Susan it isn't likely that your dexamethasone level has dropped significantly by five PM. Keep in mind that dexamethasone is extremely long lasting. Its biologic half life is 35-54 hours. I'm more inclined to think that the beneficial effects of that good breakfast you described has worn off. As you have already discovered, what you eat affects how you feel. It sounds as though you have already figured out what type of diet is best for you. I can only add that you should avoid refined carbohydrates and make sure you're getting enough of the good type of fat in your diet. Contrary to popular belief, not all fat is bad. Try to avoid saturated fats and trans-fatty acids but do try to include more of the omega-3 fatty acids in your diet. Fatty fish, fish oil and flax seed oil are all high in omega-3 fatty acids. There is a proposal by the FDA to require food labels to show trans fat content but until then just try to avoid processed foods that have partially hydrogenated oils as one of the leading ingredients. http://www.hsph.harvard.edu/reviews/transfats.html I personally tend to follow, albeit loosely, the so called 40-30-30 type of diet: I try to get about 40% of my calories from carbohydrates, 30% from protein and 30% from fat. I am by no means a fanatic about it and I certainly don't think that one size fits all. You will need to determine what works best for you. You probably would benefit from having a small meal or snack every few hours but even a snack should be nutritious food, not the junk that is passed off as snack food. Keep in mind that foods are made of chemicals just as complex as anything that comes from the pharmaceutical industry. For optimum health the food we eat is at least as important as the medicines we take. I hope this has given you some food for thought. Joan