Ok I just continued to think a little after the other post.    My thoughts ran off on a different tangent for a while...

With the nature of the HPA axis, whenever there is not enough of something like cortisol, the pituitary doesn’t quieten down. It won’t shut up until it get’s the certain levels of the hormone it is demanding a raise of.  So Jack can make corticosterone no problemo.  But I would imagine it is a weaker form of glucocorticoid.  Not quite as effective as cotisol.  Maybe it’s only made in that first mineralocorticoid pathway as a precursor for aldosterone and to spark production there?  I mean I read some while ago that aldosterone does increase when we are ill or stressed etc.  Obviously when we exert ourselves we sweat and need more sodium so the emphasis shifts and as the glucocorticoid levels usually increase perhaps this is why some goes down the first pathway and is changed to the other glucocortiocid corticosterone?  

Soooo this is what I think is happening for Jack.  Your lowering his dose, and the pituitary senses this.  So it makes more of everything it can make which is lot’s of corticosterone and aldosterone to over compensate for the lack of cortisol he is not getting.  No?  Who knows I am just theorising here.  Maybe every time you lower the cortisol -->>> more corticosterone is made and aldosterone?

Had the ACTH and renin checked of late?

I am wondering if it is best to raise the dose now after this little brain blowout?  Who knows what kind of twists and turns these things can take with the different deficiencies?  Perhaps you can go by the renin numbers?  "Surely if he cannot make cortisol though he’d make more androgens"? I hear some folks say here?  Well who knows--maybe he’s making heaps of the wrong glucocorticoid (such as the corticosterone) to over compensate?  I mean if the above theory is correct eventually you will cut right back to nothing and have lots of corticosterone made etc.  Question is, what effect does that have if this line of thinking is correct?  The other thing that concerned me thereafter was, if aldosterone levels are raised, doesn’t that slow down growth?  Would he show with high blood pressure?     

Well that’s me made a total fool of myself for the day!  I’m off...
Maybe I’m totally wrong but I am wondering how you could determine that this was not happening for him?  What hormone would you measure or enzyme would you measure?