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].

Measuring fibroblast growth factor 23 levels may be a useful future technique to provide information on cardiovascular function and prognosis [Alehagen Feb 2022].

Why Selenium and Coenzyme Q10 for senior citizens?

First of all, there is a reduced intake of selenium in many countries because of the low levels of selenium in the soil and in the food. Low intakes and low status of selenium are associated with an increased risk cardiovascular disease and mortality. Several selenoproteins are expressed in the heart and have important functions in redox regulation and protection against inflammation and oxidative stress [Al-Mubarak 2021].

To achieve an optimal expression of one of the important selenoproteins in plasma, the selenoprotein P, which is the transporter of selenium from the liver to the peripheral tissues, adult humans need an estimated daily intake of 100–150 mcg of selenium daily [Alehagen Sep 2022].

Secondly, endogenous bio-synthesis of Coenzyme Q10 decreases with increasing age once humans reach maturity. Adequate supply of Coenzyme Q10 is needed both for its essential role in the cellular generation of ATP energy and for its role as a lipid-soluble antioxidant protecting against free radical damage [Kalén 1989; Gutierrez-Mariscal 2019].

The American cardiologist Peter Langsjoen says that significant benefit in the treatment of heart disease requires supplementation sufficient to raise plasma/serum CoQ10 levels to 2.5 mg/L and raising plasma/serum CoQ10 levels to 3.5 mg/L is necessary for a therapeutic effect on neurodegenerative diseases [Langsjoen 2014].

Thirdly, the documented outcomes of the KiSel-10 study have shown the beneficial effects of combined selenium and CoQ10 supplements in senior citizens known to have a low status of both substances [Alehagen 2013; Alehagen 2018]:

  • reduced synthesis of the N-terminal-proBNP, a blood biomarker for the risk of heart failure
  • increased cardiac systolic function
  • reduced cardiovascular disease mortality
  • reduced levels of several blood biomarkers for inflammation, oxidative stress, and fibrosis
  • improved endothelial function as shown in the reduced levels of the blood biomarkers plasminogen activator inhibitor 1 and the von Willebrand factor
How Selenium and Coenzyme Q10 Affect Fibroblast Growth Factor 23?

Supplementation with selenium and Coenzyme Q10 for 48 months was associated with a significantly lower level of Fibroblast Growth Factor 23, as compared to the effect of placebo [Alehagen Feb 2022].

During 10 years of follow-up, Professor Alehagen and the KiSel-10 researchers saw two things of note [Alehagen Feb 2022]:

  • The study participants who later died a cardiovascular death had had a significantly higher Fibroblast Growth Factor 23 concentration after 48 months compared with the study participants who survived.
  • The study participants with significantly lower Fibroblast Growth Factor 23 concentrations were also study participants with a normal renal function compared to the study participants with impaired renal function.
Conclusion: Prevention of Heart Disease with selenium and Coenzyme Q10

Daily supplementation of senior citizens (average age: 78 years) with selenium and Coenzyme Q10 prevented an increase of Fibroblast Growth Factor 23 and reduced the risk of death from cardiovascular disease [Alehagen Feb 2022].

At present, the best evidence is that a selenium-enriched yeast product similar to the one used in the KiSel-10 Study is a better choice than a 100% selenomethionine product [Richie 2014]. The selenium-enriched yeast product contains several selenium species and provides a variety of species similar to the diversity of species found in food; the different species of selenium may have different functions in the body.


Al-Mubarak, A.A.; van der Meer, P.; Bomer, N. Selenium, selenoproteins, and heart failure: current knowledge and future perspectives. Curr. Heart Fail. Rep. 2021;18:122–131.

Alehagen U, Aaseth J, Larsson A, Alexander J. Decreased Concentration of Fibroblast Growth Factor 23 (FGF-23) as a Result of Supplementation with Selenium and Coenzyme Q10 in an Elderly Swedish Population: A Sub-Analysis. Cells. 2022 Feb 1;11(3):509.

Alehagen U, Johansson P, Svensson E, Aaseth J, Alexander J. Improved cardiovascular health by supplementation with selenium and coenzyme Q10: applying structural equation modelling (SEM) to clinical outcomes and biomarkers to explore underlying mechanisms in a prospective randomized double-blind placebo-controlled intervention project in Sweden. Eur J Nutr. 2022 Sep;61(6):3135-3148.

Alehagen U, Aaseth J, Alexander J, Johansson P. Still reduced cardiovascular mortality 12 years after supplementation with selenium and coenzyme Q10 for four years: A validation of previous 10-year follow-up results of a prospective randomized double-blind placebo-controlled trial in elderly. PLoS One. 2018 Apr 11;13(4):e0193120.

Alehagen U, Johansson P, Björnstedt M, Rosén A, Dahlström U. 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. Int J Cardiol. 2013 Sep 1;167(5):1860-6.

Gutierrez-Mariscal FM, Yubero-Serrano EM, Villalba JM, Lopez-Miranda J. Coenzyme Q10: From bench to clinic in aging diseases, a translational review. Crit Rev Food Sci Nutr. 2019;59(14):2240-2257.

Kalén A, Appelkvist EL, Dallner G. Age-related changes in the lipid compositions of rat and human tissues. Lipids. 1989 Jul;24(7):579-84.

Langsjoen PH, Langsjoen AM. Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone. Clin Pharmacol Drug Dev. 2014 Jan;3(1):13-7.

Richie JP Jr, Das A, Calcagnotto AM, Sinha R, Neidig W, Liao J, Lengerich EJ, Berg A, Hartman TJ, Ciccarella A, Baker A, Kaag MG, Goodin S, DiPaola RS, El-Bayoumy K. Comparative effects of two different forms of selenium on oxidative stress biomarkers in healthy men: a randomized clinical trial. Cancer Prev Res (Phila). 2014 Aug;7(8):796-804.

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

30 September 2022


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