Selenium and heart function in elderly males

Professor Urban Alehagen, Linköping University in Sweden: the changes in the expression of microRNAs — changes that are associated with serum selenium and Coenzyme Q10 concentrations — may be part of the mechanism by which selenium and Coenzyme Q10 contribute to improved heart health.

The randomized controlled clinical trial known as the KiSel-10 study documented that daily supplementation of healthy elderly adults (men and women aged 70 – 88 years) with 200 milligrams of Coenzyme Q10 and 200 micrograms of a high-selenium yeast preparation yields significant health benefits as compared with placebo supplementation:

  • reduced heart disease mortality
  • better heart function
  • fewer signs of chronic low-grade inflammation
  • fewer signs of oxidative stress (cell damage caused by harmful free radicals)

These research findings were/are encouraging for middle-aged adults and for senior citizens, no doubt about it.

The KiSel-10 study of selenium and Coenzyme Q10 treatment
Professor Alehagen and the team of bio-medical researchers in Linköping, Sweden, knew that selenium intakes and selenium status are low in Sweden generally.  They knew, moreover, that the human body’s bio-synthesis of Coenzyme Q10 declines with increasing age to the extent that, typically, an 80-year-old body produces about one half of the Coenzyme Q10 that a 25-year-old body produces.

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Serum selenium level and heart disease

Dietary selenium intakes in the Nordic countries are generally quite low.  In Finland, the situation is different because, there, the government implemented a policy of selenium fertilization of the soil.  As a result, Finns have a much higher selenium intake than their Nordic neighbors. Unfortunately, there is not enough selenium available for every selenium-poor region in the world to use soil fertilization as a solution. Supplementation is the more efficient option.

Daily supplementation for four years with a high-selenium yeast tablet and two Coenzyme Q10 capsules reduced the risk of death from heart disease in elderly men and women aged 70-80 years at the time of enrollment into the KiSel-10 randomized controlled trial.  The effective dosages were 200 micrograms of selenium and 200 milligrams of Coenzyme Q10 (100 milligrams twice a day) [Alehagen 2013].

The daily supplementation also maintained good heart function as documented on echocardiograms and reduced the concentrations of bio-markers for oxidative damage and low-grade inflammation.  Best of all, the beneficial health effects of the selenium and Coenzyme Q10 persisted for up to ten years after the four-year supplementation [Alehagen 2015].

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We must not waste selenium

Selenium exists only in scarce quantities. Adequate dietary and supplemental intakes are vital for human health.  We need to use it carefully, and we need to begin to stockpile it for the use of future generations.

Selenium is a trace element.  It exists only in rare quantities in the world.  It is produced primarily as a by-product of the process of mining copper.  It is not recyclable.  It is very unevenly distributed in the soils of the earth.

Consequently, the availability of selenium in grasses and grains and, at the next stage of the food chain, in animals, varies considerably from region to region in the world. The human dietary intakes of selenium vary accordingly around the world.

Selenium a vital nutrient for humans
Selenium is a necessary micronutrient that our bodies do not produce.  We get our selenium primarily from our diets.  Selenium is important for good immune system function, good thyroid function, good reproductive function, and good protection of our cells’ DNA.

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Selenium and Coenzyme Q10 and heart health

There seems to be a special biological inter-relationship between selenium and Coenzyme Q10 such that, taken in combination, they can provide significant heart health benefits.

In my mind, I keep coming back to the question of heart health and the role that selenium supplements play in heart health.  That may surprise many of you because we tend to think of selenium supplements primarily for the prevention of cancer and for the prevention of thyroid disorders and for protection against the toxic effects of heavy metals like mercury and cadmium.  We know that our immune system needs adequate intakes of selenium if it is to function optimally.  That’s correct, isn’t it?

Selenium supplements and good heart health
But, what about the relationship between selenium intakes and status and heart health?  Writing in the medical journal, The Lancet, Professor Margaret P. Rayman, University of Surrey, in Guildford, United Kingdom, has listed and documented the following ways that adequate selenium status and optimal levels of selenoproteins can potentially benefit the heart [Rayman 2012]:

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Selenium and heart disease

A study of serum selenium levels and supplementation with a patented organic selenium yeast preparation shows an association between serum selenium concentrations and the rate of deaths from heart disease in healthy elderly study participants.

There have been two noteworthy discoveries from a recent randomized controlled trial conducted by Dr. Urban Alehagen of Linköping University (Sweden) and his colleagues.

Firstly, people with low concentrations of selenium in their blood were found to be at significantly higher risk of death from heart disease.

Secondly, a combination of a patented high selenium yeast supplement and a proven Coenzyme Q10 supplement taken daily for four years provided significant protection against heart disease in people with low serum selenium status.

The KiSel-10 study of cardiovascular mortality
The study enrolled 668 healthy elderly individuals aged 70-80 years.  The study was well-designed and well-executed.  One group of 219 randomly selected individuals received 200 micrograms of selenized yeast tablets and 200 milligrams of Coenzyme Q10 capsules daily for four years. A second randomly assigned group of 222 individuals received matching placebos.  The remaining group of 227 individuals received no treatment at all.

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Selenium and heart muscle tissue

Daily nutritional supplementation with a combination of organic high-selenium yeast and Coenzyme Q10 for four years slowed the decline of heart function that is frequently associated with ageing.

The heart muscle tissue is frequently the first tissue in humans to suffer damage caused by selenium deficiency.  When the cell membranes in the heart muscle tissue are damaged by the action of harmful free radicals (this is called oxidative damage), many of the healthy heart muscle cells are replaced by fibrous tissue.  The resulting condition is called cardiomyopathy.

Cardiomyopathy is a disease of the heart muscle in which the heart is enlarged, thick, and rigid [Mayo Clinic].  As the cardiomyopathy worsens, the weakened heart muscle is less and less able to pump adequate quantities of blood to carry oxygen and nutrients to the cells and tissues throughout the body.  Eventually, symptoms such as shortness of breath, early fatigue, and swelling in the legs and feet and abdomen appear, the symptoms of chronic heart failure.

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Statin medications and selenium

Statin medications. What do we know? Yes, the statins are good at inhibiting the body’s own production of cholesterol. But the statins have the unintended side-effect of also inhibiting the body’s production of Coenzyme Q10 and of inhibiting the body’s ability to form selenoproteins. The inhibition of Coenzyme Q10 and selenoprotein production may lead to premature ageing and to  degenerative diseases.

Statin medications: good news and bad news?  On the one hand, statin medications are effective at reducing cholesterol levels, and, are good, apparently, at reducing the number of deaths from heart attacks.   On the other hand, we have seen a very considerable rise in the number of cases of chronic heart failure … in the same period that statin medications have been prescribed.  Drs. Okuyama and Langsjoen and their colleagues have explained the pharmacological mechanisms by which this medical paradox may be occurring [Okuyama].

Statins inhibit the body’s production of Coenzyme Q10
Okay, I was aware of the evidence from well-designed studies linking the taking of statin medications to decreased plasma levels of Coenzyme Q10.   Coenzyme Q10 is an important factor in cellular energy production and is an important lipid-soluble antioxidant [Folkers, Littarru, McMurray].  And I knew that the energy-deprived heart is a failing heart [Folkers, Molyneux, Mortensen].  So, I knew that anyone taking a statin medication needs to talk to his or her cardiologist about taking a good Coenzyme Q10 supplement.

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Daily intakes of selenium

Dietary intakes of selenium vary considerably from person to person and region to region. Selenium supplements are necessary to raise selenium status sufficiently to prevent oxidative damage to the cells, to improve immune function, and to reduce the risk of cancer and heart disease.

How much selenium from food and supplements do we need on a daily basis?  Which bio-markers of optimal selenium status seem to be most useful to answer this question?  Dr. Rachel Hurst and Dr. Susan J. Fairweather-Tait, Norwich Medical School, United Kingdom, and their colleagues set out to find answers.    The design of their study is very interesting.

They enrolled 119 healthy British men and women aged 50 – 64 years in a randomized, double-blind, placebo-controlled study that lasted 12 weeks [Hurst]. They excluded the following persons from the study:

  • smokers
  • overweight people
  • people with already high plasma selenium status
  • people with long-term illnesses
  • people on various medications
  • people unwilling to discontinue taking vitamins and herbal remedies at least one month prior to the start of the study

The 119 study participants received either placebo or one of the following treatments:

  • selenium-enriched yeast tablets containing 50, 100, or 200 micrograms of a patented organic selenium (SelenoPrecise® preparation delivered by Pharma Nord, Denmark)
  • selenium-enriched onion meals that provided the equivalent of 50 micrograms of selenium per day
  • unenriched onion meals that provided the equivalent of less than 4 micrograms of selenium per day

Measurements of selenium
Remember:
Selenium is a trace element.  We measure its intake in micrograms per day, not milligrams.  We measure selenium status in plasma and serum in terms of micrograms per liter (or equivalently, in nanograms per milliliter).  Selenium in toenails or hair, then, we measure in micrograms per gram.

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What is a high selenium yeast supplement?

Baker’s yeast and brewer’s yeast and high selenium yeast … all strains of the same species of yeast … Saccharomyces cerevisiae … High selenium yeast preparations are the most effective form of selenium supplements. The yeast in the tablets is dead and inactive. There is no risk of a yeast infection from a high selenium yeast preparation.

The trace element selenium is an essential component of the selenium-dependent enzymes called selenoproteins.  We need these selenoproteins for the optimal biological functioning of our cells.  Specifically, we need adequate daily intakes of selenium for the protection of cellular DNA, for successful reproduction, for proper thyroid gland function, for protection against infections, for anti-oxidative protection against the damage caused by free radicals, and for the prevention of cancer and heart disease.

What form of selenium is best?
Many of us cannot get enough selenium in our diets, especially if we do not regularly eat Brazil nuts (very high in selenium) or if we eat relatively little meat and fish.  However, there are various supplemental forms of selenium available to us as consumers.

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Our bodies cannot make selenium for us

Cancer studies
The research base for supplementation with selenium shows the need for adequate daily selenium intakes and adequate selenium status. The formulation and the dosage of the selenium supplement are very important.

Daily selenium intakes?  We need to get this essential trace element – selenium — in our diets and in our supplements because our bodies cannot make it for us. The work of Dr. Gerhard N. Schrauzer, Dr. Raymond J. Shamberger, and Dr. Douglas V. Frost has shown that there is an inverse relationship between our selenium status and the risk of cancer mortality.  Animal studies show an inverse correlation between selenium status and incidence of cancer.  Observational studies show lower risk of various types of cancer with higher selenium status.

Intervention studies of selenium supplementation and cancer
Clinical studies in China
Large interventional studies in China, a region of the world with selenium-poor soils and foodstuffs, have shown that selenium supplements protect against hepatitis B virus and primary liver cancer [Yu] and that supplementation with a combination of selenium and other antioxidants reduces cancer incidence and mortality in a region characterized by high cancer mortality rates [Blot].

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