i take pioglitazone 20 mg and it is not working i need help

You invariably have familial hypercholesterolaemia (FH). This is inherited and is very common (1 in 500). Women with FH have a 30% increased chance of premature heart disease by 50, whilst men ahave a 50% increaed chance. The underlying problem, most often, is a receptor defect in the liver, stopping you taking up bad cholesterol, and breaking it down. If the statins are not working, the first thing to ask is what time of day are you taking them. Statins work by preventing you manufacturing cholesterol. Since you make most cholesterol at night, you need to take the tablets last thing at night. Failing that, you could try a more potent statin, the most potent being rosuvastatin (most people start on simvastatin as it is off patent and hence the cheapest - but still good). This can be supplemented with further meds, that stop you absorbing cholesterol, ezetimibe. If in doubt, get referred to a lipidologist.