<s>[INST] female,aged 30, very high cholesterol level 11,5, inherited from father who died at age 45 of heart disease. Various medication for last 8 years, currently using Simvastatin 40mg for last 2 months but gaining weight, experiencing excessive hot flashes and muscle and joint pains. I have also suffered from migraines since my teenage years. My daughter aged 13 has the same hereditory cholesterol and last blood test results showed her levels to be 9,6. Could you possibly recommend a different cure for both me and my daughter. [/INST] Hi,welcome to Healthcare magic.Thanks for posting your question on this forum.I understand your query and concern.Hereditary cholesterol levels need multi modal aggressive approach.Drugs like fenofibrate,orilistat should be used along with statins.These drugs reduce the amount of calories that reach the systemic circulation post meal.Regular physical exercise in the form of brisk walk 30 min a day for 5 days a week is a must.Anti obesity surgery like gastric reduction,band ligation will provide excellent results in your case.I advise you to have a baseline ECG and 2 dimensional echo on the follow up to have a recent quick review of your cardiac functional reserve in view of long standing hypercholesterolemia.Consult an expert cardiologist for further expert management.Post your further queries if any.Thank you. </s>