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Apart from female and male infertility (41, 42), Se deficiency was connected to heart disease (possibly fatal congestive dilated cardiomyopathy, including endemic Keshan disease), musculoskeletal and neuromuscular disorders (e.g., KashinBeck disease), thyroid function dysfunction, disrupted immune function, poor response to acute and chronic infections (including COVID-19, Coxsackie, influenza, and HIV viral infections), chronic inflammation, cancer (including colonic, gastric, pulmonary, and prostate carcinoma), and other disorders (40, 4348)

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Sublingual administration, which bypasses the gastrointestinal tract, appears to be equally effective as IM injections while being less invasive and more cost-efficientparticularly in patients with atrophic gastritis, post-gastrectomy status, or conditions that impair intrinsic factor-mediated absorption, where long-term intervention is often required

Supplementary material The Supplementary Material for this article can be found online at: Supplementary Figure 1 Absolute BALF cell counts from allergen and cytokine challenged mice