Q: My daughter, who is 3 months old, suffers from CAH due to 21-hydroxylase deficiency. We check her sodium and potassium once a week but I think this is harmful for her. Are there any methods to check her electrolyte serum at home more simply than going to a lab?

A: It is usually necessary to check sodium and potassium frequently in the first month or so of life, until the levels have stabilized and the treatment doses do not need adjustment. Once you get the levels stabilized, though, there isn’t usually a need for such frequent checks. Usually every 3 months (along with adrenal hormones and plasma renin activity) is adequate. Perhaps your daughter is not gaining weight, or has difficulty taking her meds and that is why your doctor is checking more frequently? If that is not the case, perhaps you could ask your doctor if the blood draws could be spaced out now that she is 3 months old and stable on her meds. In terms of the routine labs that are checked every 3 months, however, unfortunately there is not a simpler way to do it.

Q: Hi, I am a 44 year old female LOCAH. I was diagnosed about 14 years ago after the birth of my second child, and have been relatively stable on 5mg. prednisone daily, and antiandrogens. I have always worked out, and had no issues with maintaining my weight. Recently, though, I’ve had an almost overnight weight gain, recurrent yeast infections, and severe reduction in my androgens. My doctor and I have stopped the antiandrogen drug, but still I am having issues with fatigue, weight, yeast, and radical headaches. My most recent labs show 17-OHP at 12f, testosterone at <10, DHEAS at <3, ACTH at 8f (6-58 range). Am I oversuppressed? Is this what happens with menopause? I fear I may be my doctor's oldest patient with this disease, so we are both chartering new territory. He has done blood work that confirms ovarian failure. Please, any input would be greatly appreciated. Thanks.

A: Yes, it does sound like you are oversuppressed. It is common for androgens (along with estrogen) to drop after menopause, and a reduction in steroid treatment is generally warranted. Some non-classical patients do not require any steroid treatment at all after menopause if they are asymptomatic. Your doctor can start to wean your prednisone while checking your hormone levels after each reduction, and if they remain low, you may be able to come off prednisone completely.