Hi Sara

I’m a parent, not a doctor - this is my understanding:

Undertreatment means that growth races ahead unchecked, the bones fuse early and final height is compromised.

Hydrocortisone suppresses growth and a fine balance is needed (to give the correct dose) to ensure that final height is as close as possible to genetic height potential.

Overtreatment (or "oversuppression") means that growth is held back too far and final height is compromised.

If a child’s levels are difficult to balance, the endo may err on the side of caution, reasoning that the risk of slight final height loss is preferable to the risk of adrenal crisis, especially in a young child.

If the trend is wrong, as in your case, you need answers. For a salt-waster, it may mean replacing some of the Cortef dose with Florinef, which seems to have little effect on growth but aids salt retention. This is where you really need to ask your endo some direct questions.

Regards