Medications That May Deplete SELENIUM
See which medications carry a reported association, how strong the evidence is, and what to discuss with your pharmacist.
Selenium is an essential trace mineral your body needs in small amounts for thyroid function, antioxidant defense, and immune health. Most people who eat a varied diet get enough, and supplements are mainly useful for those who are deficient. Because too much selenium can be toxic, stick to recommended amounts and check with your pharmacist or doctor before supplementing.
Commonly used for: Thyroid health support, Antioxidant support, Immune support, General nutrient supplementation, Reproductive/fertility support.
HelloPharmacist pharmacist-reviewed education. The medication records below are licensed clinical data, shown as published.
Deep dive: Selenium — uses, safety & drug interactions
Medications associated with SELENIUM depletion
Each record is shown as published in our licensed clinical database. Open a medication for its full nutrient report.
No results match — clear the filter to see everything.
Azelastine Hydrochloride, Fluticasone Propionate
Insufficient EvidenceBrand names include Dymista
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for thyroid function, immune defense, and protecting cells from damage. The fluticasone in this nasal spray is a corticosteroid, and some studies have found that corticosteroids can shift selenium levels in the blood, though whether those levels actually go up, go down, or stay the same varies quite a bit from study to study. Because the evidence is genuinely mixed and this is a low-dose nasal spray rather than high-dose oral steroids, there is nothing here that should worry most people using it. If you have broader concerns about your selenium status, your pharmacist or doctor is a good starting point.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Full nutrient report for Azelastine Hydrochloride, Fluticasone Propionate →
Beclometasone dipropionate
Insufficient EvidenceBrand names include Becotide
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a mineral your body uses to protect cells from damage and support a healthy immune system. Research on inhaled and oral corticosteroids like beclometasone and selenium levels is genuinely mixed: some studies found lower blood levels at high doses, while others found no change or even slightly higher levels, possibly because corticosteroids shift selenium around between the blood and tissues rather than simply draining it. Given the "Insufficient Evidence" rating, this is not something most people using beclometasone need to worry about right now. That said, if you have questions about your selenium status, a quick conversation with your pharmacist or doctor is always a reasonable step.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Beclomethasone
Insufficient EvidenceBrand names include Beclovent, Vanceril
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for thyroid function, immune defense, and protecting cells from damage. Studies on corticosteroids like beclomethasone show a mixed picture: some found lower blood selenium levels at higher doses, while others found no change or even slightly higher levels, possibly because the drug shifts selenium around between the blood and tissues rather than truly depleting it. Given that the evidence is conflicting and the clinical significance is simply not known, this is not something most people using beclomethasone need to worry about right now. If you use this medication long-term, it is worth mentioning to your pharmacist or doctor just so they can keep the full picture of your health in mind.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Beclomethasone dipropionate
Insufficient EvidenceBrand names include Qvar, QNASL
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for immune defense, thyroid function, and protecting cells from damage. Studies on corticosteroids like beclomethasone show a genuinely mixed picture, with some reporting lower blood selenium levels at high doses, others finding no change, and a few even finding higher levels that may simply reflect selenium shifting out of tissues into the bloodstream rather than a true gain. Given the conflicting data and an 'Insufficient Evidence' rating, this is not something most people using beclomethasone need to worry about right now, but if you have questions or take high doses long-term, it is worth a conversation with your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Betamethasone
Insufficient EvidenceBrand names include Celestone, Diprolene AF, Diprosone
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body needs for immune function, thyroid health, and protecting cells from damage. Research on whether corticosteroids like betamethasone actually change selenium levels is genuinely mixed: some studies found lower blood levels at high doses, others found no change, and a few even found higher blood levels, possibly because the drug shifts selenium out of tissues and into the bloodstream rather than truly depleting the body's total supply. Because the evidence is conflicting and the clinical significance is unknown, there is no reason to worry right now, but if you have been on betamethasone long-term at high doses, it is a reasonable thing to mention to your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Betamethasone Dipropionate
Insufficient EvidenceBrand names include Sernivo
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses to protect cells from damage and support thyroid function. Studies on corticosteroids like betamethasone and selenium levels have gone in different directions, with some showing lower blood levels, some showing no change, and some actually showing higher blood levels, possibly because the drug shifts selenium out of tissues and into the bloodstream. Given how mixed the evidence is, this is not something most people using betamethasone need to worry about right now, but if you use it long term at high doses, it is worth mentioning to your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Betamethasone Dipropionate, Calcipotriene
Insufficient EvidenceBrand names include Enstilar, Wynzora
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a mineral your body uses for immune function and protecting cells from damage, so it is worth understanding how corticosteroids like betamethasone might interact with it. Research on this is genuinely mixed: some studies found lower blood levels with high-dose steroid use, while others found no change or even higher levels, possibly because steroids shift selenium around between the blood and body tissues rather than truly depleting it. Because the evidence is conflicting and the clinical significance is unknown, this is not something most people using this topical combination need to worry about right now. That said, if you have any concerns about your selenium status, a conversation with your pharmacist or doctor is always a good idea.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Full nutrient report for Betamethasone Dipropionate, Calcipotriene →
Betamethasone valerate
Insufficient EvidenceBrand names include Luxiq
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for thyroid function, immune defense, and protecting cells from damage. Research on corticosteroids like betamethasone valerate and selenium levels is genuinely mixed: some studies found lower blood levels with high-dose use, others found no change, and a few actually found higher blood levels, possibly because the steroid shifts selenium out of tissues and into the bloodstream. Given how conflicting and unclear the picture is, this is not something most people using betamethasone valerate need to worry about, but if you have concerns, it is worth a quick conversation with your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Budesonide
Insufficient EvidenceBrand names include Entocort EC, Pulmicort, Uceris
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a mineral your body uses to support the immune system, thyroid function, and antioxidant defenses. Research on budesonide and selenium is genuinely mixed: some studies found lower blood selenium levels with corticosteroid use, others found no change, and some actually found higher levels in the blood, possibly because the mineral shifted out of tissues rather than truly increasing overall. Because the evidence points in different directions and clinical importance is unknown, this is something to be aware of rather than worried about. If you are a long-term budesonide user with questions, it is worth a quick conversation with your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Cisplatin
Insufficient EvidenceBrand names include Platinol-AQ
Preliminary evidence suggests that cisplatin lowers plasma selenium levels in humans. Levels appear to recover between courses, but the decrease can become progressively larger with each course of the drug. In one study, the decrease was only 1% with the first course, but reached 19% by the fourth course. This might indicate that tissues are becoming progressively more selenium-depleted, so that less is available to replenish plasma levels. The mechanism might involve binding of cisplatin to methylselenol, a selenium metabolite formed in the kidneys, resulting in increased selenium excretion. There is not enough data to know whether selenium supplements should be recommended for patients receiving cisplatin. Preliminary evidence suggests selenium supplements do not affect the systemic availability or antitumor actions of cisplatin in animal models.
Selenium is a trace mineral your body uses for immune defense, thyroid function, and protecting cells from damage. Some early research found that cisplatin may gradually lower selenium levels in the blood, possibly because the drug binds to a selenium byproduct in the kidneys and causes more of it to be flushed out in the urine. That said, the evidence here is still very preliminary, and researchers do not yet know whether this drop is clinically meaningful or whether selenium supplements are needed. If you are on cisplatin and have questions, it is worth bringing this up with your oncologist or pharmacist.
References (5)
- Sieja K, Talerczyk M. Selenium as an element in the treatment of ovarian cancer in women receiving chemotherapy. Gynecol Oncol 2004;93:320-7. PubMed
- Vernie LN, de Goeij JJ, Zegers C, et al. Cisplatin-induced changes of selenium levels and glutathione peroxidase activities in blood of testis tumor patients. Cancer Lett 1988;40:83-91. PubMed
- Baldew GS, van den Hamer CJ, Los G, et al. Selenium-induced protection against cis-diamminedichloroplatinum(II) nephrotoxicity in mice and rats. Cancer Res 1989;49:3020-3.
- Baldew GS, Mol JG, de Kanter FJ, et al. The mechanism of interaction between cisplatin and selenite. Biochem Pharmacol 1991;41:1429-37. PubMed
- Vermeulen NP, Baldew GS, Los G, et al. Reduction of cisplatin nephrotoxicity by sodium selenite. Lack of interaction at the pharmacokinetic level of both compounds. Drug Metab Dispos 1993;21:30-6. DOI
Clobetasol
Insufficient EvidenceBrand names include Temovate, Clobex
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for immune defense and protecting cells from damage. Corticosteroids like clobetasol have shown mixed results in studies: some found lower blood selenium levels with high-dose use, while others found no change or even higher levels. Because the picture is so unclear, this is listed as insufficient evidence, meaning most people using clobetasol do not need to worry about this. If you have concerns, it is worth a quick conversation with your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Clozapine
Insufficient EvidenceBrand names include Clozaril, Versacloz
Low plasma selenium levels are found in some people treated with clozapine. Since selenium has antioxidant properties, there is speculation that lowered levels might contribute to agranulocytosis and cardiac side effects of clozapine; however, there are no studies to confirm this. There isn't enough information to recommend routine selenium supplementation with clozapine therapy.
Selenium is a mineral your body uses as an antioxidant, helping to protect cells from damage. Some studies have noticed lower selenium levels in people taking clozapine, though exactly why is not yet clear, and researchers have wondered whether this plays any role in certain rare side effects of the drug. That connection is still speculative, and right now there simply is not enough evidence to say whether this matters in practice. If you have concerns, it is worth bringing up with your doctor or pharmacist rather than starting a supplement on your own.
References (2)
- Linday LA, Pippenger CE, Howard A, Lieberman JA. Free radical scavenging enzyme activity and related trace metals in clozapine-induced agranulocytosis: a pilot study. J Clin Psychopharmacol 1995;15:353-60. PubMed
- Vaddadi KS, Soosai E, Vaddadi G. Low blood selenium concentrations in schizophrenic patients on clozapine. Br J Clin Pharmacol 2003;55:307-9. PubMed
Cortisone Acetate
Insufficient EvidenceBrand names include Cortone, Cortisone Tablets
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses to protect cells from damage and support a healthy immune system and thyroid. Research on cortisone and selenium is genuinely mixed: some studies found lower blood levels with high-dose corticosteroids, others found no change, and a few even found higher blood levels, possibly because corticosteroids shift selenium out of tissues and into the bloodstream rather than actually depleting the body's total supply. Because the evidence is conflicting and the clinical significance is simply not known, there is no clear action needed right now, but if you are curious whether your selenium status matters for your situation, it is worth a quick conversation with your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Dexamethasone
Insufficient EvidenceBrand names include Decadron, Hexadrol, Dexone
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for immune defense and protecting cells from damage. Research on corticosteroids like dexamethasone and selenium levels is genuinely mixed: some studies found lower blood levels at high doses, others found no change, and a few even found higher blood levels, possibly because the drug shifts selenium out of tissues and into the bloodstream rather than truly depleting it. Given that the evidence is conflicting and the clinical significance is simply not known, this is not something most people need to worry about right now. If you take dexamethasone long-term, it is worth mentioning this to your pharmacist or doctor just to keep it on their radar.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Fludrocortisone
Insufficient EvidenceBrand names include Florinef Acetate
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a mineral your body uses for immune function and protecting cells from damage. Fludrocortisone is a mineralocorticoid, meaning it acts on the kidneys to hold onto salt and water, and this same effect may reduce how much selenium the kidneys excrete, which could actually shift selenium levels upward in the blood even while levels in tissues like the liver change in unpredictable ways. Honestly, the research here is all over the place, with some studies showing lower blood levels, others showing higher, and others showing no change at all. Given the truly insufficient evidence, most people taking fludrocortisone do not need to worry about this, but if you have questions your pharmacist or doctor can help sort out whether any monitoring makes sense for you.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Fluticasone
Insufficient EvidenceBrand names include Flovent, Flonase, Flixotide
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for antioxidant protection and a healthy immune system. Research on corticosteroids like fluticasone and selenium levels is genuinely mixed: some studies found lower blood levels at high doses, others found no change, and a few even found higher blood levels, possibly because the steroid shifts selenium out of tissues and into the bloodstream. Given that the evidence is conflicting and the clinical significance is simply unknown, this is not something most people using fluticasone need to worry about right now. If you have concerns, it is worth a quick conversation with your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Fluticasone Furoate, Umeclidinium, Vilanterol
Insufficient EvidenceBrand names include Trelegy Ellipta
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for thyroid function, immune defense, and protecting cells from damage. The corticosteroid component of this inhaler (fluticasone furoate) is the ingredient that has been loosely connected to changes in selenium levels, though the picture is genuinely mixed: some studies found lower blood levels, others found no change, and a few even found higher levels. Because the evidence is conflicting and the clinical significance is simply unknown, this is not something to worry about right now, but feel free to mention it to your pharmacist or doctor if you have questions.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Full nutrient report for Fluticasone Furoate, Umeclidinium, Vilanterol →
Fluticasone Furoate, Vilanterol Trifenatate
Insufficient EvidenceBrand names include Breo Ellipta
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a mineral your body uses to protect cells from damage and support thyroid function. The corticosteroid component of this inhaler (fluticasone furoate) has been linked to changes in selenium levels in some studies, though interestingly the research is mixed, with some showing lower blood levels, some showing no change, and some actually showing higher blood levels. Because the evidence is conflicting and the clinical significance is simply unknown, there is no reason to be concerned right now. If you have questions about selenium or your nutrition while on this inhaler long term, it is worth a quick conversation with your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Full nutrient report for Fluticasone Furoate, Vilanterol Trifenatate →
Hydrocortisone
Insufficient EvidenceBrand names include Cortef, Hydrocortone, Carmol HC cream
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for antioxidant protection and thyroid function. Research on hydrocortisone and selenium is genuinely mixed: some studies found lower blood levels at higher corticosteroid doses, others found no change, and a few even found higher blood levels, possibly because corticosteroids shift selenium out of tissues like the liver and into the bloodstream. With an 'Insufficient Evidence' rating, there is no clear clinical concern right now, but if you take hydrocortisone long-term, it is worth mentioning selenium at your next pharmacist or doctor visit just to keep it on their radar.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Methylprednisolone
Insufficient EvidenceBrand names include Medrol, Medrol Dosepak
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for immune defense, thyroid function, and protecting cells from damage. Research on methylprednisolone and selenium is genuinely mixed: some studies found lower blood levels at higher corticosteroid doses, others found no change, and a few even found higher blood levels, possibly because the drug shifts selenium out of tissues like the liver and into the bloodstream rather than truly depleting it. Given this conflicting picture, the evidence is rated insufficient, meaning no one can say yet whether this is a real concern for most people taking this medication. If you are on methylprednisolone long-term, it is worth mentioning this to your pharmacist or doctor rather than acting on it yourself.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Olopatadine Hydrochloride, Mometasone Furoate
Insufficient EvidenceBrand names include Ryaltris
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses to protect cells from damage and support thyroid function. The mometasone furoate in this combination is a corticosteroid, and studies have turned up mixed results on whether corticosteroids shift selenium levels at all: some found lower blood levels at higher doses, others found no change, and a few actually found higher blood levels, possibly because the steroid causes selenium to move out of tissues and into the bloodstream. With an 'Insufficient Evidence' rating, this is genuinely uncertain territory, so there is no action most people need to take right now. If you use this medication long-term and have concerns, it is worth a quick conversation with your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Full nutrient report for Olopatadine Hydrochloride, Mometasone Furoate →
Prednisolone
Insufficient EvidenceBrand names include Sterane, Delta Cortef, Cortalone
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for immune defense and protecting cells from damage. Research on prednisolone and selenium is genuinely mixed: some studies found lower blood levels at higher doses, while others found no change or even higher levels, possibly because the steroid shifts selenium out of tissues like the liver and into the bloodstream rather than truly depleting it. Because the evidence is conflicting and no one yet knows if any of these shifts cause real harm, this is not something most people taking prednisolone need to worry about right now. If you are on long-term, higher-dose prednisolone and have questions about your selenium status, it is worth a conversation with your doctor or pharmacist.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Prednisone
Insufficient EvidenceBrand names include Deltasone, Cortan, Orasone
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for immune defense, thyroid function, and protecting cells from damage. Research on prednisone and selenium is genuinely mixed: some studies have found lower blood levels at higher doses, others found no change, and a few even found higher blood levels, possibly because corticosteroids shift selenium out of tissues like the liver and into the bloodstream, or reduce how much the kidneys excrete. Because the evidence is conflicting and the clinical significance is simply not known, this is not something to worry about right now, but if you take prednisone long-term at higher doses, it is worth bringing up with your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Sodium valproate
Insufficient EvidenceBrand names include Epilim
Animal model research and anecdotal reports suggest that valproate reduces plasma selenium levels, possibly by chelation and increased excretion. Theoretically, this might contribute to valproate side effects. However, other studies have found no effect. There isn't enough data to recommend routine selenium supplements with valproate therapy.
Selenium is a trace mineral your body uses for antioxidant protection and thyroid function, and there are some animal studies and scattered reports suggesting valproate might lower selenium levels, possibly by binding to it in the body and nudging the kidneys to excrete more. That said, other studies have found no effect at all, and right now the evidence is simply too mixed to draw a clear conclusion. For most people taking valproate, this is more of an open question than a proven concern. Still, if you have been on valproate long-term and are curious whether this applies to you, it is worth a conversation with your pharmacist or doctor.
References (5)
- Hurd RW, Van Rinsvelt HA, Wilder BJ, et al. Selenium, zinc, and copper changes with valproic acid: possible relation to drug side effects. Neurology 1984;34:1393-5. PubMed
- Fatemi SH, Calabrese JR. Treatment of valproate-induced alopecia (letter). Ann Pharmacother 1995;29;1302. PubMed
- Linday LA, Pippenger CE, Howard A, Lieberman JA. Free radical scavenging enzyme activity and related trace metals in clozapine-induced agranulocytosis: a pilot study. J Clin Psychopharmacol 1995;15:353-60. PubMed
- Verrotti A, Basciani F, Trotta D, et al. Serum copper, zinc, selenium, glutathione peroxidase and superoxide dismutase levels in epileptic children before and after 1 year of sodium valproate and carbamazepine therapy. Epilepsy Res 2002;48:71-5. PubMed
- Kurekci AE, Alpay F, Tanindi S, et al. Plasma trace element, plasma glutathione peroxidase, and superoxide dismutase levels in epileptic children receiving antiepileptic drug therapy. Epilepsia 1995;36:600-4. PubMed
Triamcinolone
Insufficient EvidenceBrand names include Aristocort, Kenacort, Adcortyl Intra-articular / Intradermal
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses for immune defense and protecting cells from damage. With corticosteroids like triamcinolone, the picture is genuinely mixed: some studies have shown lower blood selenium levels at higher doses, while others show no change or even a slight rise, possibly because corticosteroids shift selenium out of tissues and into the bloodstream rather than truly depleting it. The evidence is too inconsistent right now to know whether any of this matters clinically, so most people using triamcinolone do not need to worry about this. If you are on long-term or high-dose corticosteroid therapy, it is worth a quick conversation with your pharmacist or doctor just to check in.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Triamcinolone Acetonide
Insufficient EvidenceBrand names include Zilretta, Xipere
Reduced plasma levels have been reported, especially with high doses of corticosteroids such as 20 to 60 mg/day of prednisolone. Other studies have shown no change in plasma levels, or even increased plasma levels, sometimes with reduced levels in tissues such as the liver. The increased plasma levels might reflect redistribution from tissues, possibly due to increases in plasma proteins which bind selenium. Increased levels could also be due to reduced selenium excretion, as a result of the mineralocorticoid effects of corticosteroids. Whether these changes in selenium levels are clinically significant is not known.
Selenium is a trace mineral your body uses to support immune function, thyroid health, and protection against cell damage. Studies on corticosteroids like triamcinolone acetonide show a genuinely mixed picture: some report lower blood selenium levels at higher doses, while others find levels unchanged or even slightly higher, possibly because the drug shifts selenium out of tissues and into the bloodstream rather than truly depleting it. Given that the evidence is conflicting and the clinical significance is simply not known, this is not something most people need to worry about on their own. If you have been on this medication long-term or at higher doses, it is worth mentioning to your pharmacist or doctor.
References (6)
- Peretz A, Neve J, Vertongen F, et al. Selenium status in relation to clinical variables and corticosteroid treatment in rheumatoid arthritis. J Rheumatol 1987;14:1104-7.
- Smith DK, Feldman EB, Feldman DS. Trace element status in multiple sclerosis. Am J Clin Nutr 1989;50:136-40. PubMed
- Marano G, Fischioni P, Graziano C, et al. Increased serum selenium levels in patients under corticosteroid treatment. Pharmacol Toxicol 1990;67:120-2. PubMed
- Koskelo EK. Serum selenium in children during anti-cancer chemotherapy. Eur J Clin Nutr 1990;44:799-802.
- Fenech AG, Ellul-Micallef R. Selenium, glutathione peroxidase and superoxide dismutase in Maltese asthmatic patients: effect of glucocorticoid administration. Pulm Pharmacol Ther 1998;11:301-8. PubMed
- Watanabe C, Kim CY, Satoh H. Tissue-specific modification of selenium concentration by acute and chronic dexamethasone administration in mice. Br J Nutr 1997;78:501-9. PubMed
Valproic Acid
Insufficient EvidenceBrand names include Depakene, Depacon, Valproate
Animal model research and anecdotal reports suggest that valproate reduces plasma selenium levels, possibly by chelation and increased excretion. Theoretically, this might contribute to valproate side effects. However, other studies have found no effect. There isn't enough data to recommend routine selenium supplements with valproate therapy.
Selenium is a trace mineral your body uses to protect cells from damage and support thyroid and immune function. Some animal studies and scattered case reports suggest valproic acid might bind to selenium in the body and push more of it out through excretion, but other studies have found no drop at all. The evidence is genuinely conflicting and too thin to draw firm conclusions, so most people on valproic acid do not need to worry about this. If you have concerns, it is worth a quick conversation with your pharmacist or doctor before considering any supplement.
References (5)
- Hurd RW, Van Rinsvelt HA, Wilder BJ, et al. Selenium, zinc, and copper changes with valproic acid: possible relation to drug side effects. Neurology 1984;34:1393-5. PubMed
- Fatemi SH, Calabrese JR. Treatment of valproate-induced alopecia (letter). Ann Pharmacother 1995;29;1302. PubMed
- Linday LA, Pippenger CE, Howard A, Lieberman JA. Free radical scavenging enzyme activity and related trace metals in clozapine-induced agranulocytosis: a pilot study. J Clin Psychopharmacol 1995;15:353-60. PubMed
- Verrotti A, Basciani F, Trotta D, et al. Serum copper, zinc, selenium, glutathione peroxidase and superoxide dismutase levels in epileptic children before and after 1 year of sodium valproate and carbamazepine therapy. Epilepsy Res 2002;48:71-5. PubMed
- Kurekci AE, Alpay F, Tanindi S, et al. Plasma trace element, plasma glutathione peroxidase, and superoxide dismutase levels in epileptic children receiving antiepileptic drug therapy. Epilepsia 1995;36:600-4. PubMed
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
SELENIUM & medications: FAQs
Which medications can lower SELENIUM?
I take one of these medications — am I deficient in SELENIUM?
Should I start a SELENIUM supplement?
Where does this information come from?
Other commonly implicated nutrients
Wondering about your SELENIUM levels?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Medication associations with SELENIUM are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.