I found a site today where I downloaded CAH DUE TO 21-HYDROXYLASE DEFICIENCY, A guide for patients and their families; from The Johns Hopkins Children's Center. Under the section on "SPECIFICS OF ENDOCRINE TREATMENT, A. GLUCOCORTICOIDS: As already noted, the goal is to administer a dose of hormone equal to normal cortisol production. Cortisol production varies greatly among individuals, from 8 to 14 mg per square meter of body surface area every 24 hours. 1.Cortisol treatment: the oral preparations available include Cortef tablets (5,10 or 20 mg) and Cortef suspension (2 mg of cortisol per 1 ml). Because gastric acid destroys some of the oral cortisol, the treatment dose must be about twice that of normal production (15 to 30 mg per square meter of body surface area every 24 hours). Due to rapid disappearance of cortisol from blood, it is necessary to administer 1/3 of a daily dose three times a day (5 to 10 mg per square meter of body surface area, every 8 hours, by mouth)." The article goes on to discuss Prednisolone treatment also. I could go back and do a search for the site if anyone feels it necessary. Our CAH granddaughter, age 5 3/4, was changed to pill form, 5 mg, three times a day, in May. Now she is showing signs of precocious puberty and we are desperately trying to find a GOOD endo in the Manassas VA area. HELP!! The family is moving there, and she is overdue for her 3-month blood work, but the endo's can't seem to take her before NOVEMBER. Should we take her to Johns Hopkins? to UVA in Charlottesville? WHERE?