I would take him off the cortef. First off, if he's got low cortisol 4x a day then he should take cortef and try to shut down the adrenals in order for them to heal. There is of course controversy over this protocol. But i have seen more people testify to being healed this route than the natural route.

I have a buddy on here that i talk to regularly and we both agree that having fluctuating cortisol is throughout the day or even having high cortisol can sometimes be more complicated to treat than low cortisol or even addisons.

Why? Because the use of adaptogens and glandulars and supplements isn't always easy to deal with. It's like i read in a book once by a lady who had adrenal fatigue. She stated "It's like having a light bulb that's either on or off. Off is like addisons disease and ON are those who are healthy. But with AF something strange is happening, the light bulb is flickering and threatening to even turn off sometimes, but it never really turns off."

So how do we fix this problem? It's different for all of us. For all of us something has triggered the adrenals to become stressed and weakened and a hormonal/chemical imbalance has occurred. Balancing this imbalance is a pain in the ass to say the least.

I had to end up going to the NTH yahoo adrenals group which is a group of patients who have written the book "Stop The Thyroid Madness." This is revolutionary group and I have seen many ppl get better there."

But they don't advocate cortef for everyone. Some people don't need to be on steroids. Some people do need only adaptogens like isocort or some other glandulars.

I'm so sorry to hear about your son. I sure do hope he finds something soon. I would also stop the DHEA as soon as possible. Make him wean off of the Cortef by 1.25 or 2.5 mg per week and the DHEA wean off as well. DHEA is a guessing game. DHEA (yes even 7 keto dHEA) will convert to other hormones and you simply don't know to what hormones. It has been found to do more harm than good in the long run.

Oh, and an AM cortisol blood draw is def not enough. You absolutelly need to get a 4x a day saliva cortisol test done to see exactly what the adrenal glands are doing. But in order for this test to be conducted you need to wean off cortef and be off for at least 2 weeks

He is lucky to have such a supportive Mother.

Just keeping learning and researching. The one thing about Adrenal Fatigue is there really is no quick fix.

It is very important to learn all of the things that trigger the stress response and avoid those (action movies, gaming, roller coaster, excessive exercise, etc.)

He'll need to make many lifestyle changes. Learning about meditation and mindfulness is important to keep emotions in check. Some people eliminate all the physical sources of stress, but them still go around getting angry all the time.

There is a lot to learn. Best of luck. Keep surfing this forum, there is a lot of experience here.