The journal of nutrition, health & aging

, Volume 23, Issue 6, pp 595–601 | Cite as

Ionized and Total Magnesium Levels Change during Repeated Exercise in Older Adults

  • Rieneke TerinkEmail author
  • M. G. Balvers
  • C. C. W. G. Bongers
  • T. M. H. Eijsvogels
  • R. F. Witkamp
  • M. Mensink
  • M. T. Hopman
  • J. M. T. Klein Gunnewiek



Magnesium is essential for health and performance. Sub-optimal levels have been reported for older persons. In addition, physical exercise is known to temporally decrease magnesium blood concentrations.


To investigate these observations in conjunction we assessed total (tMg) and ionized magnesium (iMg) concentrations in plasma and whole blood, respectively, during 4 consecutive days of exercise in very old vital adults. Design: 68 participants (age 83.7±1.9 years) were monitored on 4 consecutive days at which they walked 30–40km (average ∼8 hours) per day at a self-determined pace. Blood samples were collected one or two days prior to the start of exercise (baseline) and every walking day immediately post-exercise. Samples were analysed for tMg and iMg levels.


Baseline tMg and iMg levels were 0.85±0.07 and 0.47±0.07 mmol/L, respectively. iMg decreased after the first walking day (−0.10±0.09 mmol/L, p<.001), increased after the second (+0.11±0.07 mmol/L, p<.001), was unchanged after the third and decreased on the final walking day, all compared to the previous day. tMg was only higher after the third walking day compared to the second walking day (p=.012). In 88% of the participants, iMg levels reached values considered to be sub-optimal at day 1, in 16% of the participants values were sub-optimal for tMg at day 2.


Prolonged moderate intensity exercise caused acute effects on iMg levels in a degree comparable to that after a bout of intensive exercise. These effects were not associated with drop-out or health problems. After the second consecutive day of exercise, levels were returned to baseline values, suggesting rapid adaptation/resilience in this population.

Key words

Older adults consecutive exercise days micronutrients reference values 



Analysis of variance


Body mass index


heart rate


ionized magnesium


Lithium heparine




Revolutions per minute


total magnesium


  1. 1.
    de Baaij, J.H., J.G. Hoenderop, and R.J. Bindels, Magnesium in man: implications for health and disease. Physiol Rev, 2015. 95(1): p. 1–46.CrossRefPubMedGoogle Scholar
  2. 2.
    Finstad, E.W., et al., The effects of magnesium supplementation on exercise performance. Med Sci Sports Exerc, 2001. 33(3): p. 493–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Lukaski, H.C., Magnesium, zinc, and chromium nutriture and physical activity. Am J Clin Nutr, 2000. 72(2 Suppl): p. 585s–93s.CrossRefPubMedGoogle Scholar
  4. 4.
    Lukaski, H.C., Vitamin and mineral status: effects on physical performance. Nutrition, 2004. 20(7–8): p. 632–44.CrossRefPubMedGoogle Scholar
  5. 5.
    Konishi, M., Cytoplasmic free concentrations of Ca2+ and Mg2+ in skeletal muscle fibers at rest and during contraction. Jpn J Physiol, 1998. 48(6): p. 421–38.CrossRefPubMedGoogle Scholar
  6. 6.
    Singh, R.B., et al., Mechanisms of acute myocardial infarction study (MAMIS). Biomed Pharmacother, 2004. 58Suppl 1: p. S111–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Welch, A.A., et al., Dietary Magnesium Is Positively Associated With Skeletal Muscle Power and Indices of Muscle Mass and May Attenuate the Association Between Circulating C-Reactive Protein and Muscle Mass in Women. J Bone Miner Res, 2016. 31(2): p. 317–25.CrossRefPubMedGoogle Scholar
  8. 8.
    Barbagallo, M., M. Belvedere, and L.J. Dominguez, Magnesium homeostasis and aging. Magnes Res, 2009. 22(4): p. 235–46.PubMedGoogle Scholar
  9. 9.
    Durlach, J., et al., Magnesium status and ageing: an update. Magnes Res, 1998. 11(1): p. 25–42.PubMedGoogle Scholar
  10. 10.
    Park, C.H., et al., The association between the use of proton pump inhibitors and the risk of hypomagnesemia: a systematic review and meta-analysis. PLoS One, 2014. 9(11): p. e112558.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Elin, R.J., Assessment of magnesium status for diagnosis and therapy. Magnes Res, 2010. 23(4): p. S194–8.PubMedGoogle Scholar
  12. 12.
    Buchman, A.L., et al., The effect of a marathon run on plasma and urine mineral and metal concentrations. J Am Coll Nutr, 1998. 17(2): p. 124–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Scherr, J., et al., Repolarization perturbation and hypomagnesemia after extreme exercise. Med Sci Sports Exerc, 2012. 44(9): p. 1637–43.CrossRefPubMedGoogle Scholar
  14. 14.
    Mooren, F.C., et al., Alterations of ionized Mg2+ in human blood after exercise. Life Sci, 2005. 77(11): p. 1211–25.CrossRefPubMedGoogle Scholar
  15. 15.
    Terink, R., et al., Decrease in Ionized and Total Magnesium Blood Concentrations in Endurance Athletes Following an Exercise Bout Restores Within Hours - Potential Consequences for Monitoring and Supplementation. Int J Sport Nutr Exerc Metab, 2016: p. 1–22.Google Scholar
  16. 16.
    Durlach, J., et al., Importance of the ratio between ionized and total Mg in serum or plasma: new data on the regulation of Mg status and practical importance of total Mg concentration in the investigation of Mg imbalance. Magnes Res, 2002. 15(3–4): p. 203–5.PubMedGoogle Scholar
  17. 17.
    Ising, H., et al., Measurement of free magnesium in blood, serum and plasma with an ion-sensitive electrode. Eur J Clin Chem Clin Biochem, 1995. 33(6): p. 365–71.PubMedGoogle Scholar
  18. 18.
    Tanaka, H., K.D. Monahan, and D.R. Seals, Age-predicted maximal heart rate revisited. J Am Coll Cardiol, 2001. 37(1): p. 153–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Dill, D.B. and D.L. Costill, Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol, 1974.37(2): p. 247–8.CrossRefGoogle Scholar
  20. 20.
    American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription: Lippincott Williams & Wilkins; 2013. p 5.Google Scholar
  21. 21.
    Rayana, M.C., et al., Guidelines for sampling, measuring and reporting ionized magnesium in undiluted serum, plasma or blood: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC): IFCC Scientific Division, Committee on Point of Care Testing. Clin Chem Lab Med, 2005. 43(5): p. 564–9.PubMedGoogle Scholar
  22. 22.
    Rakhra, G., et al., Effect of physical activity and age on plasma copper, zinc, iron, and magnesium concentration in physically active healthy males. Nutrition, 2017. 43–44: p. 75–82.CrossRefPubMedGoogle Scholar
  23. 23.
    Khan, M.U., B.O. Komolafe, and K.T. Weber, Cation interdependency in acute stressor states. Am J Med Sci, 2013. 345(5): p. 401–4.CrossRefPubMedGoogle Scholar
  24. 24.
    Vormann J, Förster R, Günther T, Ebel H, editors. Lipolysis induced magnesium uptake into fat-cells. Magnesium-bulletin; 1982: 201–2.Google Scholar
  25. 25.
    Franz, K.B., et al., Physiologic changes during a marathon, with special reference to magnesium. J Am Coll Nutr, 1985. 4(2): p. 187–94.CrossRefPubMedGoogle Scholar
  26. 26.
    Singh, R. and R.G. Sirisinghe, Haematological and plasma electrolyte changes after long distance running in high heat and humidity. Singapore Med J, 1999. 40(2): p. 84–7.PubMedGoogle Scholar
  27. 27.
    Convertino, V.A., Blood volume response to physical activity and inactivity. Am J Med Sci, 2007. 334(1): p. 72–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Warburton, D.E., et al., Biochemical changes as a result of prolonged strenuous exercise. Br J Sports Med, 2002. 36(4): p. 301–3.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Saris, N.E., et al., Magnesium. An update on physiological, clinical and analytical aspects. Clin Chim Acta, 2000. 294(1–2): p. 1–26.CrossRefGoogle Scholar
  30. 30.
    Feeney, K.A., et al., Daily magnesium fluxes regulate cellular timekeeping and energy balance. Nature, 2016. 532(7599): p. 375–9.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Serdi and Springer-Verlag International SAS, part of Springer Nature 2019

Authors and Affiliations

  • Rieneke Terink
    • 1
    • 4
    Email author
  • M. G. Balvers
    • 1
    • 2
  • C. C. W. G. Bongers
    • 3
  • T. M. H. Eijsvogels
    • 3
  • R. F. Witkamp
    • 1
  • M. Mensink
    • 1
  • M. T. Hopman
    • 3
  • J. M. T. Klein Gunnewiek
    • 2
  1. 1.Division of Human Nutrition & HealthWageningen University & Research (WUR)Wageningenthe Netherlands
  2. 2.Clinical Chemistry and Haematology LaboratoryGelderse Vallei Hospital (ZGV)Edethe Netherlands
  3. 3.Radboud Institute for Health Sciences, Department of PhysiologyRadboud university medical centerNijmegenthe Netherlands
  4. 4.Wageningenthe Netherlands

Personalised recommendations