Effects of Antioxidant Supplementation on Graves' Disease: A Meta-Analysis

Objective. The main objective of this study is to evaluate the clinical efficacy of antithyroid drugs combined with antioxidant supplementation represented by selenium in the treatment of Graves' disease. Methods. Relevant randomized controlled trials (RCTs) were searched in PubMed, MEDLINE, Embase, the Cochrane Library databases, and the Chinese Medical Association. The search was conducted from the time of library construction to December 20, 2022. Three writers gradually examined, evaluated, and graded the literature and then used RevMan 5.3 to analyze the data and develop conclusions. Results. A total of seven papers were screened according to the search requirements. The results showed that free triiodothyronine (FT3) (WMD = -2.29, 95% CI: -3.55 to -1.02, P=0.0004), free thyroxine (FT4) (WMD = -0.62, 95% CI: -1.05 to -0.18, P=0.0005), thyrotropin receptor antibody (TRAb) (WMD = -1.31, 95% CI: -1.63 to -0.99, P<0.00001), and thyroid peroxidase antibody (TPOAb) (WMD = -9.8, 95% CI: -16.57 to -3.03, P=0.005) in the observation group (selenium supplementation combined with antithyroid drugs) were significantly lower than those in the control group (antithyroid drugs combined with or without placebo). In addition, selenium supplementation can increase serum selenium (WMD = 33.29, 95% CI: 30.7 to 35.87, P<0.00001), selenoprotein levels (WMD = 1.3, 95% CI: 0.8 to 1.8, P<0.00001), and blood lipid levels (WMD = 32.3, 95% CI: 17.87 to 46.74, P<0.0001). It cannot be excluded that the process of selenium supplementation treatment will affect the patient's lipid levels. Conclusion. Selenium is a trace mineral that is crucial for human health. In patients with Graves' disease, the use of antithyroid medications along with selenium supplementation can considerably enhance thyroid function. It has the potential to drastically lower TPOAb and TRAb levels as well as FT3 and FT4 levels, which is crucial for the treatment, recovery, and prognosis of hyperthyroid patients. Further research is required to determine whether the impact of antioxidant supplementation on blood lipids will restrict the use of this medication.