An August 2019 study by University at Buffalo found, “"Higher levels of HDL had the greatest impact on fatigue … possibly because good cholesterol plays a critical role in muscle, stimulating glucose uptake and increasing respiration in cells to improve physical performance and muscle strength … Fatigue in people with multiple sclerosis has been viewed as a complex and difficult clinical problem with contributions from disability, depression and inflammation. Our study implicates lipids and fat metabolism in fatigue ... This is a novel finding that may open doors to new approaches for treating fatigue."