By Richard N. Podell, M.D., MPH
BACKGROUND: Coenzyme Q10 (CoQ10) has been studied as a useful treatment for patients with congestive heart failure. Selenium has been studied in in relation to brain related disorders. We now explore possible benefits of combining both of these in a study related to brain fog.
SUBJECT OF STUDY: Does a combination of CoQ10 and selenium increase longevity and quality of life? Might they help reduce “brain fog”?
SUMMARY: A high quality double-blind study from Sweden found that older persons who took CoQ10 plus selenium for four years had fewer heart attacks, fewer total deaths and a better quality of life compared to matched controls who took a placebo. Over ten years, heart disease related deaths among those on CoQ10/selenium were only about half the rate compared to those taking placebo. Overall death rates were 18% lower.
Coenzyme Q10 plays a crucial role in energy metabolism. CoQ10 blood levels fall, often dramatically, as we age. The mineral selenium helps activate Coenzyme Q’s antioxidant effects. Therefore, scientists recruited 443 health individuals for a long-term study. Half took supplemental Coenzyme Q10 and selenium for four years. The others took a placebo.
The graph below illustrates cardiovascular mortality over ten years. The top (red) line is the coenzyme Q10/selenium group. The lower (blue) line is for those on placebo.
Quality of Life (QoL) using standard questionnaires was measured at the start of the study and again after four years. After adjusting for baseline heart disease risk factors including age, sex and a biochemical measure called brain natiuretic peptide (BNP), quality of life for the active treatment group was superior to that for those on placebo. This difference was probably not due to chance as the P value was <0.001 (that is, less than one chance in one thousand).
STUDY STRENGTHS: This study has major strengths. It began with 443 volunteers, a fairly large number. They were treated for four years. Death rates were tracked for ten years.
STUDY WEAKNESS: There was one major weakness: 29% of the participants (129 persons) dropped out of the study during the four-year treatment period. This might have compromised the four year Quality of Life data. However, since tracking of medical records is excellent in Sweden, it should not have affected the mortality rates.
TAKEAWAY: This high quality Swedish study provides strong evidence that Coenzyme Q10 plus selenium lowered heart disease and total deaths rates for elderly Swedish men and women. An important qualification is that since we have only this single study, it must be considered tentative until confirmed by other studies. If longevity and quality of life both improve, I would be surprised if this benefit did not also extend to cognition.
RECOMENDATION: Should people consider adding Coenzyme Q and selenium to their daily program, especially persons who are older, and/or suffer from mild cognitive impairment/“brain fog” such as we see with ME/CFS and Fibromyalgia? While no treatment is side-effect free for everyone, at the doses used in this study both COQ10 and selenium are usually considered to be relatively safe. Therefore, if both physician and patient understand the limitations of the data, and acquaint themselves with potential side effects, then adding CoQ10+selenium could be a reasonable option.
Richard Podell, M.D., MPH, is a graduate of Harvard Medical School and the Harvard School of Public Health. He has been treating patients with ME-CFS and Fibromyalgia for more than 20 years.
A clinical professor at New Jersey's Robert Wood Johnson Medical School, Dr. Podell see patients at his Summit, NJ and Somerset, NJ offices. His website is DrPodell.org