Selenium Status and Heart Failure

Heart failure patients with low serum selenium levels are much more likely to be re-hospitalized and/or to die than are heart failure patients with serum selenium levels above 100 micrograms per liter.

A multi-national cohort study has shown that selenium deficiency in heart failure patients is associated with impaired exercise tolerance and with a 50% higher mortality rate [Bomer].

In-vitro studies of cultured human heart muscle cells from the heart failure patients show that  low selenium levels in the heart muscle cells are associated with impaired mitochondrial function [Bomer].

Recent information shows that up to 50% of heart failure patients suffer from some form of micronutrient insufficiency, e.g. selenium, zinc, iron, or iodine [Bomer].

Selenium: An Essential Micronutrient

Selenium intakes and status vary considerably from geographical region to region according to the content of selenium in the soil and in the food.

Sufficient intakes of selenium are necessary for important biological functions: read more

Metabolic Changes After Supplementation with Selenium and Coenzyme Q10

Professor Urban Alehagen’s research has shown that there is a relatively high mortality risk in elderly Swedish subjects with low selenium intakes and low selenium status. Senior citizens in Sweden had, on average, serum selenium concentrations of 67.1 micrograms per liter. The same increased mortality risk seen in Sweden may be typical of other selenium-poor regions of the world as well.

There are clear differences in the metabolic profiles of elderly men who took 200 micrograms of selenium and 2 x 100 milligrams of Coenzyme Q10 daily for at least 18 months as compared with the metabolic profiles of elderly men who took matching placebos [Alehagen 2019].

Drawing on data from a sub-analysis of the KiSel-10 Study, Professor Urban Alehagen reported that the major differences were seen primarily in the following biological pathways [Alehagen 2019]:

  • pentose phosphate pathway (the pathway for the generation of nicotinamide adenine dinucleotide phosphate, which is a substance that reduces ubiquinone Coenzyme Q10)
  • mevalonate pathway (the pathway for the synthesis of cholesterol, Coenzyme Q10, and dolichol)
  • beta-oxidation pathway (the pathway for the breaking down of fatty acid molecules to produce energy and to produce acetyl-CoA, FADH2 and NADH, which are needed for the citric acid cycle [Krebs cycle]

There were other significant metabolic changes associated with the selenium and Coenzyme Q10 supplementation of senior citizens as well [Alehagen 2019].

Changes in Metabolic Profile After Supplementation with Selenium and Coenzyme Q10

In this study, Professor Alehagen and his team of researchers analyzed the metabolic patterns of 95 metabolites in the plasma of elderly men. read more

Selenium and Coenzyme Q10 for Senior Citizens

Professor Urban Alehagen, Linköping University, Sweden, was one of the key researchers on the Q-Symbio clinical trial and has been the lead researcher on the KiSel-10 clinical trial. He has shown that joint selenium and Coenzyme Q10 supplementation of senior citizens with low selenium status reduces the risk of cardiovascular mortality and improves heart function.

The Swedish KiSel-10 Study provides randomized controlled trial evidence that a daily combination of an organic high-selenium yeast supplement and a pharmaceutical-grade Coenzyme Q10 supplement can reduce cardiovascular mortality, improve heart function, and increase health-related quality of life in senior citizens [Alehagen 2013].

Low blood selenium concentrations and higher risk of heart disease

Professor Urban Alehagen and a team of researchers from Linköping University investigated the blood selenium levels in 688 Swedish senior citizens.  The mean blood selenium level was 67.1 micrograms per liter, which is quite low but not surprising, given that Sweden is a country with selenium-low soil and selenium-poor foodstuffs [Alehagen 2016].

When the researchers adjusted for gender, smoking, coronary artery disease, diabetes, chronic obstructive pulmonary disease, and impaired heart function, they found that the quartile of senior citizens with the lowest level of blood selenium had a 43% higher risk of all-cause mortality and a 56% higher risk of cardiovascular mortality [Alehagen 2016]. read more

Low serum selenium levels and increased cardiovascular mortality

A recent study has found a relatively high mortality risk in elderly Swedish subjects with low selenium status. Supplementation with a high-selenium yeast supplement and a Coenzyme Q10 supplement for four years resulted in significantly reduced risk of death from heart disease, better maintained heart function, and better quality of life for senior citizens. The beneficial effect of the supplementation has persisted through the 12th year of follow-up.

Low plasma/serum selenium concentrations are associated with increased risk of death from heart disease and increased risk of death from all causes.  Professor Urban Alehagen and a team of researchers at Linköping University in Sweden have investigated the relationship between low selenium levels and the risk of heart disease.

Selenium supplements suggested for adults with very low Se levels

The Swedish study shows that adults with a serum selenium concentration below 57 micrograms per liter are at significantly higher risk of death from all causes (43% increased risk) and death from heart disease (56% increased risk) [Alehagen 2016].
57 micrograms of selenium per liter of serum.  Wow!  That’s low.

These significant associations remained solid even after the researchers had adjusted for the effects of possibly modifying factors: read more

Long-term health protection of Selenium and Coenzyme Q10

The KiSel-10 study was done in Sweden, which is known to have selenium-poor soil and selenium-low foodstuffs. Consequently, daily supplementation with 200 micrograms of a high-selenium yeast preparations was appropriate. In geographical regions with higher levels of selenium in the soil and in the food, lesser selenium dosages may be needed. Selenium is an essential micro-nutrient, it has known antioxidant functions in the body, and it is associated with good thyroid health and good immune system defense.

Combining high-selenium yeast and Coenzyme Q10 supplements gives elderly people in low selenium regions good protection against heart disease.  That seems to be the take-home lesson from a 12-year follow-up analysis of the Swedish KiSel-10 study [Alehagen 2018].

Protective effects of selenium and CoQ10 persist 12 years

Originally, Professor Urban Alehagen and researchers at the University in Linköping enrolled 443 elderly Swedish citizens who were living in a community in which selenium intakes in the food were known to be low. They randomly assigned the study participants to take a combination of 200 micrograms of selenium in a high-selenium yeast tablet and 200 milligrams of Coenzyme Q10 daily or to take matching placebos.  The supplementation study lasted for four years [Alehagen 2013]. read more

Selenium and Coenzyme Q10 and heart protection

Healthy aging is the goal of us all. We want to remain physically active and mentally alert as long as we can. A study of the supplementation of elderly Swedish citizens has shown that daily supplementation with high-selenium yeast tablets and Coenzyme Q10 capsules significantly reduced the rate of death from heart disease. Depicted here: symptoms of heart attack.

Leading cardiologists in Sweden conducted a four-year study — the KiSel-10 study — of 443 of the elderly Swedish citizens and found that a prophylactic treatment with 200 micrograms of high-selenium yeast and 200 milligrams of Coenzyme Q10 daily reduces the risk of dying from heart disease by over 50 per cent.  This is an immensely interesting study result because heart disease is the number one killer in Western countries.

The KiSel-10 Study

The KiSel-10 clinical trial — a randomized, double-blind, placebo-controlled study–  investigated the effect of a combination of high-selenium yeast tablets and Coenzyme Q10 capsules, as compared with matching placebo capsules and tablets, on the following outcomes: read more

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. read more

Low serum selenium status and increased mortality

Too few studies have investigated the relationship between low serum selenium status and negative health effects. Professor Urban Alehagen from Linköping University in Sweden has published the results of a study showing that low serum selenium status is significantly associated with increased cardiovascular and all-cause mortality.

During an almost seven-year follow-up period, elderly healthy Swedish citizens with low serum selenium concentrations had significantly increased cardiovascular mortality and total mortality rates compared to contemporaries with higher serum selenium concentrations.  Specifically, there was a 56% increased risk for cardiovascular mortality and a 43% increased risk for all-cause mortality.  Accordingly, the Swedish researchers suggested that selenium supplementation should be recommended to all Swedish citizens with a serum selenium concentration below 57 micrograms per liter [Alehagen 2016].

In fact, Professor Urban Alehagen and his team of researchers at Linköping University pointed out that the average serum selenium concentrations observed in the study of elderly Swedish citizens – 67.1 micrograms per liter – is not sufficient to achieve optimal function of the important selenoproteins that require selenium as a component [Alehagen 2016]: read more

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. read more

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]. read more