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Selenium Deficiency and Heart Failure

Heart failure – the inability of the heart muscle to pump a sufficient quantity of blood out to the body – is a debilitating disease, resulting in shortness of breath, congestion in the lungs, and pooling of blood in the lower extremities. Heart failure is equivalent to diminished quality of life.

Mitochondrion
Depiction of a mitochondrion. The mitochondria in our cells convert energy sources such as fatty acids, glucose, and ketones into ATP energy molecules. Sufficient intakes of micronutrients such as selenium, Coenzyme Q10, and zinc are important for mitochondrial energy production and for antioxidant protection of cells, lipids, proteins, and DNA.

The prognosis for heart failure is poor, and the available medical therapies for patients with heart failure are inadequate. New treatment strategies are needed [Mortensen 2015].

Yin et al have analyzed the data from 39,757 adults in a cross-sectional study from the 2005–2018 US National Health and Nutrition Examination Survey. Their findings suggest that high levels of combined dietary antioxidant micronutrients are associated with decreased prevalence of various forms of cardiovascular disease and that selenium has the greatest contribution to this association [Yin 2022]. read more

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Selenium and Immune Function and DNA Repair

Selenium is a trace element essential for for DNA repair, for  good immune function, and for reduced mortality risk.

DNA double helix
Cell studies, animal models, and human clinical trials suggest that an optimal supply of selenium is required to enhance the process of DNA damage repair.

The Micronutrient Information Center maintained by staff members at the Linus Pauling Institute of the Oregon State University provides reliable information about the vitamins and minerals and trace elements used in nutritional supplements.

Today, I want to summarize the information that the Center provides about selenium and supplement that information with the latest scientific research.

An Introduction to Selenium and Selenoproteins

Selenium is a trace element that is essential that humans need for the proper functioning of selenium-dependent selenoproteins. Free selenium is rare in the body. Instead, the selenium in the body is typically a component of selenomethionine, selenocysteine, and methyl-selenocysteine. read more

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Selenium Supplementation and Autoimmune Thyroiditis

Autoimmune thyroiditis is the umbrella term for various types of thyroiditis in which the immune system mistakenly attacks the thyroid gland.

Endocrine glands placement
The thyroid gland is the butterfly-shaped endocrine gland in the lower part of the neck. It plays an essential role in the regulation of our basic metabolism.

The result is often hypothyroidism, the insufficient functioning of the thyroid gland.

The two major types of hypothyroidism are Hashimoto’s disease and atrophic thyroiditis.

Thyroiditis is the medical term for inflammation of the thyroid gland.

Immune system disorder can also cause an overactive thyroid, called hyperthyroidism; Graves’ disease is the most common form.

Selenium Supplementation to Prevent Hypothyroidism

In a 2021 review article, Filipowicz et al assert that many European endocrinologists prescribe selenium supplements to autoimmune thyroiditis patients.

For example, a 2016 survey of 815 doctors (91% endocrinologists) has shown that almost 80% of the surveyed doctors prescribe selenium supplementation to autoimmune thyroiditis patients. The rationale for the selenium supplementation is the delay of the hypothyroidism or a decrease in thyroid antibodies [Filipowicz 2021]. read more

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Selenium and Coenzyme Q10 Combination

The Swedish cardiologist Dr. Urban Alehagen has written persuasively that there exists a special inter-relationship between selenium and Coenzyme Q10 in the prevention of cardiovascular diseases.

Professor Urban Alehagen
Professor Urban Alehagen lecturing about the therapeutic cardiovascular benefits of combined selenium and Coenzyme Q10 supplementation.

Briefly, Prof. Alehagen, together with the Norwegian professor Jan Aaseth, makes the point that low selenium intakes and status could restrict the cells’ ability to get optimal concentrations of Coenzyme Q10 and that the cells need adequate of Coenzyme Q10 to permit optimal function of selenium [Alehagen & Aaseth 2015a].

The clinical outcomes of the KiSel-10 intervention study in which community living Swedish citizens, average age 78 years, were administered selenium and Coenzyme Q10 daily for four years show that combined selenium and Coenzyme Q10 supplementation, compared to placebo treatment, can be beneficial in populations that have low selenium status: read more

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Selenium Supplementation Strengthens Immune Response to Covid-19

The available vaccines do not seem up to the task of preventing infection by the fourth wave of the Covid-19 virus. Accordingly, people in high-risk groups may want to start on a course of supplementation to address possible deficiencies of selenium, zinc, and vitamin D to strengthen their immune response [Alexander 2020].

Covid-19 vaccine
Resistance to Covid-19 and other viral infections, strengthening of immune system function, and reducing chronic inflammation all depend on adequate intakes of zinc, selenium, and vitamin D [Alexander 2020].
In this article, we will address the importance of adequate selenium intakes. Readers are encouraged to google zinc and Covid-19 and vitamin D and Covid-19 on their own.

Early initiation of adequate selenium, zinc, and vitamin D supplementation in high-risk individuals and in high-risk areas and, certainly, as soon as possible after the time of suspected infection with the Covid-19 virus can help the immune system [Alexander 2020]. read more

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Selenium Status and Inflammation and Heart Disease

Low plasma selenium status is significantly associated with heart disease risk and with elevated blood bio-markers of chronic inflammation.  A 2021 cross-sectional study of elderly individuals in central Italy has revealed that individuals with a plasma selenium status lower than 60 mcg/L are especially at risk of heart disease [Giacconi 2021].

Ancona, Italy
Researchers in Ancona, Italy, have done a cross-sectional study that shows that low plasma selenium status is associated with increased risk of heart disease and with elevated levels of blood bio-markers for chronic inflammation.

Moreover, in the peripheral blood mononuclear cells of elderly individuals diagnosed with heart disease, the researchers found that low plasma selenium status was significantly associated with enhanced gene expression of inflammatory cytokines and chemokines and with a downregulation of sirtuins SIRT-1, SIRT-5, SIRT-6, and SIRT-7 [Giacconi 2021].

Note: The peripheral blood mononuclear cells are lymphocytes (e.g., T cells, B cells, NK cells) and monocytes as distinguished from such blood cells as erythrocytes, granulocytes, and platelets. read more

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Serum Selenium Status and Mortality Risk in Individuals with Hypertension

Serum selenium concentrations show a U-shaped association with all-cause mortality and with cardiovascular mortality in individuals with hypertension [Tan 2021].

Blood pressure measuredThis conclusion is based on an analysis of data from 929 individuals diagnosed with hypertension [Tan 2021].

  • The average age of the individuals was 63 years plus/minus 13 years.
  • Slightly more than half of the individuals were male: 53%.
  • The researchers followed the individuals for a mean period of slightly more than ten years: 121 months plus/minus 41 months.
  • During the follow-up period, 307 individuals died, including 56 individuals who died from cardiovascular disease.
Quartiles of Serum Selenium Status

For purposes of analysis, the researchers categorized the individuals with hypertension into quartiles of serum selenium concentration [Tan 2021]:

Q1: equal to or less than 124 mcg/L

Q2: 125-135 mcg/L

Q3: 136-147 mcg/L

Q4: greater than 148 mcg/L

Optimal Serum Selenium Levels in Individuals with Hypertension

The researchers compared the data from the serum selenium quartiles and found that the risk of death from all causes and death from heart disease were lowest in the third quartile (serum selenium concentrations between 136 and 147 mcg/L) [Tan 2021]. read more

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Selenium Status and Mortality and Type 2 Diabetes

Higher serum selenium concentrations are associated with a statistically significant 31% lower all-cause mortality and a statistically significant 34% lower heart disease mortality in individuals with type-2 diabetes [Qiu 2021].

This is the conclusion of researchers who conducted a relatively large cohort study of patients with diabetes with a long follow-up period. They analyzed the data from 3199 American adults with type-2 diabetes; the average follow-up period was 12.6 years [Qiu 2021].

During that follow-up period, 1693 deaths were documented, including 425 heart disease deaths [Qiu 2021].

Highest Quartile of Serum Selenium Compared to Lowest Quartile

Individuals in the highest quartile of serum selenium concentration had significantly lower all-cause mortality rates and significantly lower heart disease mortality rates when compared with individuals in the lowest quartile of serum selenium concentration [Qiu 2021]. read more

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Achieving Optimal Plasma Selenium Status

Hurst et al. administered 50-mcg, 100-mcg, or 200-mcg of selenium daily for ten weeks to 119 healthy men and women aged 50–64 years living in the United Kingdom.

Facial mask
A healthy immune system depends upon an optimal selenium status to promote the bio-synthesis of antioxidant selenoproteins.

The researchers were testing the effect of the different daily dosages on plasma selenium status and plasma selenoprotein P status. They used a pharmaceutical-grade high-selenium yeast preparation with a documented 88.7% absorption [Bügel 2004].

The men and women in the study had a daily dietary selenium intake of approximately 55 mcg/day.  Intakes of selenium in the United Kingdom had fallen from a mean of 60 mcg/day in 1991 to a minimum of 30 to 40 mcg/day in 1995–2000; in 2010, the mean intake was 48–58 mcg/day [Hurst 2010]. read more

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Plasma Selenoprotein P Levels and the Risk of Cardiovascular Disease

Research conclusion: “The 20% with lowest SELENOP concentrations in a N orth European population without history of cardiovascular disease have markedly increased risk of cardiovascular morbidity and mortality” [Schomburg 2019].

Heart attack
Selenoprotein-P deficiency predicts cardiovascular disease and death. Low selenium intakes result in sub-optimal bio-synthesis of selenoprotein P in the liver. Now, research shows that low selenoprotein P concentrations are associated with increased risk of cardiovascular disease and mortality.

This is the conclusion from the Malmö Preventive Project, a population-based prospective cohort study in southern Sweden, that examined the relationship between plasma selenoprotein P status and 1) risk of all-cause mortality, 2) risk of cardiovascular mortality, and 3) risk of a first cardiovascular event in 4366 study participants.

Note that this was a study done with study participants who had no history of cardiovascular disease. It was truly a study of the relationship between selenium status and the risk of heart disease. read more