Hi Jill,

The studies I mentioned come out of professional medical publications (which your endo should be reading), and are also available on the Internet.  Their presence on the Internet doesn’t make them useless, just accessible!  Our first endo told me that most of what was on this message board was wrong.  Hmmmm.

Your endo is right that there are no large, long-term studies proving the superiority of one dosing method over another.  An optimal dosing schedule will vary with each child.  There is, however, a good bit known about the natural rhythm of cortisol production (or attempted production), and a good bit known about the bioavailability of Cortef.  You put the two together, and a sensible dosing scheme emerges.

I would be happy to send you an illustration of the coverage provided by different dosing schedules for an “average” child.  There is no such thing, of course, but it’s a place to start.  Observation and testing will tell you where to go from there.

Our current endo is an angel.  She is open to new ideas, and her ego doesn’t get in the way of hearing our concerns.  She’s thrilled that our dosing schedule is working beautifully for my girls, even if it was my idea!  We make a 5 hour round trip to see her - worth every minute.

If your son is growing as expected, has appropriate bone age, and is maintaining a healthy weight, it’s probably not worth the disruption to your sleep to change.  If not, you may want to give it a whirl.  I’ll send you some info.

LauraK