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Selenium, Hypothyroidism, and a Healthy Pregnancy

If you have a thyroid condition and are pregnant, what do you need to know about selenium?
Selenium, Hypothyroidism, and a Healthy Pregnancy
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Pregnancy is an exciting time filled with hopes and dreams. For many pregnant women, pregnancy is also a time when new worries appear. “Will my baby be healthy?” “What’s safe to eat?” “Am I taking the right vitamins to protect my baby?” There’s another concern, however, and while it may not be top of mind for many pregnant women, it should be: “Will a thyroid problem interfere with my pregnancy?”

Many pregnant women start taking prenatal vitamins and cut out foods, drinks, and medications forbidden in pregnancy. Is that enough? If you are one of the millions of women who have elevated Thyroid Peroxidase antibodies (TPOAb) – consistent with the autoimmune thyroiditis,  known as Hashimoto’s disease – what else should you be aware of to help ensure that your pregnancy goes well?

Regular readers of the Paloma blog already know that sufficient levels of iodine – and the right kind of folic acid – are both essential for a healthy pregnancy for all women, especially those with thyroid dysfunction or autoimmune thyroiditis.

Based on the information in Paloma’s Selenium Guide, you may already be aware of selenium’s ability to help reduce thyroid antibodies and inflammation in autoimmune thyroiditis. But we now know that selenium also plays a vital role during pregnancy! Ahead, a look at what pregnant women need to know about selenium and thyroid disease during pregnancy.

The importance of selenium

Selenium is a mineral that acts as an antioxidant, helps regulate the immune system, and protects the thyroid gland from oxidative stress by preventing damage to the thyroid gland. Selenium also promotes the normal conversion of T4 to T3.

The general recommendation is for adults to get 60 to 70 micrograms of selenium daily. Pregnant and breastfeeding women should get 70 to 80 micrograms a day. However, many people are not getting enough selenium, and it’s estimated that as many as 500 million to 1 billion people worldwide are selenium deficient.

How much selenium do you need?

Based on newer research, the standard selenium level usually recommended during pregnancy is not enough. A higher intake of 105 micrograms per day is now suggested during pregnancy.

Food is the main source of selenium, and the primary food sources of selenium are Brazil nuts, seafood, organ meats, grains, and eggs. Unless you’re a big fan of Brazil nuts, however – which can have more than 500 micrograms per ounce – you may not get enough selenium from food sources.

As a result, selenium supplements have become popular. The general public – and pregnant women in particular – need to be careful, however, as selenium has a narrow therapeutic range, and too much selenium can be toxic. Specifically, the upper reference limit for all adults – including pregnant and breastfeeding women – is 400 micrograms daily from combined food and supplements. Above that level, there is a risk of adverse outcomes. Selenium toxicity can develop, including symptoms such as garlic breath, a metallic taste in the mouth, nausea, diarrhea, skin rashes, irritability, brittle hair and nails, loss of hair or nails, discolored teeth, and nervous system problems.

Selenium, thyroid autoimmunity, and pregnancy

If you’re pregnant and have elevated TPO antibodies – whether or not you’ve been diagnosed with hypothyroidism – there’s evidence that getting 200 micrograms of selenium daily can have multiple benefits. Selenium can:

  • Decrease inflammatory thyroid activity.
  • Reduce your thyroid peroxidase autoantibodies.
  • Reduce your risk of developing postpartum thyroid dysfunction.

If you’re a TPOAb-positive woman but don’t have overt hypothyroidism, you may still benefit from selenium. Women with elevated thyroid peroxidase antibodies who add selenium supplements are more likely to have normal postpartum thyroid status and a significantly reduced risk of developing permanent hypothyroidism after childbirth.

In addition to affecting thyroid function directly, selenium deficiency can worsen even mild iodine deficiency. Iodine is a vital nutrient in pregnancy for both the mother and the developing baby, helping to ensure healthy fetal development. Untreated maternal hypothyroidism during pregnancy can be a threat to the health of the developing baby. A dietary iodine intake of selenium, therefore, may help prevent pregnant women from becoming more iodine deficient and further jeopardizing their thyroid health.

Myo-inositol and selenium: a powerhouse duo for thyroid support

In addition to selenium, there’s another supplement that you can add to the mix that can help support a healthy pregnancy. Myo-inositol is a member of the vitamin B-complex group. One major study found that combining myo-inositol and selenium can help maintain normal thyroid hormone levels and prevent subclinical hypothyroidism. Specifically, compared to a control group, 94% of women taking a supplement containing 600 mg of myo-inositol and 83 micrograms of selenium maintained normal thyroid levels during pregnancy, compared to 69% of women not taking these supplements.

The researchers who conducted this study felt so strongly that they encouraged obstetricians to prescribe myo-inositol and selenium to pregnant women with borderline TSH levels or subclinical hypothyroidism.

A note from Paloma

Maintaining healthy serum selenium levels during pregnancy is essential for your thyroid function. In addition to reducing your risk of postpartum thyroid dysfunction and permanent hypothyroidism, sufficient selenium intake during pregnancy has other benefits. Specifically, selenium supplements help reduce the risk of gestational diabetes, preeclampsia, preterm birth, and other complications and adverse pregnancy outcomes.

When considering trying a new supplement, it’s always important to connect with your healthcare provider to ensure it’s safe for you.

If you need to increase your selenium intake, and need guidance on how to meet that goal, consider scheduling a virtual consultation with one of Paloma’s expert thyroid nutritionists. They can help you develop a nutritional plan to ensure you’re getting enough selenium in your diet and supplements without risk of toxicity.

Maintaining optimal thyroid function also depends on regular testing. The Paloma Complete Thyroid Blood Test kit makes thyroid function tests easy, convenient, and affordable, letting you test the function of your thyroid gland right from home. The Paloma home thyroid test kit includes everything you need for sample collection and testing of thyroid stimulating hormone (TSH), free T3, free T4, and Thyroid Peroxidase (TPO) antibody levels, with the option to add on reverse T3 and/or vitamin D. Your thyroid test kit is sent directly to your address, and only requires an easy finger prick. You send back your sample to the lab with Paloma’s pre-paid shipping. Your thyroid lab results are then released to your secure online dashboard within days, similar to the wait time for in-person lab results—without the inconvenience.

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For careful diagnosis and management of thyroid disease, many hypothyroid patients find comprehensive thyroid care with Paloma’s top thyroid doctors. Paloma’s dedicated team of thyroid-savvy practitioners can work with you before and after pregnancy to safely optimize your thyroid function, find the best thyroid hormone replacement medication, and resolve your symptoms.

Finally, for information on selenium supplements and other vitamins that can be helpful for people with hypothyroidism and autoimmune thyroid disease, we invite you to read the Paloma article on the Top 6 Vitamins For Hypothyroidism.

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Office of Dietary Supplements - Selenium. Published 2017.

‌Völzke H, Erlund I, Hubalewska-Dydejczyk A, Ittermann T, Peeters RP, Rayman M, Buchberger M, Siebert U, Thuesen BH, Zimmermann MB, Grünert S, Lazarus JH. How do we improve the impact of iodine deficiency disorders prevention in Europe and beyond? Eur Thyroid J. 2018;7(4):193–200. doi: 10.1159/000490347.

Hofstee P, James-McAlpine J, McKeating DR, Vanderlelie JJ, Cuffe JS, Perkins AV. Low serum selenium in pregnancy is associated with reduced T3 and increased risk of GDM. Journal of Endocrinology. Published online October 2020. doi:10.1530/joe-20-0319

Hubalewska-Dydejczyk A, Duntas L, Gilis-Januszewska A. Pregnancy, thyroid, and the potential use of selenium. Hormones. 2019;19(1):47-53. doi:10.1007/s42000-019-00144-2

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Mary Shomon

Patient Advocate

Mary Shomon is an internationally-recognized writer, award-winning patient advocate, health coach, and activist, and the New York Times bestselling author of 15 books on health and wellness, including the Thyroid Diet Revolution and Living Well With Hypothyroidism. On social media, Mary empowers and informs a community of more than a quarter million patients who have thyroid and hormonal health challenges.

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