Caution urged with selenium

In 1996 a study looking at the effects of selenium supplements in prevention of skin cancer reported no effect on skin cancer but a decrease in the incidence of prostate cancer in the selenium group–parenthetically this same study showed less lymphoma in those who did not receive selenium. (Clark et al, JAMA 276:1957-1963, 1996)

For some reason, this very preliminary incidental finding was taken as gospel and since that time innumerable food and vitamin supplements purporting to support “prostate health”, whatever that is, have contained selenium.

In the June 15th Journal of Clinical Oncology comes an article and editorial with disturbing findings and a suggestion that perhaps less selenium supplementation would be better until more is know on all the potential effects.

“Selenium supplementation does not decrease risk except possibly in selenium-deficient populations. Supplementation possibly increases risk of prostate cancer, especially aggressive disease, in selenium-replete men or men with a particular genotype for antioxidant enzymes. These hypotheses and the questions posed above suggest the need for personalized risk prediction. At present, we do not know enough to determine how much selenium any man or woman should receive from the diet or a supplement.”

“This lack of knowledge supports the common public health recommendation of moderation with respect to supplements for men and women. Furthermore, we should encourage men and women to eat a wide array of foods, maintain normal weight, be physically active, not smoke, and drink in moderation if at all to prevent chronic diseases in general. Unlike the prospect of personalized chemo-prevention,”

Medicynical note: Sometimes less is better. It’s enough to make a medicynic smile!

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