Low serum concentrations of selenoprotein P (SELENOP) are an indication of increased heart health risks. Low serum SELENOP is strongly associated with the following risks:
increased risk of a first cardiovascular event
increased risk of cardiovascular mortality
increased risk of all-cause mortality
Selenium is a scarce resource. It is a non-renewable resource. Selenium deficiency is a health problem for one half to one billion people in the world. The UK, the Nordic countries, and the Baltic countries are among the selenium-poor regions in the world.
This is the conclusion from a relatively large study of adults in Sweden. The study participants had no history of cardiovascular disease at the beginning of the study [Schomburg 2019].
There were 3,531 non-smokers and 835 smokers enrolled in the study in Sweden. At the end of the study, the study participants at increased risk of cardiovascular disease had a mean serum SELENOP level below 4.3 mg/L SELENOP. This serum concentration of SELENOP corresponds to serum selenium concentrations of less than 70 mcg/L [Schomburg 2019].read more
The association between the risk of heart disease and dietary intakes of selenium remains unclear. Here we report the results of some of the recent observational studies on this topic.
Risk of Cardiovascular Disease
Plasma selenium levels are generally low in much of Europe, usually well below 80–90 mcg/L whereas in North America, the levels are generally above 120 mcg/L [Alehagen 2022]. Low selenium status is associated with increased heart disease risk.In 2025, Liang et al investigated the relationship between the risk of cardiovascular disease and dietary selenium intake in American adults. The researchers used data from 39,372 participants in the 2003-2018 NHANES cross-sectional study. They found an overall prevalence of cardiovascular disease of 8.57% in the participants. The prevalence of cardiovascular disease declined with increasing dietary selenium intake across tertiles. For example, Tertile 2 of dietary selenium intake showed a 16% reduced risk of cardiovascular disease [Liang 2025].read more
All-cause mortality, cancer mortality, and cardiovascular disease mortality are all three significantly associated with selenium status in the blood. Higher selenium status correlates with lower mortality risk. In particular, the inverse relationship with all-cause mortality was strong among different study populations in different countries and in different study regions. The inverse relationship was strong with different selenium measurement methods, with different study recruitment years, and with different study sizes and study follow-up lengths [Cui 2025].
Nearly a billion people in the world live in selenium-poor regions. Low selenium status in humans is strongly associated with an increased mortality risk.
These are the conclusions from a systematic review and meta-analysis of 20 observational studies that enrolled 67,534 study participants. The studies included 17 studies of all-cause mortality, 7 studies of cancer mortality, and 9 studies of cardiovascular disease mortality. The review shows that a concentration increase of one standard deviation in serum or plasma selenium biomarkers was associated with 13% lower all-cause mortality, 15% lower cancer mortality, and 11% lower cardiovascular mortality [Cui 2025].read more
Reduced risk of heart disease and reduced risk of some cancers. Increasing the daily intake of selenium among individuals with low selenium status may reduce the risk of cardiovascular disease and some cancers. The available data seem to show that most adults in the Nordic and Baltic countries, with the exception of adults in Finland, have low selenium intakes and low selenium status [Alexander & Olsen 2023].
Prof. Jan Alexander, MD, PhD, Norwegian Institute of Public Health in Oslo, says: There are various factors that influence cardiovascular disease mortality and cancer incidence: diet, lifestyle, genetics, inter alia. The impact of these factors varies from one Nordic country to the next.
Selenium is an essential trace element. The human body cannot synthesize it. It must come from the diet and supplements. Selenium is a vital component of selenoproteins that are critical to normal health and physiological functioning. This is the fundamental message from a 2023 selenium scoping review conducted for the Nordic Nutritional Recommendations 2023 [Alexander & Olsen 2023].read more
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.
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
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].
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
Aging. Getting up in years. Striving to live as long as possible and to be as strong and healthy as possible. At some point, good health becomes a more important concern than wealth. Optimal selenium status is important to good health [Alehagen 2021].
Professor Jan Aaseth, MD, PhD, researcher in internal medicine, endocrinology, and toxicology and specialist in selenium research.
In a review article, Professor Urban Alehagen and Professor Jan Aaseth list the following conditions associated with biological aging [Alehagen 2021]:
chronic mild to moderate systemic inflammation
detrimental DNA alterations
mitochondrial dysfunction
oxidative stress caused by harmful free radicals
telomere shortening
Getting old is inevitable. Biological aging necessarily involves a weakening of the immune system and increased susceptibility to diseases and environmental stresses.
Selenium deficiency associated with aging and aging-related diseases
Mitochondrial injuries are an important factor in the aging of human cells. A by-product of the mitochondrial generation of ATP energy in the cells is the production of reactive oxygen species, some of which are useful and some of which are harmful. The leakage of these harmful free radicals from the mitochondrial respiratory chain increases with age, which results in cellular oxidative damage, whenever there are not enough antioxidants to neutralize the effects of the free radicals.read more
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 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 bonecells) 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
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
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 Studyshow 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.
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