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We know, for example, that [15] small intestinal bacterial overgrowth (SIBO) is commonly found with Hashimotos (a 2007 study found that about 50 percent of people with hypothyroidism have this infection), and is associated with slow gut motility and intestinal permeability

Metabolic Interventions in the Immune Response to Cancer

Causes While causes of carnitine deficiency is unknown, it is believed some dog breeds show an increased risk of developing the deficiency, including Boxers, Doberman Pinschers, Great Danes, Irish wolfhounds, and other giant breeds

basically, valproic acid (VPA) causes you to pee out your L-carnitine

some studies reveal a doseresponse link, while others do not

It's not about when you take it, it's about being saturated