Susan,

I've read of alternate day steroid treatment for other conditions ( Crohn's, nephrotic syndromes, asthma, etc.) but not for CAH.  From what I gather, the reason was to avoid the negative effects of glucocorticoid excess (cushing's syndrome, growth retardation, etc.).  As an adult who only needs the steroids for replacement purposees, it seems to me that you should be able to avoid oversuppression more easily than taking such vastly different doses every day, especially since you are taking dex, which is very strong to begin with.  When you go from .325 to .5 mg, you are increasing more than 50% in one fell swoop; and when you go down from .5 to .325, you are reducing by 35% (and this all in one day!!)  To me, it sounds like this could be very taxing on your system---talk about yo-yo effect!!!---but that is just as an outside observer, looking in.  I'm wondering how you think this approach has worked for you, and also what others think of this.