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PMID: 29076953

Patients with chronic health issues, including erectile dysfunction, inflammation-related issues, obesity, diabetes, or cardiovascular disease

Prospective cohort studies on the association have been inconsistent: a few studies have linked higher choline intakes to increased risks of atrial fibrillation (122) and cardiovascular disease-related mortality (43, 44), while several other prospective studies have found no association between choline intake and cardiovascular disease endpoints (41, 45-48)

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D-carnitine - this inactive form can cause a lack of carnitine in the human body because it inhibits the absorption of other more useful forms

So I want you to think about this as like a purposeful mechanism of our body