I do feel fortunate that Jack's height growth has been pretty good. I worry a little about bone age, I know others have posted it can increase -by years- fairly quickly. But so far, his has been ok. His 17OHP was <5 for a very long time after coming off the Cortef liquid in the spring of 2000. I was very uncomfortable with it but we didn't want to decrease too fast. (Again, I love your stomping idea. That maybe would have helped him out of the oversuppression better than all the gradual decreases).

I agree with you about letting the 17OHP go a little higher than the strict "normal" range. I know many others have posted that their dr.s also are o.k. with numbers as high as 1000ng/dl. If all we had to work with was his 17OHP, I don't think his endo would have recommended a dose increase. But, because we had so many questions about his levels and doses,  his endo agreed to test a few other levels as well. For the past few draws he has had his 17OHP, ACTH, androstendione, cortisol and well as the renin, sodium and potassium done. From the late March draw to the mid-June draw, he grew 3/4 inch and his ACTH went from 34 pg/ml to 259 pg/ml (normal range of 10-60). His cortisol in June was  <1 (normal range of 3-21 ug/dl). Given those developments, it seemed like we should increase.

I expect we will know more after his next blood draw and height measurement this Monday. This will be his first draw after the increase (when his 17OHP was 551).  I just have a feeling we are headed into an undersuppression phase. I really like your stomping idea and will strongly advocate to his dr. that we try this if his levels indicate an increase. I was talking with my husband about the stomping idea and we figured out something very interesting. Jack's period of best control was between 3 and 18 months old. At that age, I was pretty liberal about doubling his dose for colds and coughs. He probably had several days of double doses per month. He also was on a fairly low dose of Cortef. I wonder if I was unintenionally stomping his adrenals by giving the double doses so he stayed in control with a relatively low dose. Once he turned about 18 months old, he seemed to recover from colds better and I stopped doubling so much. From 18 months to 2 1/2years I probably only doubled twice. I guess I probabably shouldn't over- analyze this. CAH is an incredibly complicated condition. I can't believe how much there is to learn.

BTW -His weight has increased with every cortef increase, but at this point I try not to be too concerned with it. He eats pretty healthy and is very active. As a three year old boy, we don't have any real social issues with his weight yet (He looks stocky, but not obese). As he gets older I am sure we will have to take weight into consideration much more.

Thank you again for all your input. I will keep you posted on how his next dose change goes.