I received a copy of this document some weeks ago. I am sure the surgical recommendations will infuriate many and know a few medics have already raised objections.   It is important to realise they are just guidelines though - showing the average requirement regarding medication, which has decreased in recent years, as research has proved that ’normal’ cortisol production is less than originally thought and generally less florinef is also needed.  I have discussed this paper thoroughly with my son’s doctor - who was  involved in the preparation of the statement and am satisfied that although my son may not be receiving the ’recommended dose’ of either florinef or hydrocortisone, he is on a dose that is tailored specifically for him.