A MEDITERRANEAN diet enriched with selenium could become a mandatory part of treatment for patients with Graves’ disease (GD) with mild, active Graves’ ophthalmopathy (GO). A recent study reveals that the diet significantly improves key clinical markers associated with the autoimmune condition.
Graves’ ophthalmopathy, affecting around 25% of individuals with GD, is driven by oxidative stress, which escalates inflammation and interferes with thyroid function. Selenium, a potent antioxidant, may alleviate this stress, potentially reducing symptoms of GO. This prospective, randomized study aimed to evaluate the impact of a Mediterranean diet naturally high in selenium on thyroid function, autoimmunity, and the course of GO.
Involving 40 GD patients with untreated mild active GO, participants were randomly assigned to either a Mediterranean diet (MD) or a free diet (FD). Over 24 weeks, the MD group exhibited significant improvements in several clinical markers. Notably, the Clinical Activity Score (CAS) improved by 0.03, and soft tissue involvement also showed significant improvement compared to the FD group. The MD group also showed a notable reduction in eyelid aperture size, a common symptom of GO.
Interestingly, the MD group gained less weight over the study period compared to those on a free diet. The relative change in body mass index (BMI) was significantly lower in the MD group at the 24-week mark. Both groups showed similar reductions in thyroid function and TRABs levels. However, no exacerbation of GO symptoms occurred in either group, indicating that the Mediterranean diet did not worsen the condition.
These findings highlight the benefits of the Mediterranean diet as part of a holistic approach to managing Graves’ disease and Graves’ ophthalmopathy, providing a nutritional strategy to combat inflammation and weight gain while improving overall health. As oxidative stress and insulin resistance contribute to the pathogenesis of GO, incorporating this dietary style may reduce the autoimmune-inflammatory processes that drive the disease.
Reference:
Le Moli R et al. Mediterranean diet, selenium and Graves’ ophthalmopathy: a prospective, randomized, single-center study. Endocrine. 2025. doi: 10.1007/s12020-025-04360-2
