Preserving renal transplant function

[stauffenberg]

Most renal grafts are not lost by rejection, but by a gradual and poorly understood process of deterioration without the inflammation characteristic of rejection, which is known as 'chronic allograft nephropathy.'  A study published in a medical journal investigated two groups of renal transplant patients, one with well-preserved renal function, the other without, for some time to determine what physical parameters could be identified to distinguish them.  Almost every measured factor was found to be the same, but the one significant difference noted was that the group which had well-preserved renal graft function had normal selenium levels, while the group with poor and declining renal function all had low selenium levels.  Since selenium is a mineral with strong anti-oxidant properties, the authors of the study hypothesize that reducing oxidation of the transplanted tissue may be decisive in prolonging its survival.

Selenium can be obtained without a prescription at any store selling vitamins. 

[okarol]

I would like to read that study. Got a link?

I found this:

National Institutes of Health

Selenium

Function

Selenium has a variety of functions. It helps make special proteins, called antioxidant enzymes, which play a role in preventing cell damage. Some medical information suggests that selenium may help prevent certain cancers, but better studies are needed.

There have also been mixed results regarding selenium's impact on cardiovascular disease.

Selenium seems to stimulate antibodies after you receive a vaccination. It also may help protect the body from the poisonous effects of heavy metals and other harmful substances.

Selenium may boost fertility, especially among men. The mineral has been shown to improve the production of sperm and sperm movement.


Food Sources   

Plant foods, such as vegetables, are the most common dietary sources of selenium. How much selenium is the vegetables you eat depends on how much of the mineral was in the soil where the plants grew.

Fish, shellfish, red meat, grains, eggs, chicken, liver, and garlic are all good sources of selenium. Meats produced from animals that ate grains or plants found in selenium-rich soil have higher levels of selenium.

Brewer's yeast, wheat germ, and enriched breads are also good sources of selenium.

http://www.nlm.nih.gov/medlineplus/ency/article/002414.htm

[Wattle]

I also found this article.

Accidental death from acute selenium poisoning

We report a fatal case of acute selenium poisoning in a 75-year-old man. After reading on the Internet about a possible role of selenium in prostate cancer, the patient ingested 10 g of sodium selenite. Despite intensive care treatment, he suffered a cardiac arrest and died 6 hours after ingestion. This case illustrates the risks of failing to critically evaluate Internet information and exposes the myth that natural therapies are inherently safe.

http://www.mja.com.au/public/issues/185_07_021006/see10169_fm.html

[stauffenberg]

Laboratories conduct what are called 'Lethal Dose 50' tests for just about every substance in everyday use.  This test result shows the amount of substance a healthy rat has to consume all at once to kill 50% of the rats in the study group.  There is a Lethal Dose 50 number for everything, even apparently harmless substances, such as water or milk, because too much of anything taken all at once can kill any living thing.  In the case of lethal selenium toxicity you refer to, the person consumed, all at once, 200 times the normal daily recommended dose of selenium, which is such a huge concentration that he probably could have killed himself if he consumed 200 times the normal daily dose of catsup, mustard, salt, or apple pie!  It does not point to any special risk for selenium, given how far out of line it is with normal recommended selenium supplementation, which is 50 mcg per day.

Since I read the article about selenium and preserving renal graft function in a journal and not online I don't have a link for it, but the reference is: G. J. Morris-Stiff, et al, "Is Selenium Deficiency an Important Risk Factor for Chronic Graft Nephropathy?" Transplantation, vol. 76, no. 7 (October, 2003) pp. 1100-1104.

[okarol]

I found this:
Is selenium deficiency an important risk factor for chronic graft nephropathy? A pilot study.
http://www.medscape.com/medline/abstract/14557760?prt=true
Cannot locate any follow up study.
I did read about Selenium overdose but it's rare.

[Wattle]

the person consumed, all at once, 200 times the normal daily recommended dose of selenium,

I realize this. I was just pointing out the dangers of "self medicating". Often people think that "more is better". It is always wise to check with your Neph or Transplant team BEFORE taking any over the counter medication.

[George Jung]

the person consumed, all at once, 200 times the normal daily recommended dose of selenium,

I realize this. I was just pointing out the dangers of "self medicating". Often people think that "more is better". It is always wise to check with your Neph or Transplant team BEFORE taking any over the counter medication.

Well the post was a little misleading, at least it was for me when I first read it.  It had no mention of self medicating and the dangers, which I hope we are all smart enough to be aware of.   

[Wattle]

the person consumed, all at once, 200 times the normal daily recommended dose of selenium,

I realize this. I was just pointing out the dangers of "self medicating". Often people think that "more is better". It is always wise to check with your Neph or Transplant team BEFORE taking any over the counter medication.

Well the post was a little misleading, at least it was for me when I first read it.  It had no mention of self medicating and the dangers, which I hope we are all smart enough to be aware of.   

George, you had to read the article linked. You maybe aware of the dangers of self medicating, but others may think over the counter medication is harmless. As a dialysis patient you would be aware that we often can have compromised cardiac health. The article deals with prostate cancer and not dialysis or renal transplantation. I was not disputing the use in prolonging renal graft survival.

After a single test showing a raised level of prostate-specific antigen, a 75-year-old man became concerned about prostate cancer. Without confirmation of the diagnosis, he researched prostate cancer on the Internet and discovered that selenium may have a role in its prevention and treatment. He purchased sodium selenite powder and tablets from two separate pharmacies for supplementation.

[okarol]

I was just pointing out the dangers of "self medicating". Often people think that "more is better". It is always wise to check with your Neph or Transplant team BEFORE taking any over the counter medication.

I know this is true - people think of vitamins and supplements as harmless and don't realize the danger. Good advice - check with doc first.

[Black]

That is a conincidence, as my PA just told me to check out selenium on-line and see what I think about taking it to help my under active thyroid.

Thanks, Stauffenberg.  Your posts are always interesting.

[Black]

Selenium Critical to General Health and Thyroid Function
by Mary J. Shomon

Researchers writing in the July 15, 2000 issue of the British-based international medical journal, The Lancet, called attention to the importance of selenium to health, citing the trace mineral's potential to reduce the risk of thyroid problems, pregnancy and fertility problems, heart disease, and progression of HIV to AIDS, among other important findings.

According to the review study, diet and geographic location can impact the amount of selenium you are getting. Selenium is an essential trace mineral found in the soil. Typically, crops will convert selenium into organic forms that can be absorbed nutritionally by humans. Getting sufficient quantities of selenium may increase thyroid hormone metabolism, improve fertility, help fight cancer, and reduce risk of cardiovascular disease and arthritis.

The author of the study, ("The importance of selenium to human health," The Lancet, Volume 356, Number 9225, 15 July 2000), Margaret Rayman, a professor of nutritional medicine at the University of Surrey in Guildford, England, began focusing on selenium several years ago, after her research into the condition known as preeclampsia showed that low selenium levels were a common denominator in all the women in the study. Her research went on to discover that in the UK, and in Europe as well, selenium levels were abnormally low overall. Rayman found that dietary consumption of selenium had dropped 50% in the past two decades, a time period during which the UK had reduced it imports of selenium rich North American wheat in favor of selenium poor European wheat.

In addition to the relationship to early miscarriage, male infertility, mood problems, thyroid disorders, cardiovascular disease and arthritis, Rayman also discovered that selenium plays a key role in viral infections. In particular, higher selenium levels can help slow down the replication of the HIV virus. Her study actually found that "AIDS patients with low levels of selenium were 20 times more likely to die from an AIDS-related illness than those with healthy levels of the mineral."

In addition to selenium supplements, selenium-rich foods such as kidney, liver, crab, other shellfish, and Brazil nuts can be eaten. North American soil is also selenium rich, and crops grown in this soil have higher levels of selenium. Researchers believe that most North Americans are probably getting enough selenium, and caution that too much selenium can be toxic. The maximum level of selenium recommended per day for adults is 400 micrograms per day. However, some studies have shown that certain areas of the U.S., including, for example, the Eastern Coastal plain of the U.S., have selenium-deficient soil as well, so dietary exposure to selenium may be inconsistent. [emphasis added]

Regarding the thyroid, selenium is a component of the enzyme that helps convert T4 to T3 peripherally, so deficiencies of selenium may impair thyroid function and promote hypothyroidism. According to the New England Journal, "selenium deficiency can result in thyroid injury and decreased extrathyroidal triiodothyronine production" (reduced peripheral T3 production.) Some experts believe that low T3 levels may be characteristic in areas with insufficient selenium. Studies also show that excess intake of selenium may also depress T3 levels. With some scientists suspecting that there may be a viral component or trigger to certain autoimmune conditions such as the common thyroid condition known as Hashimoto's Disease, the anti-viral properties of selenium also become more interesting, and further research into that connection as relates to thyroid disease particularly would be illuminating.

Implications for Patients: The key issue for thyroid patients is making sure you get enough, but not too much, selenium. Talking to a good nutritionist or holistic physician can help you determine if selenium might help your health and thyroid function.

http://thyroid.about.com/library/weekly/aa072000a.htm

[stauffenberg]

There are two opposite considerations to take into account when assessing the option of self-medication if you are on dialysis or have a transplant.  I have seen patients on dialysis decide to take a multivitamin and mineral supplement which contains a huge amount of potassium, but because there are so many incredients in the tablets, they don't notice -- with disastrous consequences for their blood chemistry and life if no one intervenes.  Then there are all the horror stories about renal transplant recipients who took St. John's Wort to sleep better, before anyone knew that it interfered with the absorbtion of cyclosporine, so many of these people lost their transplants.  So there are certainly risks.

But on the other hand, it does little good to consult most doctors about supplements.  First, they get next to no training at all about supplments in medical school, which is highly ideologically committed to artificial chemical medication.  They naturally don't want you treating yourself with supplements, since these require no prescription, so you can become independent of them and thus deny their power over you, as well as their ability to profit from your disease.  Also, the pharmaceutical companies hate supplements, because any drug they can patent they can charge $40 per pill for and no one can stop them, since a patent gives a temporary monopoly control over the product.  But since all supplements have long since been in the public domain, no patents can be granted for any of them, so in the competition among sellers, no one can charge much more than it costs to manufacture each pill, thus making a comparatively tiny profit.  Since the drug companies bombard the doctors with anti-supplement propaganda all the time, since they control much of the medical research funding, and since they have powerful influence over medical journals and drug approval agencies, the propaganda against supplements is huge in the medical community.

So where does the patient turn?  With uninformed self-medication there are risks, but in consulting your doctor you are extremely unlikely to get unbiased advice.  The only alternative is to become your own doctor, to do a lot of research, and find out what is safe to take on your own.  You might want to ask your doctor, but don't rely on his or her opinion as the final answer without doing your own research.