I take 15mg, 5mg and 2.5mg and have been told it is on the high side. I am only on that much to suppress my ACTH. I know some docs go by weight but I am on the high side thanks to Cushing's. I have no adrenals. I take .1 florinef but will up to .2 next week.

Has your husband done a 24 hour urinary free cortisol on meds to see how his body handles his current dose?

Does he have any outward symptoms of Cushing's? The reason one does not want to take too high a dose is that while it may not seem too awful at first, but it will lead to bone necrosis, muscle wasting and cataracts. More subtle symtoms may be too high a blood pressure, red face, weight around the belly, high glucose, edema. It is really necessary to find the optimum dose while not taking too much - and not too little either.

I'm currently on 45mg, 30/10/5. From what I've read, 30-40 would be about right for a full replacement dosage for a male, so 30mg is not especially high for a male. My 45 is high, but I'm not responding well to any meds, so we (my MD & I) are suspecting malabsorption. I've been at that level for months, and show no hint of the symptoms that Rumpled lists (a good list). There are studies showing risk of bone loss in males at 45 vs. lower doses. I'm also on florinef, and have ranged from 0.15mg to 0.25mg, trying to keep symptoms at bay yet minimize the weight gain that comes with that one.

I take 25 for the cortef and i think 0.5 of the florinef.