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Beta-Alanine for the Athlete of Aging?

by Jonathon Sullivan MD, PhD, SSC, PBC

Beta-alanine is a popular ergogenic supplement, known for the distinct tingly sensation it causes shortly after ingestion. But does it do anything for us?

The beta-alanine tingle
Figure 1: Does the Tingle Do Anything for Us?

One of our most popular videos is our piece on creatine supplementation. In that piece, I discussed one of the few supplements that I find even partially beneficial for the athlete of aging and how it works. Creatine improves anaerobic energy metabolism, allowing us to work in a high-power range just a little bit longer. Creatine doesn’t directly make us stronger. It allows us to extend the set by another rep or two, so we can get stronger. Creatine is well-studied and safe. I wouldn’t go so far as to say I recommend it…but I use it, and I certainly don’t discourage it.

Another very popular ergogenic supplement, one commonly used with creatine in supplement compounds, is beta-alanine (β-alanine). This supplement appears to be safe, but I find the evidence for improvement in strength training a bit more equivocal than for creatine.

I’ll tell you up front that I use β-alanine in a preworkout product that combines it with creatine, and I feel like it helps, which of course is most definitely not evidence. Since most of you have heard of it, many of you have asked about it, and some of you actually use it, I thought it would be expedient to explore what we know about this popular and ubiquitous supplement.

When you take β-alanine, it actually doesn’t really do anything for you…except make you feel all tingly in a way that some find vaguely agreeable in a warm-and-fuzzy way, and that others compare to being plunged into an Olympic swimming pool full of centipedes and tabasco. This tingle, agreeable or not, is apparently harmless and appears to be an epiphenomenon resulting from the binding of β-alanine to certain receptors on sensory neurons. The sensation has absolutely no beneficial impact on physical performance…or anything else, as far as we can tell.

The benefit of β-alanine, which is an atypical amino acid, comes from its participation in the synthesis of an important muscle dipeptide (a very short “protein”) called carnosine. The manufacture of carnosine in muscle cells is limited by the availability of β-alanine, which is not stored to any appreciable degree and has very low concentrations in serum unless the diet is high in meat or supplemented. When available, β-alanine is combined with the more abundant amino acid histidine to form carnosine.

That’s the ticket, because it’s carnosine that’s doing the heavy lifting…so to speak.

Mechanisms of beta-alanine supplementation for athletic performance.
Figure: β-alanine supplementation exerts its putative effect by combining with histidine and promoting carnosine synthesis. Carnosine buffers acid and neutralizes free radicals generated during high-intensity exercise which may extend work capacity and delay fatigue...or may not. Carnosine may or may not exert a beneficial effect by decreasing protein glycation, a process associated with aging. It may also improve muscle calcium handing, an effect which may--or may not--promote performance.

Carnosine is a big deal for a number of reasons, but the most important appears to be its ability to act as a buffer. In chemistry, a buffer stabilizes the pH of a solution against the addition of acid or base.

Let’s take an example. If you have a glass of water and drip in a strong acid, you will find that the pH drops rapidly—the solution rapidly becomes more acidic. Or if you drip in a strong base, the pH will rise rapidly—the solution rapidly becomes more alkaline. But if you have a buffered solution, it will resist these precipitous changes in pH when you add a strong acid or base.

Buffers are huge in biology, because many reactions in cells generate alkali or acid. Chief among these for our purposes are the reactions of energy metabolism, particularly fast glycolysis, the anaerobic process that rapidly splits glucose to form ATP without the participation of oxygen, generating pyruvate and hydrogen ion (pyruvic acid) in the process. The hydrogen ion (proton) is the acid part of this mess, and as it accumulates in a hard-working muscle cell, the change in pH will make it harder and harder for the enzymes and other compounds involved in energy production to keep going. Your muscles will burn and fatigue, and you’ll stop, because...really, who needs this crap?

Fortunately, you have buffers like bicarbonate and phosphate and the buffering capacity of proteins themselves to retard and blunt the acidification of hard-working muscle. But every little bit helps, and so it is that a bicarbonate is a common form of “doping,” to increase the buffering capacity of muscle. Delaying and blunting the drop in pH during high-intensity effort allows us to continue that effort just a little longer.

And that’s where carnosine comes in. Carnosine is an effective cellular buffer in muscle tissue, sopping up protons that are generated in abundance when we’re exercising, particularly in the high-power anaerobic range (although we also generate proton during aerobic exercise and anytime we use ATP). By buffering protons, carnosine blunts the acidification of the muscle during exercise.

β-alanine supplementation has been decisively shown to chronically increase muscle carnosine concentration if taken at a dose of 4-6 g/day over several weeks. The tingling that you feel after a big oral dose doesn’t mean that it’s working, or that you’ve made a bunch of carnosine yet, or that you’re ready for a PR. It just means you took some β-alanine. But regular supplementation will increase your muscle carnosine levels, which raises the important question: So what?

There is evidence that β-alanine supplementation sufficient to improve muscle carnosine levels improves performance--but only specific kinds of performance. Our best data suggests that athletes will see a benefit in high power performances lasting longer than 60 seconds and less than about 4 minutes.

This makes total sense if you remember what we’ve had to say in the past about energy metabolism. When we engage in exercise, we have an anaerobic immediate system that consists of the ATP already in our muscles, which will generate high power for a couple of seconds, and an aerobic creatinecycle that will continue that high power for another minute or so, and an anaerobic fastglycolytic system that will generate moderately high power by splitting sugar and releasing acid rapidly for just a couple of minutes, and finally a low-moderate power aerobic system that burns oxygen and can go for about 95 years or so if need be.

If you’re still here and still awake, you can see why carnosine would work best in the 60s-240s range. For shorter durations, we’re generating energy without generating too much proton. For longer efforts, we’re in the aerobic energy system where acid production is moderate. It’s in the glycolytic window that the need to sop up acid proton becomes acute. So it shouldn’t surprise us that β-alanine supplementation works best for sprinters, wrestlers, gymnasts, boxers, and the like.

What about strength training? Here the data is a bit more mixed. It’s easy to see how carnosine levels would not have much affect on a heavy single, double, or triple set lasting less than sixty seconds. It’s also easy to see how carnosine might permit longer sets like 8s or 15s or more, and it may increase the ability to sustain longer workouts. Analogous to creatine, it doesn't make us stronger, but it may extend work capacity so we can get stronger.

Even so, the data on β-alanine seems to be in equipoise, which is a nice way of saying it's a mess, and on my read the data for its enhancement of strength training is not strong.

The study most relevant to my readers is the RCT by Bailey et al in the Journal of Dietary Supplements in 2018, entitled Beta-Alanine Does Not Enhance the Effects of Resistance Training in Older Adults. That’s not encouraging, I know. I love it when the title spells out what the authors found—unless they didn’t find anything, which is the case here. The paper is exemplary of the usual woeful deficiencies in this literature: This was a pathetically small trial, and was a bit short, but perhaps with enough time to show clinical differences. No assessment was made of muscle carnosine concentration, which is critically important in this case, as the investigators used about half the usual dose, and participants were expected to self-administer the supplement. So we don't know the compliance rate, and we don't know if the regimen here actually boosted muscle carnosine.

Subjects got a little stronger, but the effect sizes were not great and there was no detection of an effect of β-alanine. That’s no shocker, since the authors conducted no power analysis to show that their study was even big enough to detect a difference. My technical term for this is total loser-ness—a power analysis is so fundamental that, when I don’t see one, I know that it’s amateur hour. Combined with the standard but goofy low-dose resistance training employed in this study, there just isn't a lot that Greysteel athletes can learn from this study. It's a shame.

Where does this leave those of us who want more from life than a stimulating and slightly creepy tingly feeling? It’s important to point out that carnosine has other effects besides buffering. It seems to improve the movement of calcium in muscle during work, which is a big deal, and it also seems to sop up free radicals generated by exercise, which could contribute to improved performance—or could actually be bad, by blunting intrinsic muscle buffering capacity.

Finally, there is a suggestion in the literature that carnosine can inhibit a process called protein glycosylation, which is the nonspecific and harmful attachment of sugar molecules to proteins. This process is associated with aging, and we would rather not have it going on in our cells. What is the long-term health benefit of this property of carnosine, if any? We don’t know.

So what’s the bottom line? As I noted earlier, I use β-alanine, and I think it helps me, but this is a subjective impression, further clouded by its combination with creatine. β-alanine isn’t free, and it does have the harmless but potentially disagreeable side effect of paresthesias (tingling). Even if it does help, it probably isn’t a huge effect: A recent meta-analysis “calculated” a median effect of 2.85% improvement in an exercise measure with β-alanine supplementation when doses were adequate. Whoa daddy.

You can give β-alanine a try without having to worry too much about safety, and without having to hope for huge gains because they’re unlikely. If you are observant and precise and assiduous with your logging, you may be able to determine that it helps you, or not. If you take it, it may give you a bit of a boost with longer sets or longer workouts. If you don’t take it, you probably aren’t missing much.

As always, the fundamentals are most important: stick to your program, eat your pre- and post-workouts, get your active rest and sleep, and you’ll be doing far more for your health and performance than any pill or powder can ever do.

Jonathon Sullivan MD, PhD, SSC, PBC is a retired emergency physician and research physiologist, and the owner and head coach of the Greysteel Strength and Conditioning Clinic in Farmington Hills, Michigan, which specializes in training adults over 50. He is the author of The Barbell Prescription: Strength Training for Life After Forty, with Coach Andy Baker.

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