Selenium in combination with Coenzyme Q10

Selenocysteine, C3H7NO2Se, is known as the 21st amino acid. It contains selenium as a component. It is a constituent part of the 25 known selenoproteins and selenoenzymes found in the human body. The selenoproteins, in turn, play an important role in the body’s defense against cancer, cardiovascular disease, and neurodegenerative disease.

Selenium is an essential micronutrient for us humans.  It is a component of the selenoproteins that we need for antioxidant protection and for good immune system function.  The selenoproteins glutathione peroxidase, thioredoxin reductase, and selenoprotein P are arguably the most important selenoproteins [Alehagen 2014].

Variability of selenium content and intakes

The soil content of selenium and, thus, the dietary intake of selenium varies considerably around the world.  Consequently, the need for selenium supplementation differs from region to region of the world.  Generally, selenium intakes are lower in Europe than in the United States; there is, however, also considerable variation within the United States.  The safest thing to do is to get a plasma or serum selenium concentration test done.

Minimum daily intakes of selenium

Meanwhile, Professor Urban Alehagen, Linköping University, Sweden, the lead researcher on the KiSel-10 study and a co-researcher on the Q-Symbio study, estimates that adults need a minimum daily intake of 75 – 105 micrograms to achieve optimal plasma activity of the selenium containing enzymes glutathione peroxidase and selenoprotein P [Alehagen 2014].  Professor Alehagen points out that current estimates are that adults need a daily intake of 75 – 125 micrograms of selenium to achieve reduction of the risk of cancer [Alehagen 2014].

Optimal form of the selenium supplement

In the KiSel-10 study, Professor Alehagen chose to use a pharmaceutical-grade organic high-selenium yeast preparation that is made up of numerous selenium species [Alehagen 2014].

The KiSel-10 study was a four-year study of the effect of daily selenium and Coenzyme Q10 supplementation on the heart health of elderly Swedish citizens.  The researchers randomly assigned 443 study participants to an active treatment group receiving 200 micrograms of selenium and 200 milligrams of Coenzyme Q10 daily or to a control group receiving matching placebos.

The data from the KiSel-10 study showed the following significant outcomes of supplementation with selenium and Coenzyme Q10 as compared to the placebo treatment [Alehagen 2013; Johansson 2013]:

  • lower number of deaths from heart disease
  • improved heart muscle function as seen on cardiac ultrasound examinations
  • lower plasma concentration of a known bio-marker for heart failure

Combination of selenium and Coenzyme Q10

In the KiSel-10 study, Professor Alehagen and his colleagues tested the hypothesis that there might be a theoretical advantage to supplementing healthy elderly adults with a combination of selenium and Coenzyme Q10.  The hypothesis was based on four known facts:

  1. There is a documented special bio-medical interrelationship between selenium and Coenzyme Q10 in the human body such that low selenium status restricts the ability of the cells to obtain optimal concentrations of Coenzyme Q10 and such that human cells need adequate levels of Coenzyme Q10 to ensure the optimal function of selenium and selenoproteins [Xia 2003; Nordman 2003].
  2. Patients diagnosed with congestive heart failure have been shown to have lower plasma selenium concentrations than individuals who do not have congestive heart failure [Le Bouil 1992].  Similarly, heart failure patients have been shown to have lower levels of Coenzyme Q10 in heart muscle tissue than individuals without heart failure [Folkers 1985].
  3. From the age of 20, approximately, humans synthesize less and less Coenzyme Q10 with increasing age; the resulting deficit is practically impossible to make up in the diet, and supplementation is required [Kalén 1989].
  4. Statin medications interfere with the synthesis of selenoproteins in the body and with the bio-synthesis of Coenzyme Q10 [Alehagen 2014; Moosman 2004]

The combination of selenium and Coenzyme Q10 supplements

What have we learned from the research carried out by Professor Urban Alehagen and the team of researchers at Linköping University?

  • Oxidative stress, inflammatory disease, and atherosclerosis – these are all associated with increased risk of death from heart disease, both ischemic heart disease and heart failure [Alehagen 2014].
  • Research data show a significant association between the level of oxidative stress and the level of inflammation, which is also associated with increased risk of heart disease [Abramson 2005].
  • Selenium is one of the major antioxidant substances in the human body; it is a component of the selenoproteins that protect against oxidative damage to cells [Alehagen 2014].
  • There is a special bio-medical interrelationship between selenium and Coenzyme Q10 in which each is necessary in adequate concentrations for optimal protection against oxidative stress and inflammation [Alehagen 2014].
  • The results of the KiSel-10 randomized controlled study show that the daily supplementation with a combination of high-selenium yeast and carefully formulated Coenzyme Q10 reduces the levels of bio-markers for both oxidative stress and chronic inflammation [Alehagen 2015].


Abramson, J.L., Hooper, W.C., Jones, D.P., Ashfaq, S., Rhodes, S.D., & Weintraub, W.S. (2005). Association between novel oxidative stress markers and C-reactive protein among adults without clinical coronary heart disease. Atherosclerosis, 178:115–21

Alehagen, U., Johansson, P., Björnstedt, M., Rosén, A., & Dahlström, U. (2013). Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. International Journal of Cardiology, 167(5), 1860-1866. doi:10.1016/j.ijcard.2012.04.156

Alehagen, U., & Aaseth, J. (2014). Selenium and coenzyme Q10 interrelationship in cardiovascular diseases – A clinician’s point of view. Journal of Trace Elements in Medicine and Biology, doi:10.1016/j.jtemb.2014.11.006

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.

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.

Folkers, K., Vadhanavikit, S., & Mortensen, S.A. (1985). Biochemical rationale and myocardial tissue data on the effective therapy of cardiomyopathy with Coenzyme Q10. Proc Natl Acad Sci USA, 82:901–4.

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. doi:10.3109/14017431.2013.820838

Kalen A, Appelkvist EL, Dallner G. (1989). Age-related changes in the lipid compositions of rat and human tissues. Lipids, 24(7):579–584.

Le Bouil, A., Briand, P., Allain, P., Dupuis, J.M., Geslin, P., & Tadei, A. (1992). Plasma selenium in congestive heart failure. Clin Chem, 38:1192–3.

Moosmann, B. & Behl, C. (2004). Selenoproteins, cholesterol-lowering drugs, and the consequences: revisiting of the mevalonate pathway. Trends Cardiovasc Med, 14:273–81

Nordman, T., Xia, L., Björkhem-Bergman, L., Damdimopoulos, A., Nalvarte, I., Arnér, E. J., & Olsson, J. M. (2003). Regeneration of the antioxidant ubiquinol by lipoamide dehydrogenase, thioredoxin reductase and glutathione reductase. Biofactors (Oxford, England), 18(1-4), 45-50.

Xia, L., Nordman, T., Olsson, J. M., Damdimopoulos, A., Björkhem-Bergman, L., Nalvarte, I., & Björnstedt, M. (2003). The mammalian cytosolic selenoenzyme thioredoxin reductase reduces ubiquinone. A novel mechanism for defense against oxidative stress. The Journal of Biological Chemistry, 278(4), 2141-2146.

Disclaimer: The information presented in this review article is not intended as medical advice and should not be construed as such.

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