—We share Dr Herbert's concern regarding the safety of using 200 μg of selenium in a high-selenium brewer's yeast and have been concerned about documenting both adverse and beneficial health effects of selenium supplementation, especially those that could only be identified in a doubleblind, placebo-controlled trial. The choice of a nutritional dose diminished the safety issues in the trial and was based on the upper limit of the US Estimated Safe and Adequate Intake of selenium.1The trial's Safety Monitoring Committee reviewed the incidence of patient-reported disease and did not identify any significant adverse health events associated with selenium supplementation. The trial eligibility criteria excluded patients with active liver and kidney disease; however, we have not identified any additional groups of patients in the trial who were at particular risk of adverse health events. For safety reasons, pregnant women were also excluded from active participation. While there may be
Clark LC, Combs GF, Turnbull BW, Slate EH. Selenium Supplementation and Cancer Rates-Reply. JAMA. 1997;277(11):881. doi:10.1001/jama.1997.03540350031018
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