Dr. Caroline Kaercher Kramer – Endocrinologist | Toronto, ON

Dr. Caroline Kaercher Kramer, a Endocrinologist (Diabetes & Metabolism Focus), provides expert care for adult patients, and may also see older adolescents for certain endocrine conditions. With conditions related to Diabetes & Metabolism, she practices at an endocrinology clinic within a hospital department in Toronto, ON. She is a key member of the local medical community, adhering to the standards set by the College of Physicians and Surgeons of Ontario (CPSO). Her practice primarily centers on the comprehensive management of type 1 and type 2 diabetes, metabolic syndrome, and lipid disorders, ensuring a thorough and personalized approach to hormonal and metabolic health. The practice is dedicated to providing advanced diagnostic assessments and individualized treatment strategies tailored to each patient's needs.

Graduating with a Medical Degree from Fac Fed de Ciencias Med de Porto Alegre in Brazil, Dr. Kramer has accumulated over 10 years of experience as an Endocrinologist (Diabetes & Metabolism Focus) since 2014. She is recognized as a CPSO Recognized Specialist by the College of Physicians and Surgeons of Ontario, reflecting her expertise and commitment to excellence in endocrine care. Her professional development includes continuous education and certification in the latest endocrinological practices, ensuring her patients benefit from current evidence-based treatments.

Dr. Kramer’s clinical philosophy emphasizes evidence-based hormonal and metabolic care, prioritizing early and accurate diagnosis and patient education to empower individuals in managing their chronic conditions. She is dedicated to delivering personalized treatment plans focused on long-term health and well-being. Fluent in both English and Portuguese, she strives to build trusting, clear communication with her patients in Toronto, providing compassionate and comprehensive endocrine care.

Dr. Caroline Kramer diagnoses and treats a wide range of hormonal and metabolic disorders, including:

Diabetes & Related Metabolic Disorders

• Hypoglycemia (Low Blood Sugar - various causes): Abnormally low blood glucose levels, which can occur as a side effect of diabetes treatment (insulin or certain oral medications), or due to other underlying conditions like insulinoma or adrenal insufficiency.
• Monogenic Forms of Diabetes (e.g., MODY, Neonatal Diabetes): Rare types of diabetes caused by mutations in a single gene, differing from the more common Type 1 and Type 2 diabetes in presentation and management.
• Dyslipidemia (High Cholesterol, High Triglycerides, Low HDL): Abnormal levels of lipids (fats) in the blood, including elevated LDL ('bad') cholesterol, high triglycerides, or low HDL ('good') cholesterol, significantly increasing cardiovascular disease risk.

Thyroid & Parathyroid Gland Disorders

• Hypothyroidism (Underactive Thyroid - e.g., Hashimoto's Thyroiditis, Post-Ablation): A common condition where the thyroid gland doesn't produce enough thyroid hormone, leading to symptoms like fatigue, weight gain, cold intolerance, constipation, and dry skin.
• Thyroid Cancer (Differentiated - Papillary, Follicular; Medullary - follow-up care): Malignant tumors of the thyroid gland. Endocrinologists are involved in post-operative management, hormone suppression, and long-term surveillance.

Bone Health & Mineral Metabolism Disorders

• Disorders of Phosphate Homeostasis (Hypophosphatemia, Hyperphosphatemia): Imbalances in blood phosphate levels, which can be caused by various underlying conditions and affect bone health, muscle function, and energy metabolism.
• Paget's Disease of Bone: A chronic skeletal disorder that disrupts the normal bone remodeling process, resulting in bones that are enlarged, misshapen, and structurally unsound, leading to pain, deformities, and fractures.

This list is not exhaustive. For personalized advice regarding your specific endocrine condition, please consult with Dr. Caroline Kramer.

• Transitional Care for Young Adults with Chronic Endocrine Conditions: Facilitating the smooth transition of adolescents and young adults with lifelong endocrine disorders (e.g., Type 1 diabetes, congenital adrenal hyperplasia, hypopituitarism) from pediatric to adult endocrine care services.
• Genetic Counseling Coordination & Testing for Hereditary Endocrine Neoplasia Syndromes & Familial Disorders: Risk assessment and coordination of genetic testing and counseling for individuals and families with suspected hereditary endocrine tumor syndromes (e.g., Multiple Endocrine Neoplasia - MEN1, MEN2; Von Hippel-Lindau), familial thyroid cancer, or other inherited endocrine conditions.
• Comprehensive Endocrine System Consultation & Hormonal Health Evaluation: In-depth clinical assessment of potential hormonal imbalances and disorders affecting the endocrine glands (e.g., thyroid, pituitary, adrenal, pancreas, parathyroid, gonads). Includes detailed medical history, family history review, targeted physical examination, analysis of symptoms, and formulation of a personalized diagnostic and management plan.
• Interpretation of Complex Hormonal Assays, Dynamic Endocrine Function Tests & Genetic Markers: Expert analysis and clinical correlation of specialized blood, urine, and saliva tests measuring various hormone levels. Includes interpretation of dynamic stimulation and suppression tests (e.g., ACTH stimulation, dexamethasone suppression, oral glucose tolerance test for acromegaly) to precisely evaluate endocrine gland function and identify genetic predispositions.
• Inpatient & Outpatient Management of Endocrine Emergencies & Crises: Acute diagnosis and management of potentially life-threatening hormonal imbalances such as diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), thyroid storm, myxedema coma, adrenal crisis, severe hypoglycemia, and acute hyper/hypocalcemia, typically initiated in an emergency or hospital setting with ongoing outpatient follow-up.
• Expert Second Opinion Consultations for Complex or Rare Endocrine Disorders: Providing specialized second opinions on challenging endocrine diagnoses, interpretation of ambiguous hormone test results, or evaluation of complex or multi-faceted treatment plans.

Note: This list provides a general overview. Specific tests and treatments are determined after a thorough evaluation. Discuss with Dr. Kramer for care relevant to your specific condition.

All medical services are provided in accordance with the standards of practice set by the College of Physicians and Surgeons of Ontario (CPSO) and relevant endocrinological care guidelines. Contact the clinic or your referring physician regarding new patient intake and referral processes.

Dr. Kramer’s practice is located within an endocrinology clinic in Toronto, situated in a vibrant neighborhood encompassing Kensington Market, Chinatown, and Grange Park. The facility is conveniently accessible via public transit, including TTC (Subway, Streetcar, Bus). The location is fully wheelchair accessible, ensuring ease of access for all patients. Paid parking options are conveniently located nearby, providing flexible parking solutions for those arriving by car. The practice is easily reachable for residents of Toronto’s diverse communities, including Cabbagetown, and is committed to providing accessible, patient-centered hormone and metabolism care.

Are consultations, hormone tests, and treatments with Dr. Kramer, an Endocrinologist (Diabetes & Metabolism Focus), covered by Ontario Health Insurance Plan (OHIP) in ON?

Medically necessary consultations with a licensed Endocrinologist (Diabetes & Metabolism Focus) like Dr. Kramer, most standard diagnostic hormone blood tests, dynamic endocrine function tests when indicated, and treatments for provincially insured endocrine conditions (e.g., diabetes, thyroid disorders, adrenal insufficiency, osteoporosis management as per guidelines) are generally covered by Ontario Health Insurance Plan (OHIP) in ON when a referral from a family doctor or another specialist is in place. Some newer or specialized medications (e.g., certain advanced diabetes drugs, some growth hormone therapies, specific osteoporosis agents), medical devices (like some insulin pumps or continuous glucose monitors and their supplies), or treatments considered primarily for lifestyle or cosmetic reasons may have different coverage criteria or require special authorization. It's crucial to discuss coverage specifics for any proposed investigation or treatment with Dr. Kramer's office, the hospital/clinic, or Ontario Health Insurance Plan (OHIP) directly.

Is a referral required to see Dr. Kramer, an Endocrinologist (Diabetes & Metabolism Focus)?

Yes, for services covered by the provincial health plan, a referral from your family physician or another specialist (e.g., an internist, pediatrician, or gynecologist) is almost always required to schedule an appointment with an Endocrinologist (Diabetes & Metabolism Focus) such as Dr. Kramer. Endocrine system disorders often involve complex interactions and can have wide-ranging effects, so an initial assessment by your primary care provider helps determine if specialist care is needed and ensures that relevant preliminary tests and medical history are available to the endocrinologist. This facilitates a more focused and efficient consultation.

What treatment options for osteoporosis might Dr. Kramer discuss?

If you are diagnosed with osteoporosis, Dr. Kramer will discuss a management plan aimed at reducing your risk of fractures. This starts with lifestyle modifications, including ensuring adequate intake of calcium and vitamin D (through diet and/or supplements), engaging in regular weight-bearing and muscle-strengthening exercises, smoking cessation, and limiting alcohol intake. Fall prevention strategies are also important. If medication is indicated based on your bone density (DXA scan) and fracture risk assessment (e.g., using FRAX or CAROC tools), options include antiresorptive medications that slow bone loss (like bisphosphonates or denosumab) or anabolic agents that stimulate new bone formation (like teriparatide or romosozumab). She will help choose the most appropriate therapy based on your individual circumstances, potential side effects, and treatment goals.

What conditions does an Endocrinologist (Diabetes & Metabolism Focus) like Dr. Kramer typically treat?

An Endocrinologist (Diabetes & Metabolism Focus) is a medical doctor who specializes in diagnosing and treating diseases related to the endocrine system, which is the network of glands that produce and release hormones. These hormones control many important body functions, including metabolism (how your body gets energy from foods), growth and development, sexual function and reproduction, sleep, and mood. She is an Endocrinologist (Diabetes & Metabolism Focus), specializing in Diabetes & Metabolism. Dr. Kramer manages conditions such as diabetes, thyroid diseases (hyperthyroidism, hypothyroidism, nodules), osteoporosis, adrenal gland disorders (like Cushing's or Addison's disease), pituitary gland disorders, parathyroid and calcium imbalances, polycystic ovary syndrome (PCOS), and some forms of hypertension or lipid disorders related to hormonal imbalances.

What is Hormone Replacement Therapy (HRT) and when might Dr. Kramer recommend it?

Hormone Replacement Therapy (HRT) involves taking medication to replace hormones that the body is no longer producing in sufficient amounts. Dr. Kramer might recommend HRT for various conditions. For example, thyroid hormone replacement (levothyroxine) is used for hypothyroidism. For women experiencing troublesome menopausal symptoms, menopausal hormone therapy (MHT, using estrogen with or without progestogen) can be considered. For men with confirmed hypogonadism (low testosterone) and symptoms, testosterone replacement therapy may be an option. HRT is also crucial for individuals with adrenal insufficiency (cortisol/aldosterone replacement) or hypopituitarism (replacing deficient pituitary hormones). The decision to use HRT is highly individualized, based on the specific condition, symptoms, benefits, and potential risks, which Dr. Kramer will discuss thoroughly.

What types of diagnostic tests are commonly used by an Endocrinologist (Diabetes & Metabolism Focus) like Dr. Kramer?

An Endocrinologist (Diabetes & Metabolism Focus) like Dr. Kramer utilizes a variety of tests to diagnose endocrine disorders. Blood tests are fundamental for measuring levels of specific hormones (e.g., TSH, free T4, cortisol, ACTH, testosterone, estrogen, LH, FSH, insulin, HbA1c, prolactin, PTH, calcium, vitamin D). She often orders dynamic endocrine function tests, where hormone levels are measured after administering a stimulating or suppressing agent (e.g., ACTH stimulation test for adrenal function, oral glucose tolerance test for diabetes/acromegaly, dexamethasone suppression test for Cushing's). Imaging studies like thyroid ultrasounds, CT scans, or MRIs of the pituitary or adrenal glands are common. Bone mineral density (DXA) scans assess for osteoporosis. For thyroid nodules, a fine-needle aspiration (FNA) biopsy might be performed or arranged.

Unit 20, 60 Murray St
Toronto, ON M5T 3L9

Phone: (416) 586-4800 | Fax: (416) 586-8363

The facility is wheelchair accessible.

Dr. Kramer is a licensed Endocrinologist (Diabetes & Metabolism Focus) regulated by the College of Physicians and Surgeons of Ontario (CPSO) under the Regulated Health Professions Act, 1991 and Medicine Act, 1991 in ON. A referral from a family physician or appropriate specialist is typically required for consultations with Dr. Kramer for services covered by the provincial health plan.

Verify registration with the College of Physicians and Surgeons of Ontario (CPSO): https://doctors.cpso.on.ca/DoctorDetails/Kaercher-Kramer-Caroline/0289870-101996