Selenium and Heart Disease

Heart disease. The evidence from clinical studies is increasing. Selenium deficiency is associated with an increased risk of heart trouble [Bomer 2020]. Selenium supplementation of elderly individuals who have low selenium status is associated with improved survival, improved heart function, and improved quality of life [Alehagen 2013].

Map of Europe
Selenium intakes and selenium status in countries in northern Europe are generally quite low. Consequently, clinical trials conducted in northern Europe tend to be more valuable than clinical trials conducted in the USA where dietary selenium intakes are considerably higher for the most part.

Especially in northern Europe, clinical studies show the relationship between the need for selenium and the risk of heart disease. This makes sense because the dietary selenium intake in northern Europe is considerably lower than the dietary selenium intake in much of the United States. Consequently, the mean plasma selenium concentrations in Europe tend to be well below 80–90 mcg/L. In the USA, on the other hand, the mean plasma selenium concentrations are generally above 120 mcg/L [Alehagen 2022]. read more

Heart Failure Risk and Selenium Deficiency

Low plasma selenoprotein P levels are associated with a higher risk of heart failure in a Swedish population [Jujic 2023].

Heart rate
Selenium deficiency in heart failure patients is significantly associated with increased risk of cardiovascular mortality, impaired exercise capacity, and poorer quality of life [Bomer 2020].
Selenoprotein P is the primary protein transporter of selenium in the blood.

Plasma and serum selenoprotein P concentrations are useful biomarkers of selenium status in individuals with relatively low selenium intakes because selenoprotein P responds to different intake forms of selenium [Hurst 2010].

Selenium deficiency – defined as serum selenium concentrations below 70 mcg/L – has been associated with more severe symptoms of heart failure, poorer exercise capacity, and poorer quality of life. Sub-optimal serum selenium concentrations of 70–100 mcg/L have similar adverse associations, suggesting that values less than 100 mcg/L, might be considered abnormal [Bomer 2020]. read more

Selenium and Coenzyme Q10 Supplementation for Senior Citizens

In senior citizens, and delayed aging and longevity are associated with the antioxidant and anti-inflammatory protection derived  from daily supplementation with selenium and Coenzyme Q10 [Alehagen 2023].

Elderly couple dancing
Daily supplementation with selenium and Coenzyme Q10 seems to have a positive influence on longevity and delayed aging.

The KiSel-10 Study was a randomized, double-blind, placebo-controlled clinical trial of the effect of combined selenium and CoQ10 supplementation of senior citizens on cardiovascular mortality.

Researchers administered 200 micrograms of selenium in a selenium-rich yeast preparation and 200 milligrams of Coenzyme Q10 in the ubiquinone form or matching placebos to community living senior citizens daily for 48 months [Alehagen 2013].

Summary of Statistically Significant KiSel-10 Study Outcomes
  • reduction of cardiovascular mortality in the active treatment group vs. the placebo group (5.9% vs. 12.6%) and better cardiac function observed on echocardiograms in the active supplementation group compared to the placebo group [Alehagen 2013]
  • reduction of plasma levels of the N-terminal natriuretic peptide (NT-proBNP), a bio-marker for increased risk of heart failure [Johansson 2013]
  • improvement of health-related quality of life and fewer days in hospital [Johansson 2015]
  • reduction of cardiovascular mortality in senior citizens with low serum selenium status [Alehagen 2016a; Alehagen 2016b]
  • reduction of cardiovascular mortality that persisted after 10 and 12 years in the supplemented group and in subgroups with diabetes, hypertension, ischemic heart disease, and reduced functional capacity due to impaired cardiac function [Alehagen 2015a; Alehagen 2018]
  • reduction of plasma levels of two bio-markers for oxidative damage [Alehagen 2015c]
  • reduction of plasma levels of six bio-markers for systemic inflammation [Alehagen 2015b; Alehagen 2019b]
  • reduction of serum levels of seven bio-markers for fibrosis [Alehagen 2017b]
  • reduction of plasma levels of bio-markers for endothelial dysfunction [Alehagen 2020c]
  • increase in plasma levels of insulin-like growth factor-1, attenuating an age-related decline in IGF-1 concentrations [Alehagen 2017a]
  • reduction of fructosamine concentration compared with the concentration in the placebo group, which tended to increase, important because fructosamine concentration is positively associated with incidence of diabetes and increased blood glucose level [Alehagen 2020b]
  • improvement of renal function in elderly citizens deficient in selenium [Alehagen 2020a]
  • prevention of an increase in D-dimer levels, which are associated with increased risk of thrombotic disorders [Alehagen 2021]
  • association with significant changes in metabolic profiles and with significant changes in the pentose phosphate, the mevalonate, the beta-oxidation, and the xanthine oxidase pathways [Alehagen 2019a]
  • association with significant changes in circulating microRNA [Alehagen 2017c]
  • structural equation modelling that shows that antioxidant and anti-inflammatory effects are the primary underlying biological mechanisms to explain the success of the KiSel-10 study [Alehagen 2022b]
  • decrease in concentrations of fibroblast growth factor 23 (FGF-23) [Alehagen 2022a]
  • less shortening of leukocyte telomere length [Opstad 2022]
  • increase in serum SIRT1 concentrations [Opstad 2023]
  • improvement in serum free thiol levels, supporting a reduction in systemic oxidative stress [Dunning 2023]
  • positive effects on five age-related blood biomarkers – ICAM-1, adiponectin, leptin, stem cell factor, and osteoprotegerin – indicating an anti-aging direction compared to placebo [Alehagen 2023].
Conclusion: Delayed aging and longevity associated with Selenium and Coenzyme Q10 for senior citizens

Professor Urban Alehagen and Professor Jan Aaseth have explained an important biological interrelationship between selenium and Coenzyme Q10 and pointed to a theoretical advantage in using both substances in an intervention if there are deficiencies within the population [Alehagen 2015d]. read more

Selenium Protects Against Cadmium Poisoning and Atherosclerosis

Cadmium leaking from iron water pipes into drinking water may be a primary cause of increased risk of atherosclerosis – the increased risk of a buildup of plaque on the inside of the artery walls with inflammation as a consequence. This is the thesis of the Danish cardiologist Anton Dorph-Petersen.

Heart attack
Cadmium from drinking water accumulates in the body and causes damage to the layer of cells lining the inside of arteries, leading to a buildup of plaque and to increased risk of atherosclerosis and heart attack. Cadmium is a heavy metal that is found everywhere in the earth. Cadmium accumulates primarily in the liver and kidneys with toxic effects on the kidneys in particular. People with insufficient selenium and iron accumulate more cadmium. Cadmium takes a long time to be eliminated from the body. Iron water pipes and cigarette smoking are significant sources of cadmium in the body.

Dr. Dorph-Petersen asserts that the danger of cadmium toxicity is greatest in regions of the world in which the selenium content of the soil and plants is low and in regions of the world in which there is low dietary intake of selenium containing fish [Dorph-Petersen 2017].

Let me lay out Dr. Dorph-Petersen’s reasoning step by step. His hypothesis has not yet been verified by clinical trials.

However, we do know from a survey of 15,689 study participants in the US that low blood selenium and high blood cadmium are independent risk factors for heart failure. read more

Selenium and Systemic Oxidative Stress

Oxidative stress. A new study shows that selenium supplementation together with Coenzyme Q10 supplementation reduces the levels of systemic oxidative stress in the body.  In the study, the reduction of systemic oxidative stress is significantly associated with a reduction in the risk of death from cardiovascular diseases [Dunning & Alehagen 2023].

Prof Urban Alehagen
Prof. Urban Alehagen, lead researcher on the KiSel-10 Study, the study that has shown that combined selenium and Coenzyme Q10 supplementation reduces oxidative stress and inflammation levels, improves heart function, and reduces the risk of cardiovascular disease mortality.

Oxidative stress: An imbalance of harmful free radicals vis-à-vis protective antioxidants leads to oxidative damage to DNA, lipids, and proteins in the body and to a disruption of redox signaling processes in the cells [Dunning & Alehagen 2023].

In a 2023 KiSel-10 sub-analysis, Prof. Urban Alehagen and his research colleagues investigated the level of free thiols in the serum of elderly study participants taking 200 mcg of selenium and 200 mg of Coenzyme Q10 daily for 48 months [Dunning & Alehagen 2023]. read more

Selenium Supplementation Increases Serum Sirtuin1 Concentrations

Daily supplementation with 200 mcg of selenium and 200 mg of Coenzyme Q10 for four years has resulted in significant increases in serum SIRT1 concentrations. In the parallel placebo group, the serum SIRT1 concentrations decreased significantly [Opstad, Alehagen 2023].

Selenium Researcher Professor Jan Aaseth
Professor Jan Olav Aaseth, Inland Norway University of Applied Sciences, is the guest author on this review article. Dr. Aaseth has written extensively about selenium in health and disease. He is one of the co-authors on the Sirtuin1 study summarized here.

This is the latest evidence from the KiSel-10 Study in which researchers randomly assigned elderly community-living Swedish men and women, average age: 76 years, 49% female, to a combined selenium and Coenzyme Q10 treatment group or to a placebo group [Alehagen 2013].

In earlier papers, the KiSel-10 Study researchers have reported beneficial effects of the combined supplementation of the elderly Swedish citizens with low baseline selenium levels [Alehagen 2022; Opstad 2022]: read more

Selenium and Coenzyme Q10 Supplementation To Prevent Heart Disease

Heart disease prevention. In the KiSel-10 Study, combined supplementation of community living senior citizens for four years with an organic high selenium yeast (200 mcg selenium/day) and Coenzyme Q10 in the ubiquinone form (2 x 100 mg/day) prevented an increase in fibroblast growth factor 23 and reduced the risk of cardiovascular disease [Alehagen Feb 2022].

what is fibroblast growth Factor 23?
Prof. Urban Alehagen
Prof. Urban Alehagen was among the first cardiologists to suspect that low selenium intakes might increase the risk of death from heart disease. He designed and conducted the KiSel-10 Study to test the hypothesis that combined selenium and Coenzyme Q10 supplementation might reduce the risk of cardiovascular disease.

Professor Urban Alehagen explains that fibroblast growth factor 23 is a hormone that is secreted primarily from the osteocytes (i.e., mature bone cells) into the blood. From the blood circulation, the hormone acts on fibroblast growth factor receptors in the heart, intestine, kidney, and parathyroid gland [Alehagen Feb 2022].

Fibroblast growth factor 23 is mainly active in the metabolism of vitamin D and phosphorus. However, there have been reports that indicate an association between increased fibroblast growth factor 23 levels and cardiovascular mortality even in the patients with no sign of kidney disease [Alehagen Feb 2022]. read more

Selenium and Coenzyme Q10 Slow Down Telomere Shortening

Anti-aging effects. Longevity.  Telomere length.  Daily supplementation of senior citizens with selenium and Coenzyme Q10 for 42 months slowed down telomere shortening and reduced the risk of death from cardiovascular disease [Opstad 2022]. The two substances in combination — selenium and Coenzyme Q10 — may be the key to slowing down biological ageing.

What Are Telomeres? Why Are They Important?
Prof Urban Alehagen
The latest sub-study of the KiSel-10 Study data shows that combined selenium and CoQ10 supplementation not only reduces the risk of death from heart disease but also has anti-ageing properties. Pictured here: Professor Urban Alehagen.

Telomeres are the segments of DNA sequences that protect the ends of chromosomes from becoming frayed or tangled. Every time a cell divides, the telomeres become a little bit shorter. When, with increasing age, the telomeres become too short, the cell cannot divide successfully, and the cell dies [National Human Genome Research Institute 2022]. read more

Selenium Supplementation for Senior Citizens

Health benefits of daily supplementation of senior citizens with a combination of selenium and Coenzyme Q10:

  • improved heart function as shown on echocardiograms
  • reduced risk of death from heart disease
  • improved health-related quality of life
Professor Urban Alehagen
In the KiSel-10 Study, Prof. Urban Alehagen and the research team administered 200 mcg/day of selenium and 2 x 100 mg/day of Coenzyme Q10 for 48 months to elderly Swedish citizens whose serum selenium status at baseline was quite low (mean: 67.1 mcg/L). The duration of the study was 48 months. The benefits of the supplementation were improved heart function and reduced risk of death from heart disease.

The combined supplementation seems to work by reducing the extent of oxidative stress, systemic inflammation, and fibrosis in the study participants [Alehagen 2022a].

Now, data from the KiSel-10 Study show the following effects of the combined supplementation with respect to Fibroblast Growth Factor 23 concentrations in blood:

  • Supplementation decreased concentrations of FGF-23 hormones.
  • The study showed a relationship between the circulating level of the FGF-23 and atrial fibrillation.
  • The study showed an association between the concentration of FGF-23 and death from heart disease.
  • The study showed an effect of reduced FGF-23 levels on the risk of death from heart disease that is independent of the level of the cardiac wall tension bio-marker NT-proBNP.
  • There exists a close interrelationship between FGF-23 concentrations and kidney function.
Why are FGF-23 Concentrations Important?

Prof. Alehagen explains that FGF-23 is a hormone that is secreted into the blood circulation. One of its primary functions is the regulation of the vitamin D metabolism and of the phosphorous metabolism in the kidneys.

However, there seems to be an association between FGF-23 activity and cardiovascular mortality even in the absence of kidney disease. Experimental data show that FGF-23 may act as a mediator for cardiac hypertrophy, cardiac fibrosis, and cardiac dysfunction [Alehagen 2022b]. read more

Antioxidant Action of Selenium and Selenoproteins

Antioxidants. Several selenoproteins play important roles as antioxidant enzymes in the protection of the cells and the mitochondria against the oxidative damage caused by harmful free radicals. Prominent among the antioxidant seleno-enzymes are the glutathione peroxidases and the thioredoxin reductases [Alehagen 2022].

Professor Urban Alehagen
Professor Urban Alehagen, the lead researcher on the KiSel-10 Study, estimates that a daily selenium intake of 110-150 mcg per day is necessary to achieve optimal expression of selenoprotein P, one of the most important selenoproteins in the plasma and the main transporter of selenium in the blood [Alehagen 2022].
Note: Oxidative stress is the bio-medical term for an imbalance in the relationship of 1) harmful free radicals, mostly of the reactive oxygen species, and 2) protective antioxidants, which should neutralize the harmful free radicals.

In many regions of the world, notably in much of Europe and the Middle East, there is selenium-poor soil and selenium-poor foodstuffs. In Sweden, for example, the average daily intake of selenium among senior citizens
is approximately 35 mcg/day, well below the amounts (110–150 mcg/day) needed for an optimal expression of the selenoprotein antioxidants [Alehagen 2022].
read more