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Name: is l-carnitine a stimulant – L-Carnitine Uses & Benefits Explained:
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(5.11, 12.2) Interaction with Methotrexate: Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity

Chen Y, Tang Q, Zhu Q, Lu M, Chang E, Gao Z, et al

If it does not, that is a flag to look for other causes (kidney function, MTHFR genetic variants, certain medications)

Pharmaceutical secondary standards for application in quality control, provide pharma laboratories and manufacturers with a convenient and cost-effective alternative to the preparation of in-house working standards