Selenium deficiency in critical illness has been associated with higher rates of organ failure and mortality, in part because low selenium leaves ICU patients more vulnerable to oxidative damage and immune dysregulation. Observational studies show that many critically ill patients have serum selenium levels below about 70 µg/L, and that these low levels correlate with higher APACHE II and SOFA scores, more frequent septic shock, worse oxygenation, and a greater likelihood of death. Together, these findings suggest that identifying and correcting selenium deficiency in the ICU may be an underused strategy to support antioxidant defenses and potentially improve survival in high‑risk patients. This medication is commonly used for Inflammation.
Tan HH, Liang YC, Shao YC, Chen CM, Chou W. Impact of selenium status and supplementation on outcomes in critically ill patients. Sci Rep. 2025 Oct 10;15(1):35478. Broman M, Lindfors M, Norberg Å, Hebert C, Rooyackers O, Wernerman J, Fläring U. Low serum selenium is associated with the severity of organ failure in critically ill children. Clin Nutr. 2018 Aug;37(4):1399-1405. Costa NA, Gut AL, Pimentel JA, Cozzolino SM, Azevedo PS, Fernandes AA, Polegato BF, Tanni SE, Gaiolla RD, Zornoff LA, Paiva SA, Minicucci MF. Erythrocyte selenium concentration predicts intensive care unit and hospital mortality in patients with septic shock: a prospective observational study. Crit Care. 2014 May 7;18(3):R92. Angstwurm MW, Engelmann L, Zimmermann T, Lehmann C, Spes CH, Abel P, Strauss R, Meier-Hellmann A, Insel R, Radke J, Schüttler J, Gärtner R. Selenium in Intensive Care (SIC): results of a prospective randomized, placebo-controlled, multiple-center study in patients with severe systemic inflammatory response syndrome, sepsis, and septic shock. Crit Care Med. 2007 Jan;35(1):118-26.
Some side effects may be linked to nutrient depletion caused by this medication.
Research has found that corticosteroids increased chromium excretion in patients after just three days. Chromium is an essential mineral that helps regulate blood sugar levels. This is important because corticosteroids themselves can raise blood sugar, contributing to diabetes. Evidence suggests that chromium supplementation improved fasting blood glucose levels in patients with steroid-induced diabetes.
Maintaining healthy potassium levels is important when taking corticosteroids. These medications can increase the amount of potassium the body loses through urine. Potassium is a vital mineral that helps muscles and nerves function properly. While short-term use of corticosteroids might not cause significant problems, studies suggest that with prolonged treatment, the body's ability to maintain proper potassium balance (homeostasis) can be affected.
Corticosteroids can lower calcium levels in the body. This is a double threat to bone health because corticosteroids themselves can weaken bones. Calcium is essential for strong bones, and a study showed that supplementing with both calcium and vitamin D3 helped prevent bone loss in people with rheumatoid arthritis taking corticosteroids. Supplementation with calcium should be considered during long term corticosteroid therapy.
Corticosteroids can increase the urinary loss of selenium elevating the risk for deficient levels. Selenium is a mineral that acts as an antioxidant, helping protect cells from damage. Studies have shown that rheumatoid arthritis patients taking high doses of corticosteroids tend to have lower selenium levels. This is concerning because low selenium intake is linked to osteoporosis, and selenium has been shown to play a role in bone protection in animal models of corticosteroid-induced osteoporosis. Supplementation with selenium should be considered during long term corticosteroid therapy.
Corticosteroids can increase the body's excretion of magnesium, potentially leading to a deficiency. This is concerning because magnesium plays a vital role in many bodily functions, including muscle and nerve function. Research suggests that magnesium supplementation alleviated corticosteroid therapy associated muscle atrophy. Supplementation with magnesium should be considered during long term corticosteroid therapy.
Research suggests corticosteroids can lower vitamin D levels in the body by increasing its breakdown. This is a concern because vitamin D plays a crucial role in bone health and the immune system, and corticosteroids themselves can weaken bones. A study found that calcium and vitamin D3 supplements helped prevent bone loss in the lower back (lumbar spine) and hip (trochanter) for people with rheumatoid arthritis who were on low-dose corticosteroids. Evidence suggests vitamin D may work synergistically together with corticosteroids to improve asthma treatment by boosting the effectiveness of corticosteroids or by overcoming resistance to these medications in some patients.