Ask the doctor. My total cholesterol level is well below 200. My LDL is low, my HDL high, and my triglycerides and homocysteine are both in the "desirable" range. The one thing out of whack is that my lipoprotein(a) level is more than double the "normal" limit. My cardiologist wants me to take niacin to bring it down. I can't find any information on how serious a problem this is, especially in the context of otherwise good cholesterol levels and a healthy lifestyle. (I exercise 5 days a week; eat a low-fat, high-fiber diet; and am not overweight.).