Matthews · Medicine and science in sports and exercise 2019 · narrative review · n=?

The Physiological Roles of Carnosine and β-Alanine in Exercising Human Skeletal Muscle.

Cited 68 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of physiological mechanisms without systematic review methodology

PubMed 31083045 · doi:10.1249/MSS.0000000000002033 · record verified 2026-08-29

What was done

This paper is a narrative review synthesizing research on the physiological mechanisms of carnosine (β-alanyl-L-histidine) and its dietary precursor β-alanine in exercising human skeletal muscle, focusing beyond performance endpoints to underlying cellular roles.

What was found

The abstract reports no numerical findings or statistical effect estimates. It outlines established and emerging mechanisms for carnosine in muscle, including intracellular pH buffering, modulation of energy metabolism, regulation of calcium handling and myofilament sensitivity, reactive species scavenging, cytoplasmic calcium-hydrogen exchange, and conjugation with exercise-induced reactive aldehydes.

Why it matters

It organizes the physiological actions of carnosine beyond simple lactic acid buffering, providing a framework for how beta-alanine supplementation may influence muscle function and recovery in exercise and disease.

Limits

As a narrative review, it lacks a systematic search protocol, risk of bias assessment, or quantitative pooling. No sample sizes, effect magnitudes, or specific study populations are reported in the abstract, and several cited mechanisms remain putative.

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