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These components are considered immunological distractors with pro-inflammatory activity, capable of causing dysbiosis and increased intestinal permeability (the so-called leaky gut syndrome), so favoring the development of autoimmune diseases [142]

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Likewise, a doctor may claim to be "board-certified" by a board that isn't recognized by the American Board of Medical Specialties (ABMS), a recognized agency approving medical specialty boards since 1934

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Ferrari R, Merli E, Cicchitelli G, Mele D, Fucili A, Ceconi C, New York Academy of Sciences (2004) Therapeutic effects of L-carnitine and propionyl-L-carnitine on cardiovascular diseases: a review