2 months of sodium selenite administration, the average Se level significantly increased to 95.39 μg/l in patients of this group. The level of Tfree in these patients significantly increases from 11.12 pmol/l to 13.32 pmol/l, and the average level of TSH significantly decreases to 2.12 μIU/ml in comparison with the control group, in which a decrease in the average level of Tfree is observed during chemotherapy and an increase in mean TSH levels compared to baseline levels. In TB patients by the end of the intensive therapy phase bacterial excretion stopped in 24% of patients, which is 6.66% more than in the comparison group. In the same group, the rate of cavity healing was 10% higher when compared with the control group.
Conclusions: Thyroid function restoration under the influence of Se in patients with TB and SH without prescribing thyroid hormones was demonstrated. Protective effect of this trace element during chemotherapy for thyroid gland also was proved. Selenium improves the outcomes of chemotherapy, increasing the stopping of bacterial excretion in average by 6.66% - 20% and the healing of destruction by 10%. So, sodium selenite cold be recommended as an accompanying medicine for the chemotherapy of TB patients with SH.
References
1. Rayman M.P. The importance of selenium to human health / M.P. Rayman // Lancet. - 2000. – V.356(9225). – P. 233-241.
2. Lone Banke R., Lutz S. Selenium status, thyroid volume, and multiple nodule formation in an area with mild iodine deficiency / R. Lone Banke, S. Lutz // Eur. J. Endocrinol. – 2011. – V.164(4). – P. 585-590.
3. Derumeaux H., Valeix P., Castetbon K., Bensimon M., Boutron-Ruault M.C., Arnaud J., Hercberg S. Association of selenium with thyroid volume and echostructure in 35- to 60-year-old French adults / H. Derumeaux, P. Valeix, K. Castetbon, M. Bensimon, M.C. Boutron-Ruault, J. Arnaud, S. Hercberg // Eur. J. Endocrinol. – 2003. – V. 148(3). – P. 309-315
4. Drutel A., Archambeaud F., Caron P. Selenium and the thyroid gland: more good news for clinicians. / A. Drutel , F. Archambeaud , Caron P. //Clin. Endocrinol.(Oxf). – 2013. – V.78(2). – P.155-164.
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