Generally in CAH the ranges that they use for 17 OHP to control the condition in children affected are slightly higher than those of children with healthy adrenal glands.  This is because they generally take the bloods first thing in the morning before med’s are given.  So those figures that they give in most abstracts are the recommended numbers after factoring such things and would be the correct levels for children on conventional dosing I feel.   Those would be between 500-1000 ng/dl (15-40nmol/L).  On conventional dosing the child will have gone for many hours without med’s--from 10-11pm the preceding evening to the morning blood tests.  So whilst 500-1000 ng/dl may seem high when you compare it to the normal levels, this would be the reason why the levels are higher than that of children who do not have CAH.  Their levels are considerably lower than our kids 17 OHP levels.   

Lane’s 17 OHP results are elevated above what is normal in children of that age although they look in the normal range for our kids with CAH.    However, when they start him on glucocorticoids, this may change and they will work his med’s doses out by his length and weight initially and this may mean over shooting the mark initially so that they can gauge what is a normal dose for him.  So it may dip below 500’s or whatever it is now a month from starting the med’s, but they will adjust to suit him and if you have a good Doctor they will control him well between those figures as above.    Well that’s if he is diagnosed with CAH and need’s treatment.  I presume looking at his test results that they are elevated from when the first tests where done and that this reflects the fact that he has some problem causing such elevations.   Basically a child who did not have CAH would have much lower levels than that--even at that time of day, because they make cortisol more regularly and at just the right levels to keep things ticking over.  That is becauses they make cortisol as the pituitary demands it at various times through the day and night, so depending  on which time of day the tests are done for our kids, they can look a tad over suppressed.   I would say that the best time to get bloods would be before the morning med’s for you as any problems of over and under suppression will definately be apparent after not having med’s since the evening before.    

Regards

Anne-Marie