Dr. Évelyne Labrèche

Dr. Évelyne Labrèche diagnoses and treats a wide range of hormonal and metabolic disorders, including:

Diabetes & Related Metabolic Disorders

• Type 2 Diabetes Mellitus (T2DM): A progressive condition characterized by insulin resistance (where the body's cells don't respond effectively to insulin) and/or relative insulin deficiency, often linked to genetics, lifestyle factors, and obesity.
• 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.

Thyroid & Parathyroid Gland Disorders

• Primary Hyperparathyroidism: A disorder where one or more parathyroid glands become overactive, producing too much parathyroid hormone (PTH), leading to high blood calcium levels (hypercalcemia) and potential bone and kidney problems.
• 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.
• Hypercalcemia & Hypocalcemia (Disorders of Calcium Metabolism): Evaluation and management of abnormally high or low levels of calcium in the blood, which can have various underlying endocrine or non-endocrine causes.

Pituitary, Adrenal & Gonadal Axis Disorders

• Adrenal Nodules (Incidentalomas) & Adrenal Tumors (e.g., Pheochromocytoma, Aldosteronoma): Masses found on the adrenal glands, often discovered incidentally. Evaluation is needed to determine if they are hormonally active or potentially malignant.
• Primary Aldosteronism (Conn's Syndrome): A condition where the adrenal glands produce too much aldosterone, leading to high blood pressure and low potassium levels.
• Adrenal Insufficiency (e.g., Addison's Disease, Secondary/Tertiary Adrenal Insufficiency): Condition where the adrenal glands do not produce sufficient amounts of steroid hormones, primarily cortisol and sometimes aldosterone, leading to a range of symptoms and potentially life-threatening adrenal crisis.

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

• 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.
• 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.
• 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.
• 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.
• 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.

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

All medical services are provided in accordance with the standards of practice set by the Collège des médecins du Québec (CMQ) and relevant endocrinological care guidelines. Contact the clinic or your referring physician regarding new patient intake and referral processes.

Dr. Évelyne Labrèche practices in a conveniently situated Bureau privé in Saint-Jean-sur-Richelieu's Saint-Jean Sector North neighborhood. The facility is located within easy reach of the Commercial Corridor and Hôpital du Haut-Richelieu, ensuring accessible healthcare services. Public transit options, including Transport Urbain / Taxibus du Haut-Richelieu, provide convenient access for patients. The practice is fully wheelchair accessible, and paid parking options are conveniently located nearby, facilitating easy visits for all patients.

Are consultations, hormone tests, and treatments with Dr. Labrèche, an Endocrinologist (Diabetes & Metabolism Focus), covered by Régie de l'assurance maladie du Québec (RAMQ) in QC?

Medically necessary consultations with a licensed Endocrinologist (Diabetes & Metabolism Focus) like Dr. Labrèche, 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 Régie de l'assurance maladie du Québec (RAMQ) in QC 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. Labrèche's office, the hospital/clinic, or Régie de l'assurance maladie du Québec (RAMQ) directly.

Is a referral required to see Dr. Labrèche, 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. Labrèche. 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 is Hormone Replacement Therapy (HRT) and when might Dr. Labrèche recommend it?

Hormone Replacement Therapy (HRT) involves taking medication to replace hormones that the body is no longer producing in sufficient amounts. Dr. Labrèche 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. Labrèche will discuss thoroughly.

Does Dr. Labrèche deal with hormonal issues related to infertility or conditions like PCOS?

[IF PROVIDER IS REPRODUCTIVE ENDOCRINOLOGIST (REI):] Yes, as a Reproductive Endocrinologist and Infertility specialist (REI), Dr. Labrèche has advanced training in diagnosing and treating complex hormonal disorders that affect fertility and reproductive health in both women and men. This includes conditions like Polycystic Ovary Syndrome (PCOS), ovulatory dysfunction, endometriosis-related hormonal issues, premature ovarian insufficiency, male hypogonadism impacting fertility, and recurrent pregnancy loss. She can manage ovulation induction, provide hormonal support for assisted reproductive technologies like IVF, and address other intricate reproductive endocrine problems. [ELSE:] A general Endocrinologist (Diabetes & Metabolism Focus) like Dr. Labrèche routinely manages common endocrine conditions that can impact reproductive health, such as thyroid disorders or prolactin imbalances, and can provide initial evaluation and management for Polycystic Ovary Syndrome (PCOS), including its metabolic and hormonal aspects. For complex infertility requiring assisted reproductive technologies (like IVF) or highly specialized reproductive surgeries, She would typically collaborate with or refer patients to a subspecialist in Reproductive Endocrinology and Infertility (REI).

Dr. Labrèche 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. Labrèche uses these tests for more precise diagnosis of certain complex endocrine conditions.

Bureau privé
300-900 boul du Séminaire N
Saint-Jean-sur-Richelieu, QC J3A 1C3

Phone: (450) 376-2355 | Fax: (450) 376-2366

The facility is wheelchair accessible.

Dr. Labrèche is a licensed Endocrinologist (Diabetes & Metabolism Focus) regulated by the Collège des médecins du Québec (CMQ) under the Medical Act in QC. A referral from a family physician or appropriate specialist is typically required for consultations with Dr. Labrèche for services covered by the provincial health plan.

Verify registration with the Collège des médecins du Québec (CMQ): https://www.cmq.org/en/directory/physicians?number=17361