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Dr. Urban Alehagen, MD, PhD, has been a practicing cardiologist since 1992 at Linkoping University Hospital in southern Sweden. He commits 30% of his time to research, 50% to clinical work and the rest to other research activities.
In Sweden the government is running out of money. They don’t have enough beds in the hospitals. The have to come up with more cost effective strategies in dealing with chronic diseases and maintaining good health for their population. Dr. Alehagen became aware of research in 2003 that showed a synergy between selenium and CoQ10 for optimal cellular functioning. CoQ10 is critical for energy production in the cell, is a very powerful cell protecting antioxidant and adequate levels are critical for the proper functioning of key selenium dependent enzymes. Selenium is a critical cofactor for 25 different enzymes of which three of the most important are: selenoprotein P (Sepp1); glutathione peroxidase (GPx); and thioredoxin reductase (TrxR).
Selenium Deficiency in Europe, Australia and New Zealand
Dr. Alehagen notes it is well known that Europeans, Australians and New Zealanders have reduced levels of selenium. In the United States the general population is getting enough selenium but there is increased need for selenium with 1) disease states 2) getting older 3) breast feeding 4) wounds and 5) in the post-operative hospitalized patient. In the U.S. subjects might have adequate selenium going into the hospital but post-operatively they become selenium deficient. CoQ10 was added to this research protocol because as one ages cellular CoQ10 levels get lower and optimal levels of CoQ10 are needed for optimal functioning of selenium dependent enzymes. And the reverse is true – optimal selenium levels are needed for optimal cellular functioning of CoQ10.
Ubquinone and Yeast Bound Selenium
Ubiquinone was the form of CoQ10 used because it was 1) cheaper 2) the body converts ubquinone to ubiquinol easily which is the form the body uses 3) the company that supplies the CoQ10, Pharma Nord ApS (Denmark), has a patented crystalline architecture which was shown from researchers in Spain that this formulation of ubiquinone had a higher bioavailability than ubiquinol.
The supplement doses used in their study were ubiquinone 100 mg 2 x daily and yeast bound selenium 100 mcg 2 x daily. It didn’t matter if it was given with food or not, the important thing was to give the nutrients at the same time each day. Yeast bound selenium was used because it is 2-3 times more bioavailable than other forms of selenium.
This study evaluated healthy retired Swedish subjects with this above dose regimen for 4 years and the 5 year it was shown that there was a significant reduction in cardiac mortality in the supplemented group, reduced inflammation markers, and improvement in cardiac function documented through echocardiographic assessment.
Dr. Alehagen in a second study evaluated subjects with the same nutrient protocol for fibrosis and collagen formation. Pulsewave velocity and echocardiogram parameters improved. There was also a reduction in 6-7 biomarkers of inflammation, reduced markers of fibrosis and an increase in IGF1 levels.
In a “Perfect” World…
A goal would be to reduce hospitalization and prevent cardiovascular disease by the use of these supplements in the general Swedish population, at least in those who are low in selenium and CoQ10. Finland provided an example of successful public policy change. In 1970 reduced selenium in the Finnish population resulted in a 3 fold increase risk of cardiovascular mortality. In 1986 the Finnish government added selenium to fertilizers. This resulted in a reduction in cardiovascular mortality, stroke incidence and cardiovascular disease. It would be reasonable for the Swedes to fortify their soil as well where selenium is low. Dr. Alehagen would like the government to support adult Swedes into taking this CoQ10 and selenium combination as well.
The Use of Statins and Coenzyme Q10
Statins are used by Dr. Alehagen and he especially notes their anti-inflammatory benefit unlike other lipid lowering agents. It is noted that statins reduce endogenous CoQ10 production by 40%. In those with stain-induced muscle pain he will give CoQ10. He does not routinely measure CoQ10 levels in patients. He assumes they have low levels, especially if they are statin users. He finds about 1/3 of patients with statin-induced side effects respond to CoQ10 supplementation with reduction in muscle pain. He aims for a blood level of CoQ10 of 2.5 when he tests for CoQ10.
Conclusion
When Dr. Alehagen and his team started this research none of his fellow researchers, including himself, believed that the CoQ10 and selenium would work. When they got the positive study results he and all of his fellow researchers started to take this combination of selenium and CoQ10. He has been taking this CoQ10 and selenium combination since 2011. He feels the most important things to do are 1) eat good, real and natural food 2) get exercise and 3) and periodic vascular health screening. Dr. Alehagen’s screening of choice for himself is basic lipids and he measures his own arterial stiffness to follow the health of his arteries.
References
Supplementation with Selenium and Coenzyme Q10 Reduces Cardiovascular Mortality in Elderly with Low Selenium Status. A Secondary Analysis of a Randomised Clinical Trial.
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.
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.
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.
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.
Less fibrosis in elderly subjects supplemented with selenium and coenzyme Q10-A mechanism behind reduced cardiovascular mortality?
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