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Their study found that 44.7% of ME/CFS patients had elevated blood lactate at rest which was correlated with increased severity of PEM, although this study did not see a correlation with fatigue severity (Ghali et al., 2019)

source: Policosanol 60% Policosanol seems to decrease cholesterol production in the liver and to increase the breakdown of LDL (low-density lipoprotein or bad) cholesterol

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While theres not much research about ashwagandha and birth control specifically, a 2015 study found that ashwagandha doesnt seem to affect the enzymes that break down hormonal birth control [11], meaning that they can probably be used together

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