My daughter (non-salt waster) who weighs about 45 pounds was taking a total of 24mg of liquid Cortef before we switched her to Prednisolone, after we realized there was something wrong with the Cortef. As far as I know, the amount of medication given depends on how high the 17 hydroxyprogesterone is and how much the child weighs. According to my endo, their professions would like to see CAH kids' 17OHP level at around 400-500. of course the normal level is even better. The "rollercoaster ride" is pretty common, especially for the salt-wasters. They seem to get stressed out easier,thus leading to adrenal crisis. I "know" a grandma who gives her granddaughter stress dose when she plays hard all day, being instructed by her endo. If you have any doubts about anything, ask your endo. I know it's frustrating when different endos have different opinions. But it's always best to keep an open communication between you two.