Years ago I couldn't tolerate statins (severe GI upset) & my doctor discontinued them and suggested red yeast rice. I've been on this supplement for over 10 yrs now with no issues. I also take Cholestoff, a plant sterol/stanol supplement. My total cholesterol is borderline, slightly over 200, LDL around 115, HDL around 85 and low triglycerides. This profile is acceptable to my doctors. I recently had a cardiac screening for a procedure and had a calcium scoring test which was zero. The cardiologist had no issue with my cholesterol profile.

I've never had Lp(a) testing done.

Personally I won't go on statins. There is also a risk of diabetes with them. I live a very healthy lifestyle. Although a parent had borderline high cholesterol, she lived to be 92 and never had any coronary artery disease.

I don't believe in the "healthy fats" oxymoron. As far as I know, all saturated fat contributes to your cholesterol. The idea is to minimize saturated fats, whether "good" or "bad" ones. The idea is that if you DO use fats, use the "healthy" ones. But that's no carte blanche to overdo fats.

I've been tracking my cholesterol and dietary and supplement changes for over 15 yrs and the lowest LDL that I've ever had was when I cut out fish oil supplements. These can actually RAISE LDL cholesterol. So if you're on fish oil supplements, stop them and see if your numbers improve. I use flax meal instead, which contributes Omegas and fiber. My HDL has been great even after stopping fish oil.

My cholesterol also improved dramatically when I tried a raw plant based diet for a short period but this is not sustainable. I do not feel well on a vegetarian diet. I don't get enough protein this way and I tend to gain weight because of the heavy carbs. I do better with a meat and veggie diet.