Cindy, Thank you for your kind words. You raise some good questions. I read your earlier post about your own experience with sodium and florinef and I have a couple of comments. First it sounds as though your son was still on Solu-cortef. If so, that was certainly a wild card and might have a lot more to do with his elevated 17-OH levels than his need for florinef. 17-OH levels can be affected by the block in aldosterone synthesis but I wonder to what extent. It is also true that cortisol therapy is simply replacing what the body makes normally and the same should be true with aldosterone. The problem is that florinef has a long half-life but the need for it will vary greatly in the short term depending on how much salt has recently been consumed. It's therefore much harder to zero in on the best dose of florinef to use. Elevated plasma renin level is supposed to indicate the need for florinef but how high is too high? In my own case I was originally put on florinef because my plasma renin levels were high. In normal people elevated renin is usually associated with hypertension and all that it entails. In CAH, elevated renin seems irrelevant as a health issue since it doesn't lead to hypertension. At least for me that seems to have been the case. This is something you need to discuss with your son's endocrinologist. However I do I think that it is a good idea to stay with florinef until a child is at least old enough to be able to salt his food himself and get his own water. Perhaps when florinef is started early enough it keeps children from developing an excessive taste for salty foods and high blood pressure doesn't become an issue. So in answer to your question, the bottom line is a definite, I don't know. BTW - I think I read about the same case you mentioned in the Johns Hopkins Medical Journal back when I was in graduate school. A three year old was admitted to a regional hospital for a flu like illness. In giving his history his parents reported that he had always had an inordinate fondness for salt. The doctors, in their wisdom, put him on a restricted salt regimen. He died several days later of cardiac arrest. There are more things in Heaven and Earth than most doctors have ever dreamt of. Thanks again, Joan