I personally have been struggling with my CAH for years.  I think it all depends on the treatment you receive.  I know my first endo never mentioned that bone loss could occur and it wasn’t until I switched doctors that I found out the damage had already been done and I was a 17 year old with osteoporosis.  Right now I’m in college full time and struggling to go to all my classes in a given week.  I find some days that I’m too exhausted to move, much less walk the 4 blocks uphill and the 2 steep flights of stairs to my classes.  No matter how much sleep I seem to get my muscles are still weak and I am still exhausted.  My adrenal glands are fully atrophied now and my doctor recently "stopped seeing patients" without letting me know.  I will be switching to my 4th endo now in 5 years.  I have never felt like I was being given the proper attention or treatment for my CAH.  Now according to my lab results my DHEA levels are plummeting because my adrenals aren’t making anything, this would attribute to why I have been so fatigued and weak.  Even today, I woke up to attend my favorite class and found that with every move I became very dizzy.  Unless I wanted to risk passing out and going into crisis on the walk there, I would have to miss class.  I understand the frustration that comes with this disease for some people.  And I know how difficult it can be to make others understand that it’s not your fault and that you’re not being lazy, you’re sick.  It’s even hard to get others with CAH to understand this at times because they have had better doctors, or better luck, or maybe a better environment.  So many factors go into this illness.  I have a feeling I will never be able to work more than part-time.  But perhaps my new endo will be a little more attentive then my last 3. :-)  Thanks for listening.