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10.3390/nu12030719 Nutrients 112 RandrianarisoaE.Lehn-StefanA.WangX.HoeneM.PeterA.HeinzmannS

When the acid production is low it promotes changes in bacteria down the rest of the GI tract

Cell 184 , 28072824 (2021)

Additionally, it is linked to poor diet or certain long-term health conditions where the body struggles to maintain adequate carnitine levels on its own

PLoS One 16(6):0252899 Ma L, Kong L, Gui R, Yang X, Zhang J, Gong Q, Qin D, Zhuang M, Ashraf U, Mo Z (2021) Application of hydrogen-rich water modulates physio-biochemical functions and early growth of fragrant rice under Cd and Pb stress

I then discovered that the expiry date on the ampoules in my car was 2019 and they had obviously been exposed to extremes of heat and temperature fluctuations (but had been kept dark)