Yes Risty, I think the steroids need to be out of the system for the ACTH stimulation test to be accurate. The aim of the stimulation test, in order to assess for CAH, is to evaluate the hypothalamic-pituitary-adrenal axis (HPA) response and if it is already blunted from taking steroids, then the test is probably quite inaccurate. It is very variable as to how long the adrenal gland takes to return to its optimal functioning level...I have heard in some cases as long as a year. Obviously for a CAH person the optimal function is poor anyway, so knowing when it is the right time to have the ACTH stim test, following cessation of steroid medication, could be tricky. Any suggestions folks? (My brain is pickled, I’ve just come in from work, 11pm.....so what I’m writing here will probably make no sense in the morning, when I re-read it).

Macarena the numbers you mention for cortisol certainly are low for the baseline but then do respond quite well post stimulation but not quite as well, as most non-CAH people. What time of day was the test done? This level seems to fit with a non-classic response.

As far as the 17-OHP level goes, I’m not sure what unit of measurement the test was done in. If it is in nmol/L then the baseline is slightly elevated and again rises but more in keeping with a mild CAH condition. Of course the unit of measurement may be something else and this would/could change the expectations.

Blessings