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L-carnosine and its therapeutic uses

of Patrick Linder

What exactly is carnosine?

Carnosine, also known as beta-alanyl-L-histidine, is synthesized in the body from L-histidine and beta-alanine and is therefore called a dipeptide (chemical compound of two amino acid residues).

Since carnosine plays a central role in protecting the human brain, it is often referred to as neuropeptide and is increasingly used to treat diseases such as Parkinson's and Alzheimer's, but also autism.

The component beta-alanine is a non-essential amino acid that is not only involved in carnosine synthesis in the body, but also plays an important role in glucose metabolism and energy production. Beta-alanine also serves as a building block for proteins.

Carnosine occurs naturally in healthy muscles, the heart, brain, liver, kidneys and other tissues. Muscles contain around 20 μmol/g dry weight.

It can only be absorbed through animal food. Pork, for example, contains about 250-350 mg/100g. Red meat, poultry and mackerel usually contain between 70 and 200 mg of L-carnosine per 100 grams. The more carnosine meat contains, the longer its shelf life, as carnosine acts as a powerful antioxidant and prevents it from becoming rancid.

Its concentration decreases with increasing age.

High doses of carnosine are necessary for a therapeutic effect because the body naturally breaks down carnosine through the enzyme carnosinase. The bioavailability of pure L-carnosine from dietary supplements is >= 70% when taken orally.

Most of the absorption takes place in the small intestine. Carnosine is transported from the blood to the muscles, brain and other tissues. Human plasma does not contain measurable amounts of carnosine, so a possible deficiency cannot be determined by a blood test.

Possible risk groups for deficiency

A carnosine deficiency can be the result of an alanine deficiency. A beta-alanine deficiency can occur, for example, in a very one-sided and low-protein diet. Vegetarians and vegans are most at risk, as carnosine and alanine are not found in plant-based foods.

Since carnosine acts as an antioxidant and also compensates for a deficiency of other antioxidants such as vitamin E, a deficiency is more frequently observed in cases of chronic stress, autoimmune diseases, heavy metal contamination, etc.

What are the effects of L-carnosine?

    • Carnosine works synergistically with other antioxidants such as vitamin E & C, zinc, selenium, etc., and reduces their consumption. For example, people with a mild vitamin E deficiency (a large part of the population suffers from a vitamin E deficiency, as has been proven by worldwide epidemiological studies) consume more carnosine than normal.
    • Many antioxidants, such as vitamins C and E, aim to prevent free radicals from penetrating tissues, but have no effect once this first layer of protection has been breached. Carnosine is not only effective in prevention, but also actively works after free radicals have reacted and formed other dangerous compounds such as lipid peroxides and secondary products.
    • For example, a highly reactive lipid peroxidation end product, malondialdehyde (MDA), is blocked by carnosine. MDA can damage lipids, enzymes and DNA and plays a role in arteriosclerosis, joint inflammation, cataracts and general aging.
    • By interacting with aldehyde lipid oxidation products, carnosine protects our tissues from oxidation, since aldehydes can form adducts with DNA, proteins, enzymes and lipoproteins, leading to harmful changes in their biological activity (cf. Burcham et al. 2002).
  • sport
    • Carnosine can balance the acid-base ratio in muscle cells and thus delay muscle fatigue [cf. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257613/]. During intense physical activity, lactic acid and other metabolic products can build up, causing a drop in levels and accelerating muscle fatigue. Carnosine can regulate the acid-base balance in muscles and thus delay fatigue, which can lead to improved performance during training or competition.
    • Carnosine may also aid in post-workout recovery as it acts as an antioxidant, helping to reduce oxidative stress and support the regeneration of muscle tissue [cf. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8300828/].
    • In sports and bodybuilding, carnosine is also involved in the detoxification process of reactive aldehydes from lipid peroxidation, which are produced in the skeletal muscles during physical exertion. Therefore, carnosine protects the skeletal muscles from injury.
    • Carnosine has been given to Russian athletes and swimmers for years and provides remarkable benefits in the areas of energy and endurance. As early as 1953, Russian scientist SE Severin showed that carnosine effectively buffers lactic acid produced by working muscles and that taking carnosine increased muscle contractility and endurance. When carnosine is depleted, lactic acid builds up in the muscles, the pH drops and the muscles become fatigued. When carnosine is added, the muscles recover almost immediately and contract as if they had never been fatigued. This is known as the 'Severin Phenomenon'.
  • Longevity / Anti-Aging
    • There is some research suggesting that L-Carnosine may have anti-aging properties beyond its antioxidant cell-protective abilities. It is believed to play a role in regulation of telomere length plays [cf. https://pubmed.ncbi.nlm.nih.gov/15474517/]. Telomeres are the protective ends of DNA strands in chromosomes and shorten with each cell division. A longer telomere is associated with a longer cell lifespan.
    • extending the lifespan of cells by preventing glycation
      • One of the most important effects of carnosine is its anti-glycation effect (cf. Aldini et al 2002a, 2002b and Yeargans and Seidler 2003). Glycation means the binding of a protein to a glucose molecule, which changes the protein structure and reduces its biological activity. The result is so-called "Advanced Glycation End Products" (AGEs), which are recognized as a major factor in the aging process.
      • Once AGEs are formed, they interact with neighboring proteins to form pathological cross-links that harden the tissue. Diabetics produce excessive amounts of AGEs earlier than non-diabetics, which is why the arteries of diabetics, for example, are usually hardened.
      • Another consequence of AGEs is a 50-fold increase in the formation of free radicals, which arteries, the lens and the retina of the eyes, the peripheral nerves and the kidneys attack. Cataract can therefore also form due to glycation.
      • Carnosine counteracts glycation and can also play a role in the removal of glycated proteinBy combining carnosine with denatured molecules (“carnosinylation”), AGEs are marked for cellular removal.
    • Prevention of protein carbonylation
      • As we age, proteins tend to change in a destructive way due to oxidation, glycation and carbonylation. During carbonylation, carbonyl groups attach themselves to the protein molecules, causing them to split during protein breakdown (proteolysis).
      • This protein denaturation and protein breakdown is not only heavily involved in the aging process, but also in well-known signs such as skin aging, cataracts and nerve degeneration (ie memory loss and dementia).
      • Carnosine reacts with the carbonyl group and forms an inactive protein-carbonyl-carnosine adduct, thereby protecting the proteins and reversing denaturation.
  • brain / neuroprotective effects
    • There is also some evidence that carnosine may have positive effects on brain health. It is believed that the substance has neuroprotective properties and could protect against neurodegenerative diseases such as Alzheimer's and Parkinson's [cf. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627134/ and https://pubmed.ncbi.nlm.nih.gov/17522447/].
    • Chelation of copper and zinc (cf. Miller and O'Dowd 2000, Chez 2003): Copper and zinc are released during normal synaptic activity. However, in slightly acidic environments, which are characteristic of Alzheimer's, they are reduced to their ionic forms and thus become toxic to the nervous system. Carnosine naturally protects against the toxicity of copper-zinc in the brain by chelating the two metals. Copper-zinc chelators dissolve the drusen of Alzheimer's. In addition, carnosine prevents the cross-linking of amyloid-beta in Alzheimer's drusen.
    • The carbonylation of phospholipids primarily damages the central and peripheral nervous system and leads to memory problems and other deteriorations in cognitive abilities. Since carnosine counteracts the carbonylation of phospholipids, it is considered an important neuroprotector.
  • detoxification of heavy metals
    • Carnosine plays a role in the body's own detoxification phase II, ie in the chelation of heavy metals (cf. Miller and O'Dowd 2000, Chez 2003). After the metals have been made reactive in phase I, the chelation in phase II leads to the body being able to excrete them via the kidneys.
    • Carnosine has the ability to chelate pro-oxidative metals such as copper, zinc and toxic heavy metals (lead, mercury, cadmium, nickel).
    • Organic mercury is included in most vaccines as an antimicrobial preservative. Carnosine can chelate organic mercury (thiomersal or thimerosal).
  • autism: A double-blind study from the USA in 2002 was able to demonstrate significant effects of carnosine on autistic children (cf. https://pubmed.ncbi.nlm.nih.gov/12585724/): Thirty-one children with autism spectrum disorders were studied in an 8-week, double-blind, placebo study to determine whether 800 mg of L-carnosine daily would produce observable changes on the Gilliam Autism Rating Scale compared to placebo. After 8 weeks of L-carnosine, the children showed statistically significant improvements, while children on placebo showed no statistically significant changes. Although the mechanism of action of L-carnosine is not well understood, it may improve neurological function, possibly in the enterorhinal or temporal cortex.

  • gastric mucosa / stomach ulcers: Several recent studies show that a combination of zinc and carnosine can protect the gastric mucosa from various irritants and is effective as an antiulcer agent (Odashima et al. 2002). For example, carnosine reduces platelet clotting in patients with abnormal clotting tendencies and increases clotting in patients with reduced blood clotting.

  • Hemolytic anemia: Carnosine has protective effects on blood cell membranes, prolonging their survival, as well as cell membrane stabilizing effects, thereby protecting against chemically induced hemolytic anemia.

side effects

Since carnosine is a natural compound that occurs in the body, it is generally very well tolerated and has a low risk of side effects.

Very high doses can cause mild gastrointestinal discomfort such as nausea, abdominal pain or diarrhea.

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