Megan thanks so much. Sorry I posted in a hurry and should have said my son does have SWCAH. Morning 17 OHP (pre dose) was 520 mnol/ls, random 17 OHP taken 3 weeks later in the afternoon 390mnol/ls, A4 19.9 which to me shows poor control, ACTH not done. The endo has known about this for months but is happy to stay on the present dose, he confirmed ACTH patches. I am concerned the endo it appears does not consider this urgent! Son feels very tired, fast heart beat, bad headaches - not related to CAH apparently, weight loss over 10 kgs in 4 months! I just wonder if that once growth is over, if perhaps high levels are not as important. Also wonder if my understanding of CAH is wrong! Tests are planned but could take at least another month and then weeks to get results.Thanks for your input.