Hi Chris,

 

I was very interested to read on pg. 3 that you said Jack has 17- vs. 21-hydroxylase deficiency?  Wow..how interesting!!!  When did you find this out???  I know you have been worried about him consistently being on a very low dose of hydrocortisone, and wonder if this might have something to do with it. 

 

From what I can tell, those with 17-oh deficiency do not have excess androgen production, therefore the doses of glucocorticoids that they need to maintain control should be closer to true replacement levels, rather than the larger ones needed to effect androgen suppression.  Could THIS be an explanation for why Jack does okay on such small doses, as well as why he seems to have no problems with salt-wasting crises, even while on such small doses?  (Those with 17-oh deficiency also seem to produce normal levels of aldosterone.)

 

Except for what I can surmise from looking at the adrenal cortex diagram, I really know NOTHING about 17-hydroxylase deficiency, so this may be completely off the mark. But I couldn’t help wondering about this, after seeing your post and knowing the frustrations you’ve encountered in the past.  Just a thought.