Here is what a day of looking at one case taught me. A GP posted that his wife has the highest cholesterol he has ever seen in 40 years of medicine. UK 19 mmol/L. That is 735 mg/dL. The Cholesterol Code documentary uses her case as part of its argument that the medicine has got cholesterol wrong. Her cardiologist gave her the all clear. Two coronary scans, five years apart, both clean. Carotids clear. I came in hard on the FH framing. That may have been too fast. If her cholesterol is diet-induced on a ketogenic protocol rather than genetic, she may be a lean mass hyperresponder. The LMHR phenotype exists and has been documented. Her short duration of exposure, combined with two clean serial scans from a cardiologist who specialises in cardiac CT and soft plaque imaging, is a materially different picture than a genetic FH patient with 60 years of ApoB loading from birth. I do not know which one she is. Neither does the documentary. Her ApoB has not been published. Her genetic status has not been published. What I do know is this. The CTT Collaboration followed 170,000 patients across 26 randomised trials. Every 1 mmol/L reduction in LDL-C cuts major cardiovascular events by 22%. PCSK9 loss-of-function carriers have lifetime-low ApoB and 88% fewer coronary events. The Ference 2024 Nature Reviews Cardiology paper establishes that atherosclerotic risk is the product of ApoB particle burden multiplied by duration of exposure. These findings do not disappear because one person with extraordinary cholesterol has two clean scans. What Jen Unwin's case does is this: it raises the question of whether there is a subset of LMHR patients who sustain extreme LDL-C without accelerated plaque accumulation. That is a legitimate scientific question. The KETO-CTA preprint tried to answer it and found median non-calcified plaque progression of 5.6mm3 in one year. It did not answer it definitively. It is a preprint with no hard outcome data. So here is where I land. You cannot use one person with clean serial imaging to overturn 170,000-patient trial data. And you cannot use 170,000-patient trial data to tell one person with clean serial imaging that she is definitely accumulating plaque. Those are different arguments and they operate at different levels of evidence. The right answer for Jen Unwin is ApoB measurement, genetic testing, and continued imaging. Not a documentary.