Question: Can familial hypercholesterolemia be managed without statins?
I think there's the general perspective that there's no point in having LDL-C be any higher than 50; therefore, since it doesn't matter, let's provide a sufficient margin of error where we're real confident that getting it down to 100 is great and so why not get it down to 50? If there is any extra protection we get it and we don't lose it.
So my point of view would be, I would personally rather use a more conservative target of lowering down to 100 or so where the confidence is actually really high, because I'm not convinced by the lack of confidence that there's no neurological downside to pushing it twice as low as that. So that's my general perspective and if this were me, and it'll never be because I can't for the life of me get my total cholesterol above 160, but if it were me I'd be lowering my dose on that out of precaution on the other side.
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DISCLAIMER: I have a PhD in Nutritional Sciences and my expertise is in performing and evaluating nutritional research. I am not a medical doctor and nothing herein is medical advice.