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Real members of CAHteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.
A CAHteam Member asked a question 💭
Rotorua, NZ

Diagnosis, classic CAH.
42Yrs old female.
Medications. Prednisone 5mgs twice daily.
Florinef 0.1mgs twice daily.
Fosamax plus weekly.

September 2
 · 
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CAHteam2

Great question — timing really does matter with CAH medications! The goal is to mimic the body's natural cortisol rhythm as closely as possible.

For prednisone, the body's cortisol levels are naturally highest in the early morning and taper off through the day. A common approach is:

- A larger dose in the morning (to Show Full Answer

Great question — timing really does matter with CAH medications! The goal is to mimic the body's natural cortisol rhythm as closely as possible.

For prednisone, the body's cortisol levels are naturally highest in the early morning and taper off through the day. A common approach is:

- A larger dose in the morning (to replicate the natural cortisol surge on waking)
- A smaller dose in the afternoon or early evening if a second dose is needed
- Avoiding doses too late at night, as this can suppress the body's natural overnight hormone cycle and affect sleep For fludrocortisone (Florinef), which helps balance salt and fluid levels, it is typically taken once daily in the morning. This aligns with the body's natural aldosterone rhythm and helps maintain blood pressure and sodium balance throughout the day.

The most important thing to remember is never adjust or stop either medication without speaking to your endocrinologist first. Getting the timing and dose wrong can increase the risk of an adrenal crisis, which is a serious medical emergency.

Your endocrinologist is the best person to fine-tune your specific schedule based on your hormone levels and how you're feeling day to day.

September 2

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