Guess I'd better get my story in. It's slightly different than most others but not uncommon at all. Many years ago I went to a free cholesterol screening at a shopping mall just to make sure everything was ok. I was probably in my early 40's and had a job that took me outside and exercising regularly all summer. I was reasonably active and felt healthy. However, the screener sat down with me and said I'd better see a doctor!
The official (fasting) numbers were something like Total=280, LDL=high, HDL=25, Triglicerides=770 all in the bad range. My doctor decided I needed a low fat diet and niacin. He also said the low HDL was hereditary and could not be changed much. The niacin caused flushes, no matter what kindI used and I became more sensitive instead of less. I started using caffeine to counteract the flushing and developed an ulcer. I dropped the niacin and added Lipitor. I stuck to the low fat diet and ate a ton of carbs. I did this for nearly 10 years, which may be responcible for my developing insulin resistance. The doctor considered adding a second statin drug but decided against it, thank goodness.
I had other symptoms I became aware of only later. One was fatigue after burning the available carbs in my system. I exercised regularly then. I was a runner (10K, Bloomsday, etc) and a bicyclist. I rode two 100 mile rides but during each I nearly collapsed near the end for lack of energy. I had trouble after the middle of a run for the same reason. I had constant hunger to some degree, and an odd anal discharge that caused a rash. I even went through two painful hemmoroid operations to try to alleviate this with no help.