What makes selenium and Coenzyme Q10 a good heart health combination supplement? Here, of course, we are talking about supplementation of individuals who have low selenium and CoQ10 blood levels.
Selenium and Heart Disease
Heart disease. The evidence from clinical studies is increasing. Selenium deficiency is associated with an increased risk of heart trouble [Bomer 2020]. Selenium supplementation of elderly individuals who have low selenium status is associated with improved survival, improved heart function, and improved quality of life [Alehagen 2013].
Especially in northern Europe, clinical studies show the relationship between the need for selenium and the risk of heart disease. This makes sense because the dietary selenium intake in northern Europe is considerably lower than the dietary selenium intake in much of the United States. Consequently, the mean plasma selenium concentrations in Europe tend to be well below 80–90 mcg/L. In the USA, on the other hand, the mean plasma selenium concentrations are generally above 120 mcg/L [Alehagen 2022].
Selenium and Thyroid Health
Good thyroid health depends, in part, upon the bio-synthesis of selenium-dependent seleno-enzymes called deiodinases. These seleno-enzymes are key factors in thyroid hormone metabolism and regulation. Thyroid hormones regulate the body’s metabolism (think: energy expenditure, body weight, body temperature, digestion, heart rate, etc.).
There are three types of deiodinase enzymes. In normal thyroid function, these deiodinases regulate the activation and inactivation of the T4 and T3 thyroid hormones, as needed. Abnormal thyroid hormone function is closely associated with diminished health-related quality of life and with increased risk of cardiovascular morbidity and mortality.
In many selenium-poor regions of the world, including much of Europe and the Middle East, low selenium intake and status may cause sub-optimal synthesis of deiodinase enzymes and, consequently, sub-optimal thyroid gland function. Selenium is an essential trace element found in soil, and humans must get it from their food.
Selenium and Coenzyme Q10 Supplementation for Senior Citizens
In senior citizens, and delayed aging and longevity are associated with the antioxidant and anti-inflammatory protection derived from daily supplementation with selenium and Coenzyme Q10 [Alehagen 2023].
The KiSel-10 Study was a randomized, double-blind, placebo-controlled clinical trial of the effect of combined selenium and CoQ10 supplementation of senior citizens on cardiovascular mortality.
Researchers administered 200 micrograms of selenium in a selenium-rich yeast preparation and 200 milligrams of Coenzyme Q10 in the ubiquinone form or matching placebos to community living senior citizens daily for 48 months [Alehagen 2013].
Summary of Statistically Significant KiSel-10 Study Outcomes
- reduction of cardiovascular mortality in the active treatment group vs. the placebo group (5.9% vs. 12.6%) and better cardiac function observed on echocardiograms in the active supplementation group compared to the placebo group [Alehagen 2013]
- reduction of plasma levels of the N-terminal natriuretic peptide (NT-proBNP), a bio-marker for increased risk of heart failure [Johansson 2013]
- improvement of health-related quality of life and fewer days in hospital [Johansson 2015]
- reduction of cardiovascular mortality in senior citizens with low serum selenium status [Alehagen 2016a; Alehagen 2016b]
- reduction of cardiovascular mortality that persisted after 10 and 12 years in the supplemented group and in subgroups with diabetes, hypertension, ischemic heart disease, and reduced functional capacity due to impaired cardiac function [Alehagen 2015a; Alehagen 2018]
- reduction of plasma levels of two bio-markers for oxidative damage [Alehagen 2015c]
- reduction of plasma levels of six bio-markers for systemic inflammation [Alehagen 2015b; Alehagen 2019b]
- reduction of serum levels of seven bio-markers for fibrosis [Alehagen 2017b]
- reduction of plasma levels of bio-markers for endothelial dysfunction [Alehagen 2020c]
- increase in plasma levels of insulin-like growth factor-1, attenuating an age-related decline in IGF-1 concentrations [Alehagen 2017a]
- reduction of fructosamine concentration compared with the concentration in the placebo group, which tended to increase, important because fructosamine concentration is positively associated with incidence of diabetes and increased blood glucose level [Alehagen 2020b]
- improvement of renal function in elderly citizens deficient in selenium [Alehagen 2020a]
- prevention of an increase in D-dimer levels, which are associated with increased risk of thrombotic disorders [Alehagen 2021]
- association with significant changes in metabolic profiles and with significant changes in the pentose phosphate, the mevalonate, the beta-oxidation, and the xanthine oxidase pathways [Alehagen 2019a]
- association with significant changes in circulating microRNA [Alehagen 2017c]
- structural equation modelling that shows that antioxidant and anti-inflammatory effects are the primary underlying biological mechanisms to explain the success of the KiSel-10 study [Alehagen 2022b]
- decrease in concentrations of fibroblast growth factor 23 (FGF-23) [Alehagen 2022a]
- less shortening of leukocyte telomere length [Opstad 2022]
- increase in serum SIRT1 concentrations [Opstad 2023]
- improvement in serum free thiol levels, supporting a reduction in systemic oxidative stress [Dunning 2023]
- positive effects on five age-related blood biomarkers – ICAM-1, adiponectin, leptin, stem cell factor, and osteoprotegerin – indicating an anti-aging direction compared to placebo [Alehagen 2023].
Conclusion: Delayed aging and longevity associated with Selenium and Coenzyme Q10 for senior citizens
Professor Urban Alehagen and Professor Jan Aaseth have explained an important biological interrelationship between selenium and Coenzyme Q10 and pointed to a theoretical advantage in using both substances in an intervention if there are deficiencies within the population [Alehagen 2015d].
Selenium and Systemic Oxidative Stress
Oxidative stress. A new study shows that selenium supplementation together with Coenzyme Q10 supplementation reduces the levels of systemic oxidative stress in the body. In the study, the reduction of systemic oxidative stress is significantly associated with a reduction in the risk of death from cardiovascular diseases [Dunning & Alehagen 2023].
Oxidative stress: An imbalance of harmful free radicals vis-à-vis protective antioxidants leads to oxidative damage to DNA, lipids, and proteins in the body and to a disruption of redox signaling processes in the cells [Dunning & Alehagen 2023].
In a 2023 KiSel-10 sub-analysis, Prof. Urban Alehagen and his research colleagues investigated the level of free thiols in the serum of elderly study participants taking 200 mcg of selenium and 200 mg of Coenzyme Q10 daily for 48 months [Dunning & Alehagen 2023].
Selenium Supplementation for Senior Citizens
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
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 Study show 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.
However, there seems to be an association between FGF-23 activity and cardiovascular mortality even in the absence of kidney disease. Experimental data show that FGF-23 may act as a mediator for cardiac hypertrophy, cardiac fibrosis, and cardiac dysfunction [Alehagen 2022b].
Antioxidant Action of Selenium and Selenoproteins
Antioxidants. Several selenoproteins play important roles as antioxidant enzymes in the protection of the cells and the mitochondria against the oxidative damage caused by harmful free radicals. Prominent among the antioxidant seleno-enzymes are the glutathione peroxidases and the thioredoxin reductases [Alehagen 2022].
In many regions of the world, notably in much of Europe and the Middle East, there is selenium-poor soil and selenium-poor foodstuffs. In Sweden, for example, the average daily intake of selenium among senior citizens
is approximately 35 mcg/day, well below the amounts (110–150 mcg/day) needed for an optimal expression of the selenoprotein antioxidants [Alehagen 2022].
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.
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].
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.
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: