When my son changed from twice daily to thrice daily dosing, his total hydrocortisone for the day was actually reduced as more frequent dosing meant he didn’t need such large doses.  He lost weight as a consequence, which was great as he was starting to get quite stocky at the time. Cushingoid effects only appear with overtreatment and I believe kids on a twice daily routine are therefore more likely to have these symptoms than those on smaller more regular doses.

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