Hi Lisa,

I only have a few minutes so I’m sorry if this post is not well written, but I just had to write. My son has been struggling with his weight since birth. He is very, very active and we eat healthy foods.  I am thoroughly fed up with drs telling me it is my fault for feeding him too much food. I have learned to just ignore their comments and chalk it up to their inability to provide me with an answer.

I have kept very detailed records of my son’s weight, height and doses since birth. Every time we increase his dose, he gains weight. Every time we decrease, he maintains weight.

Last winter his endo put him on dex and he gained nearly 10 pounds in three months. We switched back to Cortef (circadian dosing) and he lost 2 pounds these last three months. I am a huge fan of circadian for those who need it.

My son seems very reactive to the timing of the doses. When he was on high evening doses he put on weight quickly. Since we started his highest dose at 3:30 am (with no dose in the evening) he has done well.

He also sleeps more when he does not have an evening dose. Up until he started circadian dosing he slept 1-2 hours less than the range for children his age. Now he sleeps a more typical amount.

I am constantly reading health articles that mention "stress hormones" or cortisol levels as the reason why people gain weight. In fact just this month Prevention magazine had an article on losing weight and it mentioned that stress hormones interfere with the body’s metabolism and cause weight gain. To me, it seems like they do know that stress (or in the case of CAH, synthetic stress hormones) cause weight gain.

I have also read several articles discussing the benefits of more sleep (or "enough" sleep) on weight gain. I believe this is why my son does best when his doses follow mealtimes, but not in the evening. He can eat the same amount but it doesn’t seem to add weight. He sleeps more and feels better.