I guess there is no ONE answer to this question. I do understand now what Joan is saying about over and undersuppression, but for some reason my maternal instincts are overriding this reason. I will tell you why and then you can tell me if it is at all possible. During the 12 months+/- that Ryan was grossly undersuppressed he had a medley of odd symptoms that the doctor told me was not related to CAH. He was very thin, grew rapidly, although not eating much. On a couple of occassions he screamed at the top of his lungs and dropped to the ground saying he was being stabbed with knives or pins and needles in his bones and face. The look on his face was of sheer horror. At times he grabbed his "heart" and said it hurt too. His doctor continued to tell me that it wasn't CAH related. He then began to go into puberty at 4 years old!! My endo STILL said it was not CAH related and told me to take him to see a psychiatrist. Prior to this time I was suspect of the doctor but still wanting to believe in his experience, but it was this last incident that I could not ignore. Everything that has ever been written about CAH states that undersuppression can lead to early puberty. So I confronted the doctor and then got my son in for a second and third opinion. I guess I am asking if it could be the strain of the sudden growth and all that came with it that could have caused a problem with his heart? Joan, your point is well taken as he WAS being oversuppressed for a couple of months to stop the rapid growth and puberty. We await the next blood tests to tell us if we are still oversuppressing. It is taking some time to titrate his levels back to normal. I am so glad that you are in such good health. This gives us all something to hope for. I also hope that your emotional health is good due to the history of CAH girls and all they have to go through. You sound like a very strong individual and good genes or not, I am sure that your state of mind had something to do with it. Thank you for taking the time to share your thoughts with me. Stick around will ya?