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 [15]. There is evidence that selenium deficiency may contribute to development of a form of heart disease, hypothyroidism, and a weakened immune system [16,17]. 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 [18].
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 [18]. 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 [12]. Researchers believe that selenium deficient people infected with a specific virus are most likely to develop Keshan disease [18,19].
Selenium deficiency has also been seen in people who rely on total parenteral nutrition (TPN) as their sole source of nutrition [20,21]. 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 [22]. 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 [23]. 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.
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