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Hello Mshaw, I am glad to hear that you eat well and exercise.  Though these may not be helping lower your cholesterol as much as you and your doctor may like, they certainly make you healthier in many other ways! One of the most important factors that determines a person's cholesterol level is genetics.  If members of your family have high cholesterol, then you are likely to have high cholesterol, too, regardless of your diet.  Especially if your cholesterol numbers are exteremly high, (LDL>300), you could have a familial cholesterol disease.  These diseases (there are several variants) are fairly common (1 in 500 people), and usually need to be treated with medications, as well as diet and exercise.  Hope this helps. To your health,Neil MD