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Three things commonly break that pathway: Low stomach acid: Production drops with age and is reduced by long-term use of proton pump inhibitors like omeprazole, pantoprazole, and lansoprazole

Food and Drug Administration (FDA) hasnt approved it as safe and effective

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The possible transport mechanisms together with the wide tissue distribution underlie the role of OCTN2 as the major transporter responsible for the traffic of carnitine and carnitine derivatives in the intestine, distribution to several body districts and reabsorption/excretion in the kidney (Figure 2)

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Despite these promising results, research is still in its early phases, with the majority of the information coming from trials conducted in labs and on animals