Sorry I try not to blabber on, and sometimes I cut it too short to be understood. My problem. Our friend with 3 kids w/CAH talked to our endo's nurse in all the confusion about switching to pills. She said that the 5 mg pills are not hydrocortisone, but hydrocortisone acetate (sp?). According to her, the 5 mg of the acetate form is only as effective as 4 mg hydrocortisone. I understood that your child was UNDER medicated on 5mg pills as compared to 5 mg in the oral suspension. IF the nurse is right, it might be because the pill is actually only 4 mg of effective medication. I don't relay this to you as the gospel truth because it's third hand, but thought you might like to know what I heard.. That's why I suggested you talk to Dr and pharm. Our daughter is on the full 10 mg per day, so we don't need to worry about it. If the 5 mg really are only equal to 4 mg it would be good, since if you split in in quarters you would be working with 1 mg. But I guess if it is 5 mg per pill 1.25 mg is pretty close. As far as being OVER supressed on switching to the pills, one explanation I heard was since the suspension was so inadequate at treating the condition, endos ended up uping the doses just to keep things under control since the suspension was only 50% (or whatever) effective. When they took those numbers and switched their kids to an equivalent dose of hydro that was 100% effective, they were nowhere near the right doses. Not their fault. Look to Upjohn for that one.