October 1, 2006
Selenium Overdose Death

An Australian man has died after swallowing 10,000 times the daily dose
of selenium, reports The Age online newspaper. The 75-year-old
mistakenly "purchased sodium selenite powder used primarily as a
supplement for livestock, swallowing 10 grams."

According to The Age, Australian doctors who treated the 75-year-old
"have used his death to highlight the dangers of promoting complementary
medicines without adequate instructions." The doctors in this case blame
the internet.
Selenium for human consumption, as sold in pharmacies, health stores and
supermarkets , typically comes in 200 microgram (µg)  pills or
capsules, which may be printed "200 mcg."

The Age reporter writes:
The unnamed man had searched the internet for possible prostate
prevention and treatment after receiving an abnormal but unconfirmed
test result, it was revealed in the latest Medical Journal of Australia.

He found websites discussing the benefits of selenium, an essential but
highly toxic trace element found at low levels in seafood, grains and
eggs.

In Australia, the element is marketed as a health supplement but the man
mistakenly purchased sodium selenite powder used primarily as a
supplement for livestock, swallowing 10 grams.

"Despite intensive care treatment he suffered a cardiac arrest and died
six hours after ingestion," wrote the staff who dealt with his case at
Brisbane's St Andrew's War Memorial Hospital.
Internet searches found that the link between selenium and prostate
cancer was mentioned on almost 300,000 websites.

"This case highlights the risks associated with failure to critically
evaluate internet material and exposes the myth that natural therapies
are inherently safe," the authors wrote.

They said the World Health Organisation (WHO) had devised guidelines to
help net surfers judge medical information on the web, available online
through the Therapeutic Goods Administration.

But the specialists said more was needed, calling for an Australian
database listing side effects of all current therapies.

"Adverse outcomes of complementary and alternative medicines should be
better publicised and more stringently reported to the Adverse Drug
Reactions Advisory Committee, the doctors wrote.

Cases of selenium poisoning are rare, with fewer than 20 reported
worldwide before 1997.

Selenium is a trace mineral that is essential to good health but
required only in tiny amounts. Many plant foods contain trace selenium,
but the amount varies with growing region. Soil conditions vary by
region and country. Worldwide, lowest selenium content in soil and plant
foods is in China. In the USA, highest selenium levels are found in the
high plains of northern Nebraska and the Dakotas. People living in those
regions generally have the highest selenium intakes in the United States
(U.S.) , but show no signs of toxicity. In Australia, University of
Adelaide School of Agriculture reported last year that selenium levels
in soil and in peoples' blood is generally on the low side. They are
considering biofortification to raise selenium levels in Australian
wheat.

Individuals vary in their ability to absorb dietary selenium from the
digestive tract. Illnesses like Chron's disease affect selenium
absorption and possibly so may aging.

Studies of whether daily dose of 200 micrograms (µg)  prevents
prostate cancer are ongoing in the USA (see links below). Selenium is
included in a clinical trial of minerals and antioxidants underway in
France. This trial, which began in 1994, has yielded preliminary
results.

According to the US National Institutes of Health Fact Sheet on
Selenium, "High blood levels of selenium (greater than 100 μg/dL)
can result in a condition called selenosis [62]. Symptoms of selenosis
include gastrointestinal upsets, hair loss, white blotchy nails, garlic
breath odor, fatigue, irritability, and mild nerve damage [2].

Selenium toxicity is rare in the U.S. The few reported cases have been
associated with industrial accidents and a manufacturing error that led
to an excessively high dose of selenium in a supplement. The Institute
of Medicine of the National Academy of Sciences has set a tolerable
upper intake level (UL) for selenium at 400 micrograms per day for
adults to prevent the risk of developing selenosis. "

Sources and links:

Internet advice a health risk doctors warn The Age Oct 1, 2008
Dietary Supplement Fact Sheet: Selenium. Office of Dietary Supplements
• NIH Clinical Center • National Institutes of Health
National Cancer Institute (NCI), USA, in its statement about selenium
testing in the SELECT clinical trial, says:
What is selenium? Why study it for prostate cancer prevention?
Our bodies need selenium, a nonmetallic trace element that we get from
foodâ€"especially plant foods like rice and wheat, seafood, meat,
and Brazil nuts. Selenium is an antioxidant that might help control cell
damage that can lead to cancer.
The Nutritional Prevention of Cancer Trial, published in 1996, included
1,312 men and women who had skin cancer. Men who took selenium to
prevent nonmelanoma skin cancer received no benefit from selenium in
preventing skin cancer. However, men who had taken selenium for 6½
years had approximately 60 percent fewer new cases of prostate cancer
than men who took the placebo (2). In 2002, study data showed that men
who took selenium for more than 7½ years had about 52 percent fewer
new cases of prostate cancer than men who took the placebo (3). This
study is one of the reasons selenium is being studied in SELECT. (See
Question 11 for more information about selenium.)
# How much selenium is being used in SELECT? What risks might be
involved?
11. How much selenium is being used in SELECT? What risks might be
involved?
The amount of selenium (provided as l-selenomethionine) is 200
micrograms (µg) daily. Although the initial results of the
Nutritional Prevention of Cancer Trial showed an overall decrease in
cancer incidence from selenium, a 2003 update reported 17 percent more
new nonmelanoma skin cancers in the selenium group compared with the
placebo group (5). It is not clear how these results would apply to men
who did not already have skin cancer when they enrolled in SELECT, or to
men who are not at increased risk for skin cancer.
More about clinical trials of selenium:
Selenium in Treating Patients Who Are Undergoing Brachytherapy for Stage
I or Stage II Prostate Cancer
Clinical Trials with Selenium - Prostate Cancer Prevention Program at
the University Arizona
• • •

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc