Dr. David Lawrence Kendler

Dr. David Kendler diagnoses and treats a wide range of hormonal and metabolic disorders, including:

Diabetes & Related Metabolic Disorders

• Gestational Diabetes Mellitus (GDM): Diabetes diagnosed during pregnancy that was not clearly overt diabetes prior to gestation, requiring careful management to ensure healthy outcomes for both mother and baby.
• Prediabetes & Insulin Resistance: A state where blood glucose levels are higher than normal but not yet high enough for a type 2 diabetes diagnosis. Insulin resistance is a key feature, where cells don't respond well to insulin.
• 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.

Pituitary, Adrenal & Gonadal Axis Disorders

• Cushing's Syndrome & Cushing's Disease (Hypercortisolism): A hormonal disorder caused by prolonged exposure of the body's tissues to high levels of cortisol, either from medication (exogenous) or due to overproduction by the body (endogenous - e.g., pituitary or adrenal tumor).
• Polycystic Ovary Syndrome (PCOS) - Endocrine Management: A common hormonal disorder among women of reproductive age, characterized by irregular periods, signs of androgen excess (e.g., hirsutism, acne), and polycystic ovaries on ultrasound, with associated metabolic risks.
• Diabetes Insipidus (Central or Nephrogenic): A rare disorder characterized by intense thirst and the excretion of large amounts of dilute urine, caused by problems with the hormone vasopressin (ADH) or the kidneys' response to it.

Bone Health & Mineral Metabolism Disorders

• Rickets & Osteomalacia: Conditions characterized by softening and weakening of bones, typically due to severe and prolonged vitamin D deficiency. Rickets occurs in children, leading to skeletal deformities, while osteomalacia occurs in adults.
• 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.
• Osteopenia (Low Bone Mass): A condition where bone mineral density is lower than normal peak density but not yet low enough to be classified as osteoporosis. It indicates an increased risk for developing osteoporosis.

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

• 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.
• 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.
• 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.
• 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.
• 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.
• 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.

Note: This list provides a general overview. Specific tests and treatments are determined after a thorough evaluation. Discuss with Dr. Kendler 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 British Columbia (CPSBC) and relevant endocrinological care guidelines. Contact the clinic or your referring physician regarding new patient intake and referral processes.

Dr. Kendler's practice is situated within an endocrinology clinic in the vibrant Fairview neighborhood of Vancouver. The facility is conveniently located near Heritage Hall and Mount Pleasant Neighbourhood, accessible via public transit options including TransLink's SkyTrain Expo, Millennium, and Canada Lines, as well as bus services, the SeaBus, and the West Coast Express at Waterfront station. The clinic premises are wheelchair accessible, ensuring ease of access for all patients. Parking is available at or near the facility, making it straightforward for patients to attend appointments.

Are consultations, hormone tests, and treatments with Dr. Kendler, an Endocrinologist (Diabetes & Metabolism Focus), covered by Medical Services Plan (MSP) in BC?

Medically necessary consultations with a licensed Endocrinologist (Diabetes & Metabolism Focus) like Dr. Kendler, 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 Medical Services Plan (MSP) in BC 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. Kendler's office, the hospital/clinic, or Medical Services Plan (MSP) directly.

Is a referral required to see Dr. Kendler, 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. Kendler. 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.

I have a thyroid nodule. What can I expect during an evaluation with an Endocrinologist like Dr. Kendler?

When evaluating a thyroid nodule, an Endocrinologist like Dr. Kendler will conduct a thorough assessment. This typically involves reviewing your medical history (including any symptoms of thyroid dysfunction or family history of thyroid disease), performing a physical examination of your neck and thyroid gland, and ordering blood tests to check your thyroid function (TSH, and possibly free T4, T3, and thyroid antibodies). A thyroid ultrasound is almost always performed to precisely characterize the nodule's size, number, and sonographic features (e.g., solid, cystic, calcifications, irregular margins). Based on these ultrasound characteristics and the nodule's size, Dr. Kendler will determine if a fine-needle aspiration (FNA) biopsy is needed to obtain cells for microscopic examination to rule out thyroid cancer. Most thyroid nodules are benign.

What treatment options for osteoporosis might Dr. Kendler discuss?

If you are diagnosed with osteoporosis, Dr. Kendler 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). He will help choose the most appropriate therapy based on your individual circumstances, potential side effects, and treatment goals.

Dr. Kendler mentioned 'dynamic endocrine testing'. What does that mean?

Dynamic endocrine testing involves tests that assess how your endocrine glands respond when stimulated or suppressed by specific substances. Unlike simple blood tests that measure baseline hormone levels, these tests evaluate the gland's functional reserve or its responsiveness to normal control mechanisms. For example, an ACTH stimulation test checks how well your adrenal glands produce cortisol when stimulated. A dexamethasone suppression test helps diagnose Cushing's syndrome by seeing if cortisol production can be suppressed. An oral glucose tolerance test can be used to diagnose diabetes or acromegaly. These tests usually involve taking a baseline blood sample, then administering a medication or substance, followed by one or more timed blood samples to measure hormone changes. Dr. Kendler uses these tests for more precise diagnosis of certain complex endocrine conditions.

What conditions does an Endocrinologist (Diabetes & Metabolism Focus) like Dr. Kendler 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. He is an Endocrinologist (Diabetes & Metabolism Focus), specializing in Diabetes & Metabolism. Dr. Kendler 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.

150-943 Broadway W
Vancouver, BC V5Z 4E1

Phone: (604) 263-3661 | Fax: (604) 263-3744

The facility is wheelchair accessible.

Dr. Kendler is a licensed Endocrinologist (Diabetes & Metabolism Focus) regulated by the College of Physicians and Surgeons of British Columbia (CPSBC) under the Health Professions Act in BC. A referral from a family physician or appropriate specialist is typically required for consultations with Dr. Kendler for services covered by the provincial health plan.

Verify registration with the College of Physicians and Surgeons of British Columbia (CPSBC): https://www.cpsbc.ca/public/registrant-directory/search-result/304279/Kendler%2CDavid