Diet and exercise alone never hardly touched my cholesterol levels. My liver just makes cholesterol ( genetic). Lipitor helped at 40 mg/ day or greater, but I couldn’t tolerate that dose with the side effects. I went down to 20 mg/ day, but that did very little for my numbers and I still had a little trouble with the side effects. Then my cardiologist put me on Repatha 140mg/ 2 weeks sureclick injectable and Lipitor 10 mg/ day. I exercise, but I eat anything and everything I want to and my total cholesterol is 79, LDL= 29, HDL=50 and triiglycerides =90. Most insurances will not cover Repatha until you prove intolerance to statins, so you have to jump through those hoops. It’s the magic bullet for me. Mine went from 269-350 range to the present level in a little over a month with Repatha+ 10 mg Lipitor with no diet.