Selenium and Coenzyme Q10 for Senior Citizens

Like a good detective inspector, Professor Urban Alehagen has investigated the biological mechanisms that could explain how combined selenium and Coenzyme Q10 supplementation reduces the risk of death from heart disease in senior citizens. Among the suspects that he has investigated are oxidative stress, systemic inflammation, fibrosis, and endothelial function.

Four years of daily supplementation with 200 micrograms of a patented high-selenium yeast and 200 milligrams of Coenzyme Q10 (in divided doses: 2 x 100 milligrams) has lowered the risk of dying from cardiovascular disease significantly by 54% (p=0.02) [Alehagen 2013].

The study participants were senior citizens aged 70-88 years (average age: 78 years) who were still able to live at home.

Professor Urban Alehagen and a team of researchers from Linköping University in Sweden randomly assigned the senior citizens to take the active treatment (selenium plus Coenzyme Q10) or matching placebos in a double-blind clinical study named the KiSel-10 Study [Alehagen 2013].

Improved Heart Function with Coenzyme Q10 and Selenium

Compared to the senior citizens in the placebo group, the senior citizens in the active treatment group had a significant improvement in heart function as measured on echocardiograms compared to placebo (p=0.03) and a significant improvement in a biochemical marker, NT-proBNP (p=0.014). NT-proBNP is a reliable indicator for heart disease; the heart muscle typically produces more of the NT-proBNP protein whenever the heart is exposed to stress or injury [Alehagen 2013].

Special Interrelationship Between Coenzyme Q10 and Selenium

In deciding upon the active treatment combining selenium with Coenzyme Q10, Professor Alehagen drew on research showing that there is a key intracellular relationship between the two substances [Alehagen 2013]. Basically, the research showed that less than optimal levels of selenium will restrict the cells’ ability to achieve optimal concentrations of Coenzyme Q10 and that the cells are dependent on adequate levels of Coenzyme Q10 to realize the optimal function of selenium [Alehagen & Aaseth 2015].

Mechanisms of Heart Protection with Coenzyme Q10 and Selenium

Professor Alehagen and the research team carried out a number of sub-studies to investigate the possible biological mechanisms that could explain the beneficial heart health effects of the combined selenium and Coenzyme Q10 supplementation: the reduced risk of death from heart disease and the improved heart function seen on echocardiograms.

Reduced Levels of Bio-Markers of Oxidative Stress [Alehagen 2015]
Reduced Levels of Bio-Markers of Systemic Inflammation [Alehagen 2015; Alehagen 2018]
Reduced Levels of Bio-Markers of Fibrosis [Alehagen 2017]
Reduced Levels of Bio-Markers Indicating Endothelial Dysfunction [Alehagen 2020]
Increased Levels of Bio-Markers of Insulin-like Growth Factor-1 [Alehagen 2017]
Clear Differences in the Metabolic Profiles Seen in Plasma of the Active Treatment Group and the Placebo Group [Alehagen 2019]
Clear Differences in the Status of Several microRNAs between the Active Treatment Group and the Placebo Group [Alehagen 2017]

Persistent Effects of the Coenzyme Q10 and Selenium Treatment

With access to information in the Swedish National Registry of Mortality death certificates and in autopsy reports, Professor Alehagen was able to follow-up on the study participants for up to 10 and 12 years following the four-year intervention period. No study participant was lost to follow-up [Alehagen 2015; Alehagen 2018].

The significantly reduced risk of death from heart disease, first reported in 2013, was seen to persist for the entire 12-year follow-up period in the study participants who had received the Coenzyme Q10 and selenium combination. Sub-group analysis of the data showed that the effect persisted in both males and females.

Summary: Combined Selenium and Coenzyme Q10 Supplementation

48 months of daily supplementation with a combination of high selenium yeast and Coenzyme Q10 Coenzyme Q10 was associated with significantly reduced risk of death from heart disease and with significantly improved heart function in community dwelling senior citizens. The reduced risk of death from heart disease has persisted through 12 years of follow-up [Alehagen 2018].

Take-home messages:

People living in selenium-poor regions will need selenium supplementation; it is best to have one’s selenium status tested.
People normally bio-synthesize less and less Coenzyme Q10 as they age. Hence the need for a documented CoQ10 supplement.
Selenium and Coenzyme Q10 have a special interrelationship that promotes good cardiovascular health.
The mechanisms by which selenium and Coenzyme Q10 protect heart function have not been fully explained but are thought to include beneficial effects on oxidative stress, inflammation, fibrosis, and endothelial function.
High-selenium yeast containing as many as 20 different species of selenium is the best form of selenium supplement [Richie 2014].
It is important to select a Coenzyme Q10 supplement with documented absorbability.
Selenium and Coenzyme Q10 supplements are safe, effective, and affordable.

References

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.

Alehagen, U., & Aaseth, J. (2015). Selenium and Coenzyme Q10 interrelationship in cardiovascular diseases–A clinician’s point of view. Journal of Trace Elements in Medicine and Biology, 31: 157-162.

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.

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.

Alehagen, U., Aaseth, J., & Johansson, P. (2015). Reduced Cardiovascular Mortality 10 Years after Supplementation with Selenium and Coenzyme Q10 for Four Years: Follow-Up Results of a Prospective Randomized Double-Blind Placebo-Controlled Trial in Elderly Citizens. Plos One, 10(12), e0141641.

Alehagen, U., Alexander, J., & Aaseth, J. (2016). Supplementation with Selenium and Coenzyme Q10 Reduces Cardiovascular Mortality in Elderly with Low Selenium Status. A Secondary Analysis of a Randomised Clinical Trial. Plos One, 11(7), e0157541.

Alehagen, U., Johansson, P., Aaseth, J., Alexander, J., & Wågsäter, D. (2017). Significant changes in circulating microRNA by dietary supplementation of selenium and Coenzyme Q10 in healthy elderly males. A subgroup analysis of a prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Plos One, 12(4), e0174880.

Alehagen, U., Johansson, P., Aaseth, J., Alexander, J., & Brismar, K. (2017). Increase in insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 1 after supplementation with selenium and Coenzyme Q10. A prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Plos One, 12(6), e0178614.

Alehagen, U., Aaseth, J., Alexander, J., Svensson, E., Johansson, P., & Larsson, A. (2017). Less fibrosis in elderly subjects supplemented with selenium and coenzyme Q10-A mechanism behind reduced cardiovascular mortality? Biofactors (Oxford, England), doi:10.1002/biof.1404

Alehagen, U., Aaseth, J., Alexander, J., & Johansson, P. (2018). 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, 13(4), e0193120.

Alehagen, U., Alexander, J., Aaseth, J. & Larsson, A. (2019). Decrease in inflammatory biomarker concentration by intervention with selenium and Coenzyme Q10: a sub-analysis of osteopontin, osteoprotergerin, TNFr1, TNFr2, and TWEAK. Journal of Inflammation, 16,5,1-9.

Alehagen U, Johansson P, Aaseth J, Alexander J, Surowiec I, Lundstedt-Enkel K & Lundstedt T. (2019). Significant changes in metabolic profiles after intervention with selenium and Coenzyme Q10 in an elderly population. Biomolecules, 9(10): 10.3390/biom9100553.

Alehagen, U., Alexander, J., Aaseth, J. et al. (2020). Significant decrease of von Willebrand factor and plasminogen activator inhibitor-1 by providing supplementation with selenium and coenzyme Q10 to an elderly population with a low selenium status. Eur J Nutr. Epub.

Richie, JP, Das, A, Calcagnotto, AM, Sinha, et al. (2014). Comparative effects of two different forms of selenium on oxidative stress biomarkers in healthy men: A randomized clinical trial. Cancer Prev Res (Phila); 7(8): 796-804.

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

16 March 2020