Cortisol and adrenaline (also known as "epinephrine") are made in two different parts of the adrenal gland....cortisol in the outer part of the gland called the "cortex;" adrenaline in the inner part of the gland called the "medulla." In the past, it was believed that people with CAH---who have problems with their adrenal cortex---had normal adrenaline production. However, recent studies have shown that many with CAH also have a problem with their adrenal medulla, and that they produce LOWER than normal levels of adrenaline.

There are a couple of articles about this on the web, prob. more if you do a more comprehensive search.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11070100&query_hl=2&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14764767&query_hl=5&itool=pubmed_docsum

While these studies show a lower adrenaline reserve in CAH patients, I (personally) believe that doctors have only uncovered the tip of the iceberg. In times of emotional distress, I have seen my CAH son behave in ways that would suggest a HIGHER adrenaline response. This leads me to wonder whether there is some short of short circuit that occurs between the adrenal cortex and adrenal medulla of someone with CAH, in times of severe emotional stress. Bottom line....yes, it does appear that there is a problem with adrenaline production in those with CAH. But, doctors are just starting to understand some of the implications.