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Liliana Ribeiro Santos Internal Medicine Department, Hospital of Santa Maria, Lisbon, Portugal
Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal

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Inês Vasconcelos Bessa Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal

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Adriana Gaspar da Rocha Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal
Public Health Unit, ACES Baixo Mondego, Coimbra, Portugal

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Celestino Neves Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
Department of Endocrinology, Hospital University Centre of São João, Porto, Portugal

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Cláudia Freitas Department of Endocrinology, Hospital University Centre of Porto, Porto, Portugal

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Paula Soares Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal
Department of Pathology, Faculty of Medicine of the University of Porto, Porto, Portugal

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). Moreover, these disorders have great impact on the quality of life (QoL) of patients, with symptoms including mood disorders, changes in bowel habits, weight and sleep variations, and orbital involvement ( 5 ). The relevance of selenium (Se) in thyroid

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Camilla Bøgelund Larsen Department of Endocrinology, Odense University Hospital, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark

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Kristian Hillert Winther Department of Clinical Research, University of Southern Denmark, Odense, Denmark

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Per Karkov Cramon Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

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Åse Krogh Rasmussen Department of Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark

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Ulla Feldt-Rasmussen Department of Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
Institute of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen University, Copenhagen, Denmark

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Nils Jakob Knudsen Department of Endocrinology, Bispebjerg University Hospital, Copenhagen, Denmark

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Jakob Bue Bjorner Department of Public Health, Copenhagen University, Copenhagen, Denmark
QualityMetric Inc, Johnston, Lincoln, Rhode Island, USA

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Lutz Schomburg Institute for Experimental Endocrinology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Kamil Demircan Institute for Experimental Endocrinology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Thilo Samson Chillon Institute for Experimental Endocrinology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Jeppe Gram Medical Department, Endocrinology, University Hospital of South-West Jutland, Esbjerg, Denmark

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Stinus Gadegaard Hansen Medical Department, Endocrinology, University Hospital of South-West Jutland, Esbjerg, Denmark

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Frans Brandt Department of Clinical Research, University of Southern Denmark, Odense, Denmark
Internal Medicine Research Unit, University Hospital of Southern Jutland, Aabenraa, Denmark

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Birte Nygaard Department of Endocrinology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark

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Torquil Watt Department of Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
Institute of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen University, Copenhagen, Denmark

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Laszlo Hegedüs Department of Endocrinology, Odense University Hospital, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark

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Steen Joop Bonnema Department of Endocrinology, Odense University Hospital, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark

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fact that the aetiology of AIT is multifactorial, with complex interactions between genetic and environmental factors, as well as personality traits ( 9 ), further emphasises the need to search for ways of improving treatment ( 10 ). Selenium is a

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Kristian Hillert Winther Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Enrico Papini Department of Endocrinology and Metabolism, Ospedale Regina Apostolorum, Rome, Italy

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Roberto Attanasio Endocrine Unit, IRCCS Galeazzi Institute, Milan, Italy

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Roberto Negro Division of Endocrinology, V. Fazzi Hospital, Lecce, Italy

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Laszlo Hegedüs Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Introduction Since 1991, when selenium was identified in type 1 deiodinase that catalyzes the conversion of thyroxine (T4) to triiodothyronine (T3) [ 1 ], the relevance of this trace element for thyroid health and disease has been extensively

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Chae Won Chung Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea

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Kyungsik Kim Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

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Sue K Park Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea

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Dal Lae Ju Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, Korea

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Young Joo Park Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea
Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea

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Choong Ho Shin Department of Pediatrics, Seoul National University Children’s Hospital and Seoul National University College of Medicine, Seoul, Korea

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Jong Kwan Jun Department of Obstetrics and Gynecology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea

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June-Key Chung Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea

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Yoon Ju Song Department of Food Science and Nutrition, The Catholic University of Korea, Bucheon, Korea

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Young Ah Lee Department of Pediatrics, Seoul National University Children’s Hospital and Seoul National University College of Medicine, Seoul, Korea

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Gi Jeong Cheon Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea

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Sun Wook Cho Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea

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Introduction Selenium is an essential micronutrient that exerts its biological actions through the formation of selenoproteins, such as glutathione peroxidase (GPx), thioredoxin reductases (TXNRD), and iodothyronine deiodinases (DIOs). These

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Esther J. van Zuuren Departments of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands

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Amira Y. Albusta College of Medicine, AMA International University of Bahrain, Manama

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Zbys Fedorowicz UKCC (Bahrain Branch), The Cochrane Collaboration, Awali, Bahrain

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Ben Carter Institute of Primary Care & Public Health, Cardiff University School of Medicine, Cardiff, UK

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Hanno Pijl Departments of Endocrinology, Leiden University Medical Centre, Leiden, The Netherlands

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prevalence is influenced by ethnicity, environmental factors, such as iodine and selenium status, age and gender [ 1 , 2 ]. Clinical manifestations of the disease are caused primarily by low levels of thyroid hormones, for which the treatment is hormone

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Nora Dehina Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin
Department of Ophthalmology, University Hospital Essen, Essen, Germany

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Peter Josef Hofmann Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin

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Thomas Behrends Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin

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Anja Eckstein Department of Ophthalmology, University Hospital Essen, Essen, Germany

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Lutz Schomburg Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin

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]. The trace element selenium (Se) is of central importance for the immune system as it affects antioxidative protection and thyroid hormone metabolism [ 10 , 11 ]. Accordingly, a Se supplementation trial in mild GO has been conducted [ 12 ]. GO

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Roberto Negro Division of Endocrinology, ‘V. Fazzi' Hospital, Lecce

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Roberto Attanasio Endocrinology Service, Galeazzi Institute IRCCS, Milan

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Franco Grimaldi Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria ‘S. Maria della Misericordia', Udine

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Claudio Marcocci Department of Clinical and Experimental Medicine, University of Pisa, Pisa

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Rinaldo Guglielmi Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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Enrico Papini Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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Introduction An essential trace element, selenium (Se) is required for correct immune system function and plays a key role in thyroid physiology [ 1 ]. Se is incorporated into the molecular structures of some proteins. These so

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Jan Calissendorff Department of Clinical Science and Education, Section of Endocrinology, Karolinska Institutet, Södersjukhuset, Sweden

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Emil Mikulski Department of Medicine, Mälarsjukhuset, Eskilstuna, Sweden
Centre for Clinical Research in Sörmland, Uppsala University, Uppsala, Sweden

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Erik H. Larsen National Food Institute, Technical University of Denmark, Søborg, Denmark

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Marika Möller Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
Centre for Clinical Research in Sörmland, Uppsala University, Uppsala, Sweden

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symptoms either for shorter periods or sometimes for months [ 5 ]. In Western Europe, selenium (Se) blood levels are low [ 6 ]. This trace element is an essential component of selenoproteins with primarily anti-oxidative functions. Humans acquire Se in

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Roberto Negro Division of Endocrinology, ‘V. Fazzi' Hospital, Lecce

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Giacomo Greco Faculty of Medicine, San Raffaele Hospital, Milan, Italy

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oxidative stress is higher in overt hypothyroid patients than in euthyroid or subclinical hypothyroid patients, and the total antioxidant status is lower in overt hypothyroid subjects compared to the other groups [ 15 ]. Selenium (Se) has physiological

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Michele Marinò Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, University of Pisa, Pisa

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Claudio Marcocci Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, University of Pisa, Pisa

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Paolo Vitti Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, University of Pisa, Pisa

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Luca Chiovato Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Scientifici Maugeri IRCCS, University of Pavia, Pavia

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Luigi Bartalena Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy

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- Italian Chapter) on the use of selenium in thyroid disease. Both Negro et al. [ 1 ] and, especially, Hegedüs et al. [ 2 ], in the accompanying Editorial [ 1 , 2 ], underscored the abuse of selenium in thyroid disease. There is no question that the use

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