Selenium, an essential trace element, functions in a variety of enzyme-dependent pathways, especially those utilizing selenoproteins. Much of its supplemental efficacy is due to its antioxidant properties. Glutathione peroxidase incorporates this mineral at its active site, and as dietary selenium intake decreases, glutathione levels drop (Ursini et al. 1999).

Patients supplement with selenium for a variety of reasons, most notably a supposed improvement in immune status. Elderly patients may be inclined to supplement with selenium for this reason.

Toxicity with selenium supplementation begins at intake greater than 750 |xg/day and may manifest as garlic-like breath, loss of hair and fingernails, gastrointestinal distress, or central nervous system changes (Patterson and Levander 1997, Fan and Kizer 1990). Few interactions with other pharmacological agents have been found (Hendler and Rorvik 2001).

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