Personally, I have always doubled the dose of cortisol (atleast) with a cough or a cold as even if a fever is not present, to my mind I feel that the body is still going to be trying to deal with such and therefore cortisol levels are going to be stressed.  (If there has been a fever I have tripled the dose and given pain relief medication as this brings the fever down also ) Also, when my child was small and couldn't communicate very well, I was always told to 'err on the side of caution' and if in doubt to double the meds.  This cannot do any harm and if anything is playing safe.  To me a fever is at the peak of becoming sick and there are many other things happening within the body before things reach such a peak that are negative, and therefore,  I would not wait for that to happen.  On several occasions I have gone with my gut on this and doubled and only be just in time to stop him from progressing to the vomiting stage. I have known this as he has complained of nausea one minute and then after cortisol has said that he felt much better.  Other times we have not acted quite quickly enough (using the above principle!) and he has not been able to keep his meds down at all.  Even when there have been no signs of a cold and it could very well be just a vomiting illness, it is irrelevant as at the end of the day, if you cannot get the meds down them, you are in my opinion in very deep water and need cortisol shots or a drip, as no one can determine what will happen and to what extent your child's needs for cortisol are at that time without these.  We have had many close shaves now when I reflect on things and a lot of the time I have had differing opinions on exactly 'when' to double or triple.'  I think really at the end of the day, you really need to assume that it is better to be on the safe side.  Frankly, when a doctor tells me that it can affect the next blood tests and throw them out, I have always perceived this as a silly attitude to take.  Since I feel if I didn't act as I did half the time and trust my own judgement and gut instinct where this is concerned, things could be a lot worse than just it 'affecting the next lot of blood tests.'  I hope that this helps in some way and I am sure that there are many on the board who will have hit these periods and do the same.  

 

JH