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The effectiveness of oral supplementation is questionable since most carnosine absorbed from the gut is destroyed in the bloodstream by enzymes called carnosinases

The relatively high systemic insulin levels counteract the lipolytic effects of the high GH levels in fat and muscle, but they do not reach adequate levels in the portal vein, so the liver remains under the control of GH, which still induces gluconeogenesis, increasing hyperglycemia [33]

Non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids are commonly used for the management of OA

This conclusion is in line with and supported by recent findings