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]:
- prevention of the oxidative damage to lipids
- inhibition of platelet aggregation
- reduction of inflammation
Moreover, Professor Rayman has cited a meta-analysis of 25 observational studies. That meta-analysis showed that a 50% increase in selenium concentrations was associated with an average 24% (confidence interval: 7%, 38%) reduction in the risk of coronary heart disease [Flores-Mateo].
Need for intervention studies of selenium supplementation and heart health
Okay, those studies were observational studies. What we need is data from intervention studies, i.e. randomized controlled studies in which there is a treatment group receiving a daily selenium supplement and a control group receiving a matching placebo.
At this writing, 2017, we have some data from well-designed intervention studies using a pharmaceutical-grade organic high-selenium yeast preparation as the test supplement. Let’s take a look.
The UK PRECISE Pilot Study of selenium and cholesterol
Professor Rayman and her research team reported the results from a study enrolling 501 elderly British citizens with low selenium status. In this pilot study, six months of supplementation with both 100 micrograms and 200 micrograms lowered total serum cholesterol and non-HDL cholesterol significantly.
The effect of the selenium supplementation in improving the ratio between total cholesterol and HDL cholesterol suggests that selenium supplementation has a potentially beneficial effect on the risk of heart disease in elderly populations with low selenium status [Rayman 2011].
The KiSel-10 study of combined selenium and Coenzyme Q10 supplementation
The exciting results have come from a study carried out in Sweden by Professor Urban Alehagen and his research colleagues. In the KiSel-10 study, the researchers enrolled 443 elderly citizens from a rural area in Sweden.
The study participants were randomly assigned to an active treatment group receiving 200 micrograms of the organic high-selenium yeast tablets and 200 milligrams of Coenzyme Q10 capsules daily. Study participants randomly assigned to the control group received matching placebos daily. The treatment continued for four years.
Significant benefits of combined selenium and Coenzyme Q10 supplementation
The data from the KiSel-10 study showed the following statistically significant benefits of the combined supplementation compared to the placebo supplementation [Alehagen 2013; Johansson; Alehagen 2015]:
- Reduced risk of death from heart disease
- Less age-related decline in heart function as shown on echocardiograms
- Lower blood levels of the NT-proBNP bio-marker for the severity of heart failure
- Lower blood levels of bio-markers for oxidative stress damage
- Lower blood levels of bio-markers for inflammation
- Reduced need for hospitalization
Ten-year follow-up results of selenium and Coenzyme Q10 supplementation
The Swedish researchers used registers of death certificates and autopsy reports to check the effect of the four-year-long period of combined supplementation on the participants for up to ten years after the intervention. They reported that they did not lose track of a single study participant.
And the results of the follow-up? The significantly reduced risk of death from heart disease persisted during the ten years after the active treatment period of the study. The persistent effect was strong in both genders [Alehagen 2015].
The special inter-relationship between selenium and Coenzyme Q10
Professor Alehagen (Sweden) and Professor Aaseth (Norway) have explained the special inter-relationship between selenium and Coenzyme Q10 in the following way:
- Low selenium status limits the cells’ ability to get optimal concentrations of Coenzyme Q10.
- Sufficient levels of Coenzyme Q10 are needed for the cells to realize optimal function of the selenium containing selenoproteins [Alehagen & Aaseth 2014].
Selenium-Coenzyme Q10 combination for cardiac surgery patients
In 2010, Dr. Franklin Rosenfeldt and a research team in Melbourne, Australia, reported the results of a study in which they randomly assigned 117 coronary artery bypass surgery and/or heart valve surgery to an active treatment group receiving a combination of supplements or to a placebo group [Leong].
The active treatment consisted of the following supplements:
- Coenzyme Q10
- magnesium orotate
- lipoic acid
- omega-3 fatty acids
Treatment in both groups, the active treatment group and the placebo control group, began approximately two months prior to surgery and lasted one month past the surgery.
The results showed that the daily supplement of selenium and Coenzyme Q10 reduced the extent of the oxidative stress damage caused by the surgical procedures and shortened the length of the post-operation hospital stays [Leong]. The supplementation of the surgery patients was safe, inexpensive, and effective.
Selenium-Coenzyme Q10 combination for heart failure patients
In 2005, Dr. Klaus Witte and a research group in the United Kingdom reported the results of a nine-month randomized controlled trial in which heart failure patients were assigned to an active treatment group received a daily dose of selenium and Coenzyme Q10 and other micronutrients or placebos [Witte].
The study data showed that the treatment of elderly heart failure patients with selenium and Coenzyme Q10 and other micronutrients had the following health benefits:
- Improved left ventricular volumes
- Improved left ventricular ejection fraction
- Better quality of life scores
Selenium + Coenzyme Q10 = better heart health
Dr. Rosenfeldt said it best, I think. He said, the adjunctive treatment incorporating daily supplementation with selenium and Coenzyme Q10 was safe, was inexpensive, and saved both the patients and the hospitals money.
Alehagen, U., Aaseth, J., & Johansson, P. (2015). Reduced Cardiovascular Mortality 10 Years after Supplementation with Selenium and Coenzyme Q10 for Four Years: Follow-Up Results of a Prospective Randomized Double-Blind Placebo-Controlled Trial in Elderly Citizens. Plos One, 10(12), e0141641. doi:10.1371/journal.pone.0141641.
Alehagen, U., Aaseth, J., & Johansson, P. (2015). Less increase of copeptin and MR-proADM due to intervention with selenium and coenzyme Q10 combined: Results from a 4-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Biofactors (Oxford, England), 41(6), 443-452. doi:10.1002/biof.1245
Alehagen, U., Lindahl, T. L., Aaseth, J., Svensson, E., & Johansson, P. (2015). Levels of sP-selectin and hs-CRP Decrease with Dietary Intervention with Selenium and Coenzyme Q10 Combined: A Secondary Analysis of a Randomized Clinical Trial. Plos One, 10(9), e0137680. doi:10.1371/journal.pone.0137680
Flores-Mateo, G., Navas-Acien, A., Pastor-Barriuso, R., & Guallar, E. (2006). Selenium and coronary heart disease: a meta-analysis. The American Journal of Clinical Nutrition, 84(4), 762-773.
Johansson, P., Dahlström, Ö., Dahlström, U., & Alehagen, U. (2013). Effect of selenium and Q10 on the cardiac biomarker NT-proBNP. Scandinavian Cardiovascular Journal: SCJ, 47(5), 281-288.
Leong, J., van der Merwe, J., Pepe, S., Bailey, M., Perkins, A., Lymbury, R., & … Rosenfeldt, F. (2010). Perioperative metabolic therapy improves redox status and outcomes in cardiac surgery patients: a randomised trial. Heart, Lung & Circulation, 19(10), 584-591. doi:10.1016/j.hlc.2010.06.659
Rayman, M. P. (2012). Selenium and human health. Lancet (London, England), 379(9822), 1256-1268. doi:10.1016/S0140-6736(11)61452-9.
Rayman, M. P., Stranges, S., Griffin, B. A., Pastor-Barriuso, R., & Guallar, E. (2011). Effect of supplementation with high-selenium yeast on plasma lipids: a randomized trial. Annals of Internal Medicine, 154(10), 656-665. doi:10.7326/0003-4819-154-10-201105170-00005
Witte, K. A., Nikitin, N. P., Parker, A. C., von Haehling, S., Volk, H., Anker, S. D., & … Cleland, J. F. (2005). The effect of micronutrient supplementation on quality-of-life and left ventricular function in elderly patients with chronic heart failure. European Heart Journal, 26(21), 2238-2244.
Disclaimer: The information disseminated in this article is not intended for use as medical advice and should not be regarded as such.