Hello and thank you for using HCM.I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. You should know that cholesterol target levels depends on some factors like your age and other associated rics factors like hypertension , diabetes , smoking and hereditary history of high cholesterol levels. If you don t have other risc factors that I mention before, your normal cholesterol level should be below 200 mg / dl. As you mention you have a story whith high cholesterol and strong efforts to lower it by lifestyle modification and physical activity. Even though your cholesterol is still high. In this situation, my opinion is that you should start medical treatment, a statine class. Sometimes there are hereditary history or genetic factors that cause this high value and medication treatment is the only way to keep things under control and prevent risky events in the future. Hope I was helpful.Wish you good health. Best regards