{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:32:52Z","timestamp":1783488772101,"version":"3.55.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Endocrinol Diabetes"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The main objective was to assess the therapeutic efficacy of selenium alone versus a combination of myo-inositol and selenium (MI\u2009+\u2009Se) in treating patients with autoimmune thyroiditis (AIT). The study aims to determine which treatment option is more effective in restoring euthyroid state, as indicated by changes in thyroid-stimulating hormone (TSH), T3, T4, thyroid peroxidase antibodies (TPOAb), and thyroglobulin antibodies (TgAb)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Google Scholar and PubMed databases were searched for randomized controlled trials (RCTs) and observational studies that reported outcomes of combined treatment (MI\u2009+\u2009Se) in restoring a euthyroid state, specifically comparing it with selenium-only (Se-only) treatment. Changes in TSH, T3, T4, TPOAb, and TgAb levels from baseline were defined as indicators to compare the effect of combined versus selenium-only treatment in restoring euthyroid levels. The Cochrane risk of bias tool and Newcastle Ottawa Scale were used to assess the quality of the randomized control trials included in the study. Review Manager (version 5.4, Nordic Cochrane Centre, Copenhagen, Denmark) was used for statistical analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result:<\/jats:title>\n                    <jats:p>\n                      We pooled three studies, enrolling 151 participants in the MI\u2009+\u2009Se group and 137 participants in the Se group. Supplementation of Se with MI demonstrated a significant reduction in TSH levels compared to Se alone (SMD\u2009=\u2009\u22121.15, 95% CI: \u22121.60 to \u22120.69,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.00001). MI\u2009+\u2009Se treatment also significantly reduced TgAb levels compared to Se (SMD\u2009=\u2009\u22120.51, 95% CI: \u22120.78 to \u22120.24,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0002). In contrast, TPOAB, T3 and T4 levels were non-significantly reduced from baseline in patients treated with MI\u2009+\u2009Se when compared to Se alone (SMD\u2009=\u2009\u22120.81, 95% CI: \u22120.44 to 0.09,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.20), (SMD\u2009=\u20090.16, 95% CI: \u22120.09 to 0.42,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.22), and (SMD\u2009=\u20090.30, 95% CI: \u22120.23 to 0.83,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.26) respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Supplementation of Se with MI showed a significant reduction in TSH and TgAb levels compared to selenium-only treatment, with a non-significant reduction in TPOAB, T3, and T4 levels. This entails the need for powered clinical trials and observational studies with longer follow-ups to critically assess the role of combined therapy in restoring euthyroid state in patients with AIT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795514241300998","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T07:17:12Z","timestamp":1733469432000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Role of Supplementation with Selenium and Myo-Inositol Versus Selenium Alone in Patients of Autoimmune Thyroiditis: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8640-6872","authenticated-orcid":false,"given":"Varisha","family":"Zuhair","sequence":"first","affiliation":[{"name":"Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areeba Tufail","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Ziauddin University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimra","family":"Shafi","sequence":"additional","affiliation":[{"name":"Bahria University Medical and Dental College, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areesha","family":"Babar","sequence":"additional","affiliation":[{"name":"Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areeb","family":"Khan","sequence":"additional","affiliation":[{"name":"Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arooba","family":"Sadiq","sequence":"additional","affiliation":[{"name":"Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Afnan","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Sharif Medical and Dental College, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khuld","family":"Nihan","sequence":"additional","affiliation":[{"name":"Jinnah Sindh Medical University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Hamza","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burhan","family":"Khalid","sequence":"additional","affiliation":[{"name":"Gujrawala Medical College, Gujrawala, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syeda","family":"Haya Fatima","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirza Ammar","family":"Arshad","sequence":"additional","affiliation":[{"name":"Rahbar Medical and Dental College, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Ali","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,6]]},"reference":[{"key":"e_1_3_5_2_2","first-page":"205","volume-title":"Thyroid Diseases: Endocrinology","author":"Wiersinga WM","unstructured":"Wiersinga WM. Hashimoto\u2019s thyroiditis. In: Vitti P, Heged\u00fcs L, eds. Thyroid Diseases: Endocrinology. Cham: Springer, 2018:205-247."},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1020709"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000150"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00138"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1480389"},{"key":"e_1_3_5_7_2","first-page":"904573","article-title":"Selenium supplementation for autoimmune thyroiditis: a systematic review and meta-analysis","volume":"1","author":"Fan Y","year":"2014","unstructured":"Fan Y, Xu S, Zhang H, et al. Selenium supplementation for autoimmune thyroiditis: a systematic review and meta-analysis. Int J Endocrinol. 2014;1:904573.","journal-title":"Int J Endocrinol"},{"key":"e_1_3_5_8_2","first-page":"2549491","article-title":"Treatment with myo-inositol and selenium ensures euthyroidism in patients with autoimmune thyroiditis","volume":"1","author":"Nordio M","year":"2017","unstructured":"Nordio M, Basciani S. Treatment with myo-inositol and selenium ensures euthyroidism in patients with autoimmune thyroiditis. Int J Endocrinol. 2017;1:2549491.","journal-title":"Int J Endocrinol"},{"key":"e_1_3_5_9_2","first-page":"51","article-title":"Myo-inositol plus selenium supplementation restores euthyroid state in Hashimoto\u2019s patients with subclinical hypothyroidism","volume":"21","author":"Nordio M","year":"2017","unstructured":"Nordio M, Basciani S. Myo-inositol plus selenium supplementation restores euthyroid state in Hashimoto\u2019s patients with subclinical hypothyroidism. Eur Rev Med Pharmacol Sci. 2017;21:51-59.","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4008"},{"key":"e_1_3_5_12_2","first-page":"14898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne JAC","year":"2019","unstructured":"Sterne JAC, Savovi\u0107 J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. Br Med J. 2019;366:14898.","journal-title":"Br Med J"},{"key":"e_1_3_5_13_2","unstructured":"The Ottawa Hospital Research Institute. Accessed October 18 2023. https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_3_5_15_2","first-page":"424163","article-title":"Combined treatment with myo-inositol and selenium ensures euthyroidism in subclinical hypothyroidism patients with autoimmune thyroiditis","volume":"1","author":"Nordio M","year":"2013","unstructured":"Nordio M, Pajalich R. Combined treatment with myo-inositol and selenium ensures euthyroidism in subclinical hypothyroidism patients with autoimmune thyroiditis. J Thyroid Res. 2013;1:424163.","journal-title":"J Thyroid Res"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ20-0062"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1559631"},{"key":"e_1_3_5_18_2","first-page":"1297658","article-title":"Selenium and thyroid disease: from pathophysiology to treatment","volume":"1","author":"Ventura M","year":"2017","unstructured":"Ventura M, Melo M, Carrilho F. Selenium and thyroid disease: from pathophysiology to treatment. Int J Endocr. 2017;1:1297658.","journal-title":"Int J Endocr"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.662582"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-018-9477-9"}],"updated-by":[{"DOI":"10.1177\/11795514251395247","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T00:00:00Z","timestamp":1762646400000}}],"container-title":["Clinical Medicine Insights: Endocrinology and Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795514241300998","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11795514241300998","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795514241300998","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:00:12Z","timestamp":1777406412000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11795514241300998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":19,"alternative-id":["10.1177\/11795514241300998"],"URL":"https:\/\/doi.org\/10.1177\/11795514241300998","relation":{},"ISSN":["1179-5514","1179-5514"],"issn-type":[{"value":"1179-5514","type":"print"},{"value":"1179-5514","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]},"article-number":"11795514241300998"}}