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D-carnitine competitively inhibits carnitine acetyltransferase and carnitine palmitoyltransferase, inactivating carnitine acetyltransferase, leading to symptoms of fatigue, and in severe cases, may cause muscle atrophy

Because PPIs can only be converted to their active form in highly acidic environment at the external surface of stimulated parietal cells, they must be administered ~30 min prior to a meal in order to reach their maximal plasma level at the time when acid secretion is maximal

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And it does so without suppressing endogenous production

Glutamate is released by dendritic cells during T cell interaction, where it has dual roles (179)