If you have the common pattern of high LDL particle number (NMR) with small LDL --a pattern highly related to coronary plaque--which is better:
Lipitor or a combination of fish oil, vitamin D, and elimination of wheat?
Lipitor quite effectively reduces LDL particle number, usually on the order of 40% or so. Effect on LDL particle size: None. Side-effects: plenty, including muscle aches (inevitable in my experience, not the ridiculous 2% they claim) and occasionally mental effects such as impaired short-term memory.
Lipitor does seem to exert a modest effect on reduction of C-reactive protein, around 30%. It also reduces cardiovascular events by 30%.
A combination of fish oil, vitamin D, and elimination of wheat:
Reduces LDL particle number commonly by a similar 40% (though variable, depending on body weight). There is substantial improvement in LDL particle size, a large drop in C-reactive protein, often >50%, a 30% or more reduction in cardiovacular events.
On this combination, however, you also:
--Lose weight, often substantially.
--Improve bone health, esp. osteoporosis and arthritis.
--Reduce cancer risk from the vit D supplementation.
--Reduce risk of stroke.
--Reduce postprandial (after-eating) abnormalities like intermediate-density lipoprotein.
--Reduce winter blues.
--Experience more energy.
--Obtain increased clarity of thought (from elimination of wheat).
--Reduce blood pressure.
Oh, and there's no muscle aches.