I’m sorry this reply doesn’t cut it for me  ;-) .

"Our endo (who is highly respected from Johns Hopkins) said that it would be unlikely b/c we are putting into his system what he doesn’t produce himself. And that it would be a different story if a person was getting too high of a dose of steroids (more than his body needed)".

This sounds just like the pat reply that doctors usually give us regarding the relationship of weight gain or osteoporosis to replacement dosing.

This seems to be a crazy answer to your question because it’s got nothing to do with how much the body needs but it has to do with the dose going into the stomach. Normal endogenous cortisol doesn’t go near the stomach and therefore it isn’t an issue. However we have to take steroids orally and the stomach is the first point of call. Even if it is a small dose it is usually commensurate to the age and size of the child/person. Obviously the more you take the more chance of problems but that doesn’t mean it can’t happen with a replacement dose - IMHO.

Look in any pharmacopoeia and they will say that oral steroids can cause peptic ulcers. I think the best protection is NOT to take steroids on an empty stomach.