Hi Megan,

I am very sorry to hear about your mother-in-law. 

I agree completely with all you have said about timing of doses.  To me, dose timing is closely related to the issue of size of dose....in theory, if you dose as closely as possible to the way that nature intended, then the total amount of medication can be reduced, because you would be achieving maximum efficiency. 

But, as you said in a different post, even if we try to mimic normal cortisol production as closely as we can, it will still be impossible to get it absolutely perfect...so, there will still be times of minor oversuppression and minor undersuppression.  What happens when we add the cumulative effects of those periods of glucocorticoid excess or androgen excess (however small) over a person’s lifetime?  That is the part that still worries me, for my son....what long-term negative effects are going to be inevitable, no matter how hard we try?  

At any rate, there is certainly a lot more to be said on this subject, but like you, I will have to cut this short for now....we’ll pick it up another time.  Thanks for your input and have a safe trip.

Carol