First, the idea of good and bad cholesterol is at best out of date by decades, like the training of our GPs.
There are multiple forms of the so-called bad cholesterol (LDL). The most important thing to know is that particle size is very important, as large LDL particles are very healthy, small particles (that are sometimes damaged or oxidised) are less healthy. You can’t get an LDL particle size test (LDL-P) on the NHS you have to go private for it. More medically advanced countries like Australia nd Denmark do provide LDL-P tests to their general public. You can have a high LDL quantity and have only very healthy LDL. This is part of the reason that an ApoB test that calculates the number of particles is far more instructive than a regular LDL test.
25% of people who have heart attacks have low LDL cholesterol.
Studies have shown that people with very low cholesterol die earlier. All-cause mortality matters!
Different people have different genes. Different people have different weights. Different people have different lifestyles. So no single thing that works for one person will work for everyone.
I have always been naturally slim compared to friends and could be described as part of a cohort called Lean Mass Hyper Responders. This cohort tend to have high cholesterol naturally as they use fat more for energy than others, this means that they can significantly lower their cholesterol numbers by adding a lot of carbs.
My Total Cholesterol score was over 11.5 at one point. I do not have Hyper Familial Cholestemia or genetically high LP(a). Now with Statins and Ezetemibe the LDL is around 3. I eat mostly protein and fat sources, and eggs everyday. High blood sugar for decades is abrasive to your arteries.
You can’t out-medicate a bad lifestyle, if you are inactive and eat low-quality food such as cereals and seed oils you will just slow down your health decline rather than reverse it.
If you want to try a supplement alternative to statins, you can try Niacin (Vit B3) but it has to be the flush type (a lot of people don’t like the flush). Before statins were invented doctors prescribed Niacin. Another supplement is Berberine which works pretty well to reduce cholesterol via a similar mechanism to the PCSK9 inhibitor drugs. One more to try is Quercetin which reduces oxidised LDL.
The problem with both supplements and drugs is that they all can have other intended of unintended effects too. For example, Niacin can increase blood sugar for a few months, Statins can reduce bile salts and lead to Type 2 Diabetes, Berberine can lower blood sugar levels similar to the weight loss jabs etc.
Most of the cholesterol in your body is created by your liver. When someone consumes dietary cholesterol it is absorbed by receptors grabbing onto it.
Drinking Benecol and the like work because the stenols compete with cholesterol by attaching to the same receptors. If a receptor is attached to a stenol particle it can’t also attach to a cholesterol particle. This reduces how much cholesterol can be absorbed. However, if you eat less cholesterol then your liver simply tends to make more if it wants more. This is why Benecol can work for a short time and then appear to stop working as your liver might just create more cholesterol in response.
PCSK9 inhibitor drugs work by preventing damage to receptors thereby increasing cholesterol clearance/recycling. The drug Ezetemibe works by increasing the number of receptors so the cholesterol is cleared faster.
If you do go on a statin look into also supplementing with CoQ10 and TUDCA.
To look after your arteries, eat well; pomegranites and beetroot for example.