Johnson,
Your numbers aren't too bad. One thing you can do to bring your total down is to cut out carbohydrates like pasta, potatoes, sugar and alcohol, particularly beer. This will lower your triglycerides. Make sure you eat enough protein. You can eat meats, trim the fats and this will help lower your cholesterol because your liver will get the message that it doesn't have to make an overabundance. Most of the cholesterol in those results is from what your body manufactures. Eating a low fat/high carb diet is very counter productive to this end since insulin stimulation then triggers cholesterol production.
I know I am going all over the map here, but I need to leave soon.
We eat a balanced diet rich in meats, protein, eggs, butter, cheese, non-starchy veggies and salads.
I also take red yeast rice, along with NAC, selenium, vitamins (B, C, E, D), calcium, flax seed oil, and coenzyme Q10. The red yeast rice is an over the counter "herbal" remedy that is essentially a low dose, natural form of Mevachor, another statin drug like Lipitor.
I had a panel about a month ago that was a TC of 409. A couple of days later another test was done and it came out as a TC of 299. I've been on the red yeast rice for three weeks and my TC is 239. I have no side effects and I don't need an Rx for it.
What would I do in your shoes? I'd tell the doc I want to try and lower the numbers with diet before trying the Lipitor. What the heck? The high numbers are only a red flag. You could have high cholesterol from having had a really high sugar couple of weeks or days prior to the test. High cholesterol doesn't mean you are going to have a heart attack right away. If you have a lot of plaque in your arteries, then you should worry. At your age, you are probably okay for now. This is really more of a wake up call to make some dietary changes that can heal your body now before it gets to be a problem. And why make your liver dependent on the drug at such an early age when I truly believe you can correct the trends through diet?
You might need to learn how to cook if you don't already. Shop around the perimeter of the grocery store. Meats, fish, produce, dairy. The middle aisles are the processed foods and BAD!

Cut out as much of the simple carbs. Try to increase your protein. Remember that you need to read labels...there is sugar in just about everything nowadays! Most "low-fat" prepared foods are really high in calories and hidden sugars.
Read "The Schwarzbein Principle" by Diana Schwarzbein, MD, an endocrinologist in Santa Barbara. It makes total sense to me and my husband.
You will be fine. It's a good thing to know this trend now, while you are young. But I think the Lipitor is a drastic measure at this juncture.
Best of luck and please, keep us posted.

Nel