Hi Megan,

Thanks for the link.  Believe it or not, the 80:1 dex to hc relative potency for treating adrenal insufficiency was reported as far back as the 1950’s by Lawson Wilkins, one of the "founding fathers" of pediatric endocrinology.  What is most dismaying to me is that, even when research is done and new information available, no one really seems to pay much attention!  

With the equivalency issue, I think the tough thing to wrap one’s brain around is that the relative potency of a medication can change depending on the condition being treated....and probably a whole host of other factors.  It is not an absolute number, like saying there are 12 inches in a foot.  So the numbers one sees listed in standard drug charts (which generally state that dex is either 25 or 30 or 40 times stronger than hc) are not incorrect, per se.  They are just not correct when talking about treating CAH.  They are probably absolutely correct when talking about treating another condition such as asthma.

I share your hope that maybe in another 100 years, the right studies would have been done and someone, somewhere will benefit!  The more I think about it, however, the more I feel that, as long as treatment for CAH is based on using glucocorticoid medications, there is a good likelihood that we are going to keep running around in circles about meds, doses, timing of doses, and testing.  So, I am actually holding out hope that someone, somewhere will develop a different class of drug altogether! 

Sorry, if I am sounding a bit cynical right now...been sitting in front of a computer screen all day trying to produce a project on CADD at the same time that I am trying to learn the program, so am feeling EXTREMELY cynical and frustrated!  Time to quit, have a drink, and go watch some baseball!