Cricket, What I am going to say will probably surprise you and go against all your instincts as a mother. I also hope that it will make you feel more confident about the outlook for your son's future health. Well managed CAH does not result in the deteriortion of the body. It is oversuppression of CAH that is likely to cause the body to deteriorate. While undersuppression of CAH is dangerous, chronic oversuppression carries its own risks including immune system suppression, poor wound healing and muscle breakdown. The goal in CAH management is, to quote from the treatment section of http://faculty.washington.edu/momus/PB/cah.htm, (to administer) "Glucocorticoids at lowest dose that achieves adrenal suppression ". I am figuratively speaking from a possible future for your son as well as all children with CAH. I am a fifty year old woman with classic salt wasting CAH. My health and physical condition are both excellent, better in fact than most of my non CAH contemporaries, including my siblings. I attribute this to good genes (mostly), my attention to good nutrition and fitness and my ability to maintain precise control over my hydrocortisone levels. I am living proof that, as long as it is properly managed, CAH does not have deleterious affects on the body. Good luck to you and your son, Joan