Sorry I didn't see this thread earlier.
I have QA1s on my Superformance that came with stock 10" 450# front coil-over springs and 12" 425# springs in the rear. I could not get any more adjustment to lower the fronts so I switched to 8" 450# Carreras, and at the same time, switched the rears to 12" 145/350" progressive rate springs from QA1. While I was in the process, I found out from Dennis Olthoff of Olthoff Racing fame that they usually invert the shocks and get better performance overall because of lower unsprung weight at the wheels. So, I installed them inverted (shock body up top). Quite frankly, I didn't really notice any difference other than a more comfortable ride with the softer initial rate of the rear springs. I also seemed to get better bite during the occasional rapid acceleration runs.
Recently, the 10" 225/475# springs became available from QA1 so I got them and attempted to install them to the fronts, I struggled to re-install them but since I got nowhere and it being a royal PITA, I re-installed the 8" 450# fronts and decided to install the 10" progressives to the rears. I had to order (4) 1" spacers from QA1, stackable to 2" each side, and the results so far are phenomenal. I don't bottom out anymore on the large bumps, yet retain the comfort of softer initial rate at cruising speeds. Of course, now after I have everything set up, I learned of a trick to compress the spring/shock assy before mounting so I may get another pair of progressives for the front and attempt that again.

Well to answer the initial question, you CAN install the shocks with the body up top, but each manufacturer is different. Bilsteins and QA1s are OK, SOME Carreras can't be inverted. I don't have a problem changing ride height w/ adjusters up top, I just jack it up and squeeze between the fender and the top of the tire. I also turned it so the adjuster knobs are now facing the tire.
