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2021) was included in Table 2 for comprehensive reporting of diet-related studies, but formal Cochrane RoB 2 assessment was not applicable due to its case-control design

1 Introduction Post-exertional malaise (PEM) is characterized by a significant worsening of symptoms, such as fatigue and cognitive dysfunction, following mild physical, cognitive, or emotional exertion that the patient previously tolerated well

Lipophilicity, a critical property for drug permeability, is moderate to high across all lignans, as evidenced by their consensus LogP values, ranging from 3.53 (gomisin A) to 4.40 (schisandrin A)

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