TY  - JOUR
T1  - ACute selenium toxicity associated with a dietary supplement
AU  - MacFarquhar JK, Broussard DL, Melstrom P, et al
Y1  - 2010/02/08
N1  - 10.1001/archinternmed.2009.495
JO  - Archives of Internal Medicine
SP  - 256
EP  - 261
VL  - 170
IS  - 3
N2  - Background 
    Selenium is an element necessary for normal cellular function, but it can have toxic effects at high doses. We investigated an outbreak of acute selenium poisoning.Methods 
    A case was defined as the onset of symptoms of selenium toxicity in a person within 2 weeks after ingesting a dietary supplement manufactured by “Company A,” purchased after January 1, 2008. We conducted case finding, administered initial and 90-day follow-up questionnaires to affected persons, and obtained laboratory data where available.Results 
    The source of the outbreak was identified as a liquid dietary supplement that contained 200 times the labeled concentration of selenium. Of 201 cases identified in 10 states, 1 person was hospitalized. The median estimated dose of selenium consumed was 41 749 μg/d (recommended dietary allowance is 55 μg/d). Frequently reported symptoms included diarrhea (78%), fatigue (75%), hair loss (72%), joint pain (70%), nail discoloration or brittleness (61%), and nausea (58%). Symptoms persisting 90 days or longer included fingernail discoloration and loss (52%), fatigue (35%), and hair loss (29%). The mean initial serum selenium concentration of 8 patients was 751 μg/L (reference range, ≤125 μg/L). The mean initial urine selenium concentration of 7 patients was 166 μg/24 h (reference range, ≤55 μg/24 h).Conclusions 
    Toxic concentrations of selenium in a liquid dietary supplement resulted in a widespread outbreak. Had the manufacturers been held to standards used in the pharmaceutical industry, it may have been prevented.
SN  - 0003-9926
M3  - doi: 10.1001/archinternmed.2009.495
UR  - http://dx.doi.org/10.1001/archinternmed.2009.495
ER  -