Dr. Sarah Elizabeth Capes

Dr. Sarah Capes diagnoses and treats a wide range of hormonal and metabolic disorders, including:

Diabetes & Related Metabolic Disorders

• Type 1 Diabetes Mellitus (T1DM): An autoimmune condition resulting in the destruction of insulin-producing beta cells in the pancreas, requiring lifelong insulin therapy for survival and glucose management.
• 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.

Thyroid & Parathyroid Gland Disorders

• 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.
• 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.

Pituitary, Adrenal & Gonadal Axis Disorders

• Pituitary Adenomas & Tumors (e.g., Prolactinoma, Non-Functioning Adenoma, GH-secreting/Acromegaly, ACTH-secreting/Cushing's Disease): Mostly benign growths in the pituitary gland that can cause symptoms due to hormone overproduction (e.g., prolactin, growth hormone, ACTH), hormone deficiency (hypopituitarism), or pressure effects on surrounding structures.
• Primary Aldosteronism (Conn's Syndrome): A condition where the adrenal glands produce too much aldosterone, leading to high blood pressure and low potassium levels.

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

• 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.
• 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.
• 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 H... 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.

Note: This list provides a general overview. Specific tests and treatments are determined after a thorough evaluation. Discuss with Dr. Capes 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.

Sarah Capes Clinic Victoria is situated in the vibrant Fairfield East neighborhood of Victoria, BC. The clinic is conveniently located near the Coho/Clipper Ferry Terminals and Float Plane Terminals, making it accessible for patients arriving by water. Public transit services are readily available through the Victoria Regional Transit System (BC Transit), providing easy access from various city locations. The facility is wheelchair accessible, ensuring barrier-free access for all patients. Paid parking options are conveniently located nearby, offering flexible and accessible parking solutions for visitors to the clinic. The setting provides a welcoming environment for comprehensive endocrine care, with easy access and modern amenities designed to support patient comfort and convenience.

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

Is a referral required to see Dr. Capes, 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. Capes. 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 types of diagnostic tests are commonly used by an Endocrinologist (Diabetes & Metabolism Focus) like Dr. Capes?

An Endocrinologist (Diabetes & Metabolism Focus) like Dr. Capes 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. Capes typically approach managing diabetes (Type 1 or Type 2)?

Dr. Capes'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.

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

When evaluating a thyroid nodule, an Endocrinologist like Dr. Dr. Capes 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. Dr. Capes 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 is Hormone Replacement Therapy (HRT) and when might Dr. Capes recommend it?

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

Sarah Capes Clinic Victoria
308-1990 Fort St
Victoria, BC V8R 6V4

Phone: (250) 595-6210 | Fax: (250) 595-6240

The facility is wheelchair accessible.

Dr. Capes 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. Capes 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/328937/Capes%2CSarah