Definitely, don't be afraid to overdose. A couple weeks ago, we went to see a "new" endo. The man was brilliant in his CAH knowledge. He talked continually & voluntarily for about 25 minutes about CAH, you could tell he was a physician who truly cared about his patients. Also, he only sees adult patients, not children, but yet he voluntarily told us so much. Nearly every sentence he spoke used a term such as adrenal crisis, salt/water balance, blood glucose, etc. He is 65 years-old & the director of the endo dept. He said, give extra at the first sign of a fever, do not wait until the fever is 101 or above to give extra, because you want to ward off an adrenal crisis situation. If the fever is 101 or above, then give 3 or 4 times the cortef. He also said, give extra with colds, the first 2 days - this can be a critical period for them with a cold. He said you want to mimic what the adrenal glands would do in a normal person (i.e. giving extra for any fever and also for colds).