Well, that’s the million dollar question that I’m not sure about. I do know there are genetics involved making my cholesterol a bit pesky. :). I know for whatever reason my body requires an extremely consistent diet, exercise, strengthening and stretching, and we don’t make changes often. So much that it doesn’t leave time for much else but with a trade off that I can function. I am learning everything affects everything. I would say stay activity, go see your ENT for your sinus issue and see what they think about timing of when to try Repatha (I think there are sinus related side effects). The doc that prescribes my cholesterol treatment is who I go to when I think I am having side effects and he is helpful to address them.