All of Kelvin's doctors have said to make sure always that steroids are taken in the morning (first thing after eating) so it doesn't mess up their natural Cortisol levels. Cortisol is a corticosteroid hormone or glucocorticoid produced by the adrenal cortex, that is part of the adrenal gland. It is usually referred to as the "stress hormone" as it is involved in response to stress and anxiety, controlled by CRH. It increases blood pressure and blood sugar, and reduces immune responses. It is very important to keep their natural Cortisol in check. Go to Wikipedia to read more about Cortisol levels. When you read about Cortisol levels, it makes me wonder about behavior issues in the boys and how it could be causing greater issues for those who take it later in the day. Michelle
We do the steroids in the morning as well. But there are some supps we give at night and some that we give both AM and PM. For example, if you give more than about 600mg of calcium at once, the body can't absorb it all. So we give 600mg AM and 600mg PM. We also split the antioxidants; green tea in the morning, vitamin C and Protandim at night.
Just to add on to what the other's have said... steroids increase urine production and cause jitterness so I don't think you want these things happening at nighttime.
I also split our sons meds/supplements up throughout the day. Green tea is given before dinner so he's not all wired up before bedtime. Calcium and vitamin D are given together. I usually give this if he is getting ready to go outside and with another calcium product.
We were told to give steroids in the morning because they can have a stimulant-like effect -- if the kid's going to be "wired," best it's during the day.
The Calcort label says it's not to be taken within two hours of an antacid, so we give the calcium supplements (Tums) later in the day.
I give Ben his calcium, multi-vitamin, and CoQ10 together, so that calcium can go in with the vitamin D & the CoQ10 can go in with the vitamin E (it's *supposed* to help with CoQ10 absorption -- some brands come with vitamin E included, but I've been using it plain, alongside the separate multi-vitamin).