Selenium & CoQ10 for telomere & cardiovascular protection
18th Oct, 2022


Short telomeres are associated with ageing and cardiovascular disease. However, a recent study suggests that long-term coenzyme Q10 (CoQ10) and selenium supplementation can preserve telomere length and reduce cardiovascular mortality (1).

Telomeres are an essential part of human cells that affect how our cells age. They are combinations of DNA and proteins at the end of chromosomes, helping them remain stable. During cell replication, the telomeres function by ensuring the cell's chromosomes do not fuse or rearrange, and with each replication, the telomeres shorten (2,3). Telomere shortening is a well-known hallmark of cellular senescence and ageing, and accelerated telomere shortening is a common feature of age-related diseases (4). Previous studies have demonstrated that oxidative stress and inflammation may contribute to shortened telomere length (5,6) and increase the risk of age-related diseases, such as cardiovascular disease (CVD) (7,8)

Selenium is an essential micronutrient and is included in enzymes (selenoproteins) in the body, which regulate immunity, redox state, and inflammation (9). Selenium may prevent telomere shortening by reducing inflammation and oxidative stress (10). In vitro studies have reported increased telomerase expression and longer telomeres with selenium supplementation (11), and observational studies have demonstrated the association between dietary selenium and telomere length (12,13). However, human clinical studies investigating the benefits of selenium supplementation are lacking.

CoQ10 is another powerful antioxidant primarily present in the mitochondria as part of the electron transport chain. CoQ10 occurs in cells in two related forms, oxidised (ubiquinone) and reduced (ubiquinol). The continual interconversion between these CoQ10 forms is necessary for normal mitochondrial function, energy production and antioxidant protection. In vitro, a modified form of CoQ10 prevented telomere shortening and increased the lifespan of fibroblasts under conditions of mild oxidative stress (14).

Selenium and CoQ10 are interrelated, as the synthesis of CoQ10 and selenoproteins are both dependent on the same metabolic pathway (15). Furthermore, the selenoprotein thioredoxin reductase reduces ubiquinone to its active antioxidant form ubiquinol. Therefore, adequate amounts of both nutrients are necessary for optimal energy production and antioxidant protection. Insufficient serum levels of either selenium or CoQ10 have been associated with an increased risk of cardiovascular disease (15,16).

Dietary intakes of selenium are insufficient in many countries due to the low soil content of selenium (17,18,19). Furthermore, the endogenous production of CoQ10 declines with age, and myocardial production of CoQ10 at the age of 80 years is only half of that obtained at the age of 20 years (20). Previous studies have reported the beneficial effects of combined supplementation with CoQ10 and selenium on CVD mortality, biomarkers relating to oxidative stress, inflammation, and endothelial dysfunction (21,22,23,24,25,26,27,28).

Although research is scarce, it is known that Australian soils are deficient in selenium, and the selenium content in Australian food is declining (29). Furthermore, studies suggest that the mean selenium plasma concentration of Australians is 94 ug/L (30), which is below the recommended daily intake of 100-150 µg/day of selenium, necessary for the optimal expression of selenoprotein P, which transports selenium from the liver to peripheral tissues (31). Therefore, supplementation may be warranted since many Australians have inadequate selenium dietary intakes due to declining soil concentrations, and further studies are required.


Study results

This explorative sub-study analysed data collected from a prospective, randomised, placebo-controlled study involving Swedish citizens low in selenium aged 70-88 years (21). The original study included 443 healthy elderly participants randomly assigned to receive either a placebo or nutrient supplements for four years. The supplements contained CoQ10 (ubiquinone) (200 mg/day) and yeast-derived organic selenium (selenomethionine) (200 µg/day). The follow-up after 5.2 years showed significantly reduced CVD mortality, improved cardiac function and lowered biomarkers of cardiomyocyte damage (21,22).

The daily co-administration of CoQ10 and selenium for four years produced persistent and significant reductions in cardiovascular mortality years after termination of the supplementation. After ten years, the risk of death due to CVD was still 49% lower in those receiving selenium and CoQ10 (25). An equally positive risk reduction was observed in individuals with ischaemic heart disease. After 12 years, the risk of death due to CVD was 41% lower in the selenium + CoQ10 group. As indicated in subgroup analysis, the risk of cardiovascular mortality was significantly reduced in those with diabetes, ischemic heart disease, hypertension, and impaired functional capacity (26).

The new telomere analysis included data from 118 participants of the larger clinical trial, with leukocyte telomere length (LTL) quantified at the start of the study and again after 42 months of supplementation. LTL is believed to reflect telomere length in other cells and tissues, including vascular cells, and has been linked to CVD. There was significantly less shortening of telomeres at 42 months in the selenium + CoQ10 group compared to the placebo. Correlations were also reported after six years of follow-up between those who died of cardiovascular-related causes and shorter telomere length after the study. In addition, less telomere shortening during the follow-up period was associated with significantly longer survival.



The study cannot prove a causal relationship between combined selenium and CoQ10 supplementation, increased telomere shortening and cardiovascular mortality. Furthermore, the differentiated effect of selenium versus CoQ10 cannot be assessed by this study. However, the results suggest that combined supplementation has long-term benefits for cardiovascular mortality in elderly individuals low in selenium. This study builds on a body of research demonstrating the beneficial effects of combined selenium and CoQ10 supplementation on cardiovascular health, including reduced oxidative stress, inflammation, and clot formation, improved cardiac function, and reduced cardiac mortality risk. Further studies are warranted to elucidate the individual and synergistic benefits of CoQ10 and selenium supplementation for human ageing and cardiovascular disease and understand their role in telomere preservation in elderly individuals.

1Opstad TB, Alexander J, Aaseth JO, Larsson A, Seljeflot I, Alehagen U. Selenium and Coenzyme Q10 Intervention Prevents Telomere Attrition, with Association to Reduced Cardiovascular Mortality—Sub-Study of a Randomized Clinical Trial. Nutrients. 2022 Aug 15;14(16):3346.
2Razgonova MP, Zakharenko AM, Golokhvast KS, Thanasoula M, Sarandi E, Nikolouzakis K, Fragkiadaki P, Tsoukalas D, Spandidos DA, Tsatsakis A. Telomerase and telomeres in aging theory and chronographic aging theory. Molecular Medicine Reports. 2020 Sep 1;22(3):1679-94.
3Chakravarti D, LaBella KA, DePinho RA. Telomeres: history, health, and hallmarks of aging. Cell. 2021 Jan 21;184(2):306-22.
4Zhu Y, Liu X, Ding X, Wang F, Geng X. Telomere and its role in the aging pathways: telomere shortening, cell senescence and mitochondria dysfunction. Biogerontology. 2019 Feb;20(1):1-6.
5Gavia-García G, Rosado-Pérez J, Arista-Ugalde TL, Aguiñiga-Sánchez I, Santiago-Osorio E, Mendoza-Núñez VM. Telomere length and oxidative stress and its relation with metabolic syndrome components in the aging. Biology. 2021 Mar 24;10(4):253.
6Erusalimsky JD. Oxidative stress, telomeres and cellular senescence: What non-drug interventions might break the link?. Free Radical Biology and Medicine. 2020 Apr 1;150:87-95.
7Herrmann W, Herrmann M. The importance of telomere shortening for atherosclerosis and mortality. Journal of Cardiovascular Development and Disease. 2020 Aug 6;7(3):29.
8Chiriacò M, Georgiopoulos G, Duranti E, Antonioli L, Puxeddu I, Nannipieri M, Rosada J, Blandizzi C, Taddei S, Virdis A, Masi S. Inflammation and vascular ageing: from telomeres to novel emerging mechanisms. High Blood Pressure & Cardiovascular Prevention. 2019 Aug;26(4):321-9.
9Cardoso BR, Cominetti C, Seale LA. Selenium, Human Health and Chronic Disease. Frontiers in Nutrition. 2021;8.
10Alehagen U, Opstad TB, Alexander J, Larsson A, Aaseth J. Impact of selenium on biomarkers and clinical aspects related to ageing. A review. Biomolecules. 2021 Oct 7;11(10):1478.
11Liu Q, Wang H, Hu DC, Ding CJ, Xiao H, Xu HB, Shu BH, Xu SQ. Effects of sodium selenite on telomerase activity and telomere length. Sheng wu hua xue yu Sheng wu wu li xue bao Acta Biochimica et Biophysica Sinica. 2003 Dec 1;35(12):1117-22.
12Shu Y, Wu M, Yang S, Wang Y, Li H. Association of dietary selenium intake with telomere length in middle-aged and older adults. Clinical Nutrition. 2020 Oct 1;39(10):3086-91.
13Zhang L, Zeng H, Cheng WH. Beneficial and paradoxical roles of selenium at nutritional levels of intake in healthspan and longevity. Free Radical Biology and Medicine. 2018 Nov 1;127:3-13.
14Saretzki G, Murphy MP, Von Zglinicki T. MitoQ counteracts telomere shortening and elongates lifespan of fibroblasts under mild oxidative stress. Aging cell. 2003 Apr 1;2(2):141-3.
15Xia L, Nordman T, Olsson JM, Damdimopoulos A, Björkhem-Bergman L, Nalvarte I, Eriksson LC, Arnér ES, Spyrou G, Björnstedt M. The mammalian cytosolic selenoenzyme thioredoxin reductase reduces ubiquinone: a novel mechanism for defense against oxidative stress. Journal of Biological Chemistry. 2003 Jan 24;278(4):2141-6.
16Hargreaves IP, Mantle D. Supplementation with selenium and coenzyme Q10 in critically ill patients. British Journal of Hospital Medicine. 2019 Oct 2;80(10):589-93.
17Lopes G, Ávila FW, Guilherme LR. Selenium behavior in the soil environment and its implication for human health. Ciência e Agrotecnologia. 2017 Nov;41:605-15.
18Lyons GH, Judson GJ, Ortiz-Monasterio I, Genc Y, Stangoulis JC, Graham RD. Selenium in Australia: selenium status and biofortification of wheat for better health. Journal of Trace Elements in Medicine and Biology. 2005 Sep 19;19(1):75-82.
19Rayman MP. Selenium and human health. The Lancet. 2012 Mar 31;379(9822):1256-68.
20Kalén A, Appelkvist EL, Dallner G. Age-related changes in the lipid compositions of rat and human tissues. Lipids. 1989 Jul;24(7):579-84.
21Alehagen U, Johansson P, Björnstedt M, Rosén A, Dahlström U. 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. 2013 Sep 1;167(5):1860-6.
22Alehagen U, Alexander J, Aaseth J. 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. 2016 Jul 1;11(7):e0157541.
23Alehagen U, Lindahl TL, Aaseth J, Svensson E, Johansson P. 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. 2015 Sep 16;10(9):e0137680.
24Alehagen U, Alexander J, Aaseth J, Larsson A. Decrease in inflammatory biomarker concentration by intervention with selenium and coenzyme Q10: A subanalysis of osteopontin, osteoprotergerin, TNFr1, TNFr2 and TWEAK. Journal of Inflammation. 2019 Dec;16(1):1-9.
25Alehagen U, Aaseth J, Johansson P. 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. 2015 Dec 1;10(12):e0141641.
26Alehagen U, Aaseth J, Alexander J, Johansson P. 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. 2018 Apr 11;13(4):e0193120.
27Alehagen U, Alexander J, Aaseth J, Larsson A, Lindahl TL. 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. European Journal of Nutrition. 2020 Dec;59(8):3581-90.
28Alehagen U, Johansson P, Svensson E, Aaseth J, Alexander J. Improved cardiovascular health by supplementation with selenium and coenzyme Q10: applying structural equation modelling (SEM) to clinical outcomes and biomarkers to explore underlying mechanisms in a prospective randomized double-blind placebo-controlled intervention project in Sweden. European Journal of Nutrition. 2022 Apr 6:1-4.
29McNaughton SA, Marks GC. Selenium content of Australian foods: a review of literature values. Journal of Food Composition and Analysis. 2002 Apr 1;15(2):169-82.
30Lymbury R, Tinggi U, Griffiths L, Rosenfeldt F, Perkins AV. Selenium status of the Australian population: effect of age, gender and cardiovascular disease. Biological trace element research. 2008 Dec;126(1):1-0.
31Shimada BK, Alfulaij N, Seale LA. The impact of selenium deficiency on cardiovascular function. International Journal of Molecular Sciences. 2021 Oct 2;22(19):10713.