Hi Salad - Yes DH's issues are hereditary, we moved and he got referred to another specialist who had a different approach. As he explained to us (apologies for the dodgy not very scientific explanation) - We generally ate quite healthily, home cooked lots of veges so it was a bit of a shock. DH makes more cholesterol himself so needed to ensure he gets lots of fibre which helps the body to expel the excess cholesterol. He also needed to make sure he got enough good fats also (we eat salmon at least once a week as well as the nuts/avocado). Your DH's issues may be completely different though. Initially DH took Metamucil as well, but has not needed to for 2 years now. Really we just tweaked a few things and DH dropped about 6 kg and he has not needed to go back on the meds yet. I was really stressed when DH first got diagnosed, as his parents both had strokes/heart disease in their 30's. Take care.