There are several medications you can use with a prescription such as Lipitor. The problem is that you have to remain on these medications for the rest of your life. Diet and exercise still remain the best options.
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The surest way to reduce high cholesterol is to have a statin class medication (atorvastatin - Lipitor, simvistatin - Zocor, etc.) prescribed by your physician, in combination with a low cholesterol, low saturated fat diet. Niacin can be quite helpful, as well (but in tolerable doses - which minimizes skin and facial flushing), along with omega-3 fatty acid supplementation (fish oil or prescription Lovaza, or flax seed oil). Some people and doctors prefer using bile acid binding resing (such as cholestyramine).
Eating fish high in omega-3 fatty acids (salmon, etc.) can be helpful, as well. For those adults who are not predisposed to alcohol abuse or dependence, a glass of red wine 5-6 days per week is also beneficial (as wines such as Pinot Noir and Merlot contain resveratrol, which also has been shown to lower cholesterol).
It is worthwhile discussing the above with your physician, if your cholesterol level is above 200, and definitely if it is above the 220-240 range. And it is even more important to have this discussion with your physician if you also have a family history of Heart disease.