There is no clear evidence that nuts affect the effectiveness of Lipitor, a medication used to lower cholesterol levels. According to Drug Patent Watch [1], Lipitor's active ingredient is atorvastatin, which works by blocking an enzyme that produces cholesterol in the liver. The medication is typically taken once a day, with or without food. However, it is recommended to avoid consuming grapefruit or grapefruit juice while taking Lipitor, as it can increase the risk of side effects.

Ginkgo, on the other hand, may interact with Lipitor and decrease its effectiveness. According to Mayo Clinic [2], ginkgo can interfere with blood clotting and may increase the risk of bleeding when taken with blood-thinning medications like Lipitor. It is recommended to avoid taking ginkgo with Lipitor or any other blood-thinning medication without consulting a healthcare provider.

If Lipitor is not effective in lowering cholesterol levels, there are other options available. According to Harvard Health Publishing [3], some people may not respond well to statins like Lipitor, or may experience side effects that make it difficult to continue taking the medication. In such cases, alternative medications such as bile acid sequestrants, niacin, or PCSK9 inhibitors may be prescribed. Additionally, lifestyle changes such as a healthy diet, regular exercise, and weight loss can also help lower cholesterol levels.

Sources:
[1] https://www.drugpatentwatch.com/p/tradename/LIPITOR
[2] https://www.mayoclinic.org/drugs-supplements-ginkgo/art-20362032
[3] https://www.health.harvard.edu/newsletter_article/help-for-your-cholesterol-when-the-statins-wont-do