I wanted to post this as my son’s labs had been coming back very high.  We are on our 5th endocrinologist the doctor we have now is the only doctor we have seen that believes the dosages need to be administered at certain times (circadian rhythm).  My son’s 17OHP was running anywhere from 2700-3600ng/dl.  This was with him on 35 mg of Cortef per day.  According to the calculations of his weight and height, he should have only been taking 20 mg.  Originally we were giving him his morning at 6:00. 

As a result of all this, he started into puberty at the age of 11.  This I know is a borderline age, but he also has advanced bone age.  Our new Dr. reduced his dosage back to 20 mg.  He takes his largest dose in the morning as he feels that taking a large dose at bedtime doesn’t do any good as it is out of his system by the time he needs it.  We give 12.5mg at 4:30am, 2.5mg after school and 5mg at bedtime.  We were told the timing wasn’t as important for the 2nd and 3rd doses.  When we had our first lab his 17OHP was under 20!!!!  I couldn’t believe the timing could make such a difference. 

I look back and wonder where we would be now if we would have had this information from the beginning!!!