Hi Donna,

First of all, congratualtions on your pregnancy!  I’m a 42 year old male with CAH. Having gone through three pregnancies with my wife, I can report that mood swings are a natural part of the process.  But over the years, I have learned to listen to my body when I am feeling "low" on medication -- during periods of high stress or illness.  When I recognize this feeling, I give myself an additional stress dose, which usually corrects the problem.  But I’ve never had to worry about the health of a baby inside me.  Communicate with your doctor and tell him/her how you are feeling.  Combine that regular level testing, then have your doctor communicate to you the potential risks to your fetus.  This should help you regulate your dose, and understand what you are feeling, or at least, help you realize it’s something you should deal with in order to keep your baby safe.

For the record, everyone’s dosing needs are different and ever changing.  When I’ve shared with this board that I’ve been on 60 mg. of hydrocortisone per day for over 20 years, some have expressed shock or even disbelief.  But my testing show that I remain undersuppressed.  I have never showed any signs of being cushionoid (swollen joints), and my general health remains excellent, so I continue to listen to my body and endocrinologist, and trust I’m doing what’s right for me.

I hope this message has been some help, and wish you the best of luck -- Eric