Dr. Galina Smushkin

Dr. Galina Smushkin diagnoses and treats a wide range of hormonal and metabolic disorders, including:

Diabetes & Related Metabolic Disorders

• 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.
• 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.

Pituitary, Adrenal & Gonadal Axis Disorders

• Primary Aldosteronism (Conn's Syndrome): A condition where the adrenal glands produce too much aldosterone, leading to high blood pressure and low potassium levels.
• Male Hypogonadism (Primary & Secondary Testosterone Deficiency): Condition in which the body doesn't produce enough testosterone, leading to symptoms like low libido, fatigue, muscle loss, and infertility. Can be due to testicular failure or pituitary/hypothalamic issues.

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.
• 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.

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

• 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.
• 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.
• 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.
• 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.
• 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.

Note: This list provides a general overview. Specific tests and treatments are determined after a thorough evaluation. Discuss with Dr. Smushkin 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. Galina Smushkin practices in the Burnside Gorge and Hillside-Quadra neighborhoods of Victoria, BC. Her clinic is conveniently situated near the BC Transit Hub and Downtown Core, making it accessible via the Victoria Regional Transit System (BC Transit). The facility is wheelchair accessible, ensuring ease of access for all patients. Metered street parking and nearby parking lots are available for those arriving by car. The practice is committed to providing a welcoming environment with convenient public and private transportation options to serve the community effectively.

Are consultations, hormone tests, and treatments with Dr. Smushkin, 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. Smushkin, 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. Smushkin's office, the hospital/clinic, or Medical Services Plan (MSP) directly.

Is a referral required to see Dr. Smushkin, 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. Smushkin. 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 symptoms might lead my doctor to refer me to an Endocrinologist like Dr. {provider_name_doctor_last}?

Your doctor might refer you to an Endocrinologist like Dr. Dr. Smushkin if you have symptoms or test results suggestive of a hormone imbalance or endocrine gland problem. This could include: unexplained significant weight gain or loss; persistent fatigue or lethargy; changes in mood or energy levels; excessive thirst or urination; new or worsening high blood sugar; symptoms of an overactive or underactive thyroid (e.g., palpitations, heat/cold intolerance, changes in hair/skin); bone density loss (osteoporosis); recurrent kidney stones; menstrual irregularities or fertility issues; unexplained high blood pressure; or physical changes like excessive hair growth, acromegaly features, or signs of Cushing's syndrome.

Does Dr. Smushkin 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. Smushkin 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. Smushkin 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).

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

An Endocrinologist (Diabetes & Metabolism Focus) like Dr. Smushkin 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.

How does Dr. Smushkin typically approach managing diabetes (Type 1 or Type 2)?

Dr. Smushkin's approach to diabetes management is comprehensive and individualized. For Type 1 diabetes, the focus is on intensive insulin therapy (using multiple daily injections or an insulin pump), continuous glucose monitoring (CGM), carbohydrate counting, and education on managing blood sugar fluctuations and preventing hypoglycemia. For Type 2 diabetes, management often starts with lifestyle modifications (diet, exercise, weight loss), followed by oral medications if needed. Newer injectable medications (like GLP-1 receptor agonists or SGLT2 inhibitors) or insulin may be added as the disease progresses or if blood sugar targets aren't met. In both types, a key goal is to achieve optimal glycemic control (measured by HbA1c and glucose monitoring) while minimizing side effects and preventing long-term complications affecting the eyes, kidneys, nerves, and cardiovascular system. This often involves a multidisciplinary team approach.

Dr. Galina Smushkin
303-1711 Cook St
Victoria, BC V8T 3P2

Phone: (250) 385-5255 | Fax: (778) 433-6487

The facility is wheelchair accessible.

Dr. Smushkin 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. Smushkin 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/340264/Smushkin%2CGalina