think with any regime Jill when a child is ill, their doses need to be spaced equally apart.  I never allow Ashley to go to 2am on the occasion that he is ill.  The last few days for example he has been sick with a cold and sore throat.  He felt nausea come on at dinner time and I then divided his total daily dose into three (his total daily is 15mg--so doing this it ends up as 5mg) and then I double or triple that dependant on the illness.  For colds that are causing nausea (without temp) I double and I triple if he is not feeling better on the next dose.

So in all he ends up on 10mg or 15mg per dose when sick and I space the doses 8 hourly literally until I see he is obviouslt recovering.  

The reason that I do this is because when these kids are ill doubling "each" singular dose may not be enough coverage.  For example if I just left him 11 hours from the 3.15pm dose until his 2am dose, he would certainly be very low in cortisol at the end of that 11 hour period and I would only be giving him 7.50mg (if I doubled) and really that may not be enough to help him cope with whatever is causing the illness.  Especially when he has gone 11 hours anyway.  I suspect that 17 Hydroxyprogesterone in illness raises quite rapidly and in that case 11 hours in illness would mean by the time he did get the 2am dose- the dose of 7.50mg would in no way have a chance of doing what it needs to do as it has to deal with the excess 17 OHP before it can really help with cortisol levels. 

When people with normal functioning adrenals are ill I believe no matter what time of day or night it is, the cortisol levels would naturally be high through such an illness to help the body deal with that.  Even in sleep I feel really.   they would certainly be much higher than normally.  So as your probably aware, it is senseless waiting until the 2-3am dose anyway.   At times like that in any case dealing with the illness is priority and getting your child well again.  I don’t think that children grow very well or thrive well when ill--so the sooner you get control of that situation the better really.  Even if this means giving the doses at 7am, 3pm and 11pm as I do when he is sick.   just bring the evening dose forward and I get to lie through--lol--well not really I sleep with one eye open in such instances!

regards

 

Anne-Marie