Hello Chris Just a couple of thoughts Does your endo do 24hr 17OHP tests? We get them done in the UK and they usually show some daily fluctuation. I have been reading a lot recently about circadian rythyms and how the level of cortisol fluctuates in the blood over 24 hrs. I have noticed that with our daughter - 15 months - her 17 OHP level is higher in the am (over 300) and very low (less than 20) in the evening. We haven't sorted out her levels properly yet because her endo wants to increase her cortisol to get her high 17OHP levels down. But we have been saying that although her levels are way out at one time of the day - at the others they are relatively low. So we have suggested moving some of her later dose forward to the morning dose to give her more cortisol when she seems to "need" it and less later in the day when she doesn't seem to "need" so much. ie we are trying to get better results without increasing her overall doseage. Mind you we haven't her new blood results back yet! In your case - what I just thought was, what time of day are you taking the 17OHP bloods and how does this time relate to the doseage times? Maybe the levels are very low at one time but they might be more at another. According to the circadian pattern, you should expect to have a greater need of cortisol first thing in the morning and a lesser need at night - except for times of stress/illness etc. So the high 17OHP levels of our daughter in the morning seem to indicate the need for more cortisol then, rather than later. Don't know if this is any help, but it might give you something else to think about. Best wishes Sarah