Clinical Cases

When the Issue is Metabolic and Not Cognitive: A Case of Hypothyroid in a Boy of 10

Written by Shawn Vale

Homeopath Shawn Vale shares a case of hypothyroid in boy of 10. Weakness from slight exertion, obesity, perspiration during slight exertion and late learning to walk were among the symptoms leading to the simillimum.

In January of 2013 I received a call from a mother whose eldest son was struggling in school. Recently he had been referred to an after-school speech and learning program located two hours from their home. Attendance three times a week posed a hardship on the family. A month ago, her son was diagnosed with an underactive thyroid. TSH levels were just under 4.0

She was familiar with homeopathy in her home country of Bangladesh, and found my services on the internet.

A.’s mother, his maternal grandmother, and his mother’s two sisters were all diagnosed with hypoactive thyroids in their youth. There was no further information about his family’s medical history.

My small office suddenly felt crowded. A. was accompanied by his father, his younger brother by two years, and his pretty mother, her smiling round face outlined by a pastel hijab. I observed that A. took after his mother’s roundness and his father’s serious, unsmiling demeanor.

[OBS. I observed that A. seemed to be looking out from under his brows, as if his forehead was leaning on his eyes. Compared to his brother, his movements were slow and awkward.]

While her husband took the two boys down to the street to get a drink, their mother and I had some time to speak alone.

Mother: A. said he was itchy in his throat. The doctor gave us something for congestion. Before he was 5 years-old he often had sore throats in the winter. After 5 years old, he didn’t have so many. He suffered a lot when he was 2 or 3. Earaches too. Now he is just itchy in his throat. In six months he gained 5 pounds.

What was your pregnancy like?

He was born prematurely by Caesarian at 8 months 7 days. I had morning sickness for the first 3 months. Before married life, I was a thyroid patient. I took lots of medicine. During the pregnancy my thyroid was not controlled. I was taking thyroid and hormone medicines. At 3 months, I started to swell up. My feet got large. If they kept the pregnancy to the end, it could have been dangerous. On the third day after he was born, I gave him my breast for the first time.

I was breastfeeding him for 2 years. At 13 months he was walking. Everything was slow. But in my country he was already talking at 9 months. Then when he was 15 months we moved here to the United States, and he stopped talking.

What was it like?

We are immigrants. We are very alone. A. and I were alone all day. My husband is working a lot. An American doctor sent him to a specialist for speech therapy. He was trying to talk to me. In Bangladesh I have a big family. That is why he started talking early. Then he stopped when we arrived. At around 2 ½ years he started talking again.

His stool is dry and hard when he has no vegetables. From newborn to 2 ½ years he suffered badly from constipation. Sometimes even now.

Three or four months ago he started to complain, “Mom I feel tired”. One day I got crazy with him. I asked him , “Why do you say you are tired all the time?” This past November I made a doctor’s appointment for A. We had just returned from our annual trip to Bangladesh. The doctor sent us to an endocrinologist. I have a prescription, but I am waiting to fill it. I would prefer that my son not be dependent on medicine the rest of his life like I am.

The last month and a half I see that he is sweating from his head when he is playing with his brother. Being so tired and sweating is something new. He is sweating before he goes to school in the morning and whenever he feels tired.

A. enters the consultation room with his father and brother. He sits in a chair between his father and mother. His younger brother sits on a small stool towards the back of the room where he amuses himself with a video game.

I ask A., “What do you enjoy?”

He hesitates and looks at his mother before answering, “Watching TV.”

What is your favorite show?


Is that a television show or a game?

PAUSE. Game.

Do you have a favorite subject in school?

Math!!! Because everything is easy!

“What about Language Arts?” I ask. (His mother told me when she made the appointment that he is having difficulty with reading and composition.)

A: No. That has longer stories and longer questions and longer pages. Too many pages to do. I can do Math faster.

A: This year I feel more warm. The weather is hotter and the house is hotter because my mother keeps the windows closed.

What do you like to eat?

A: The only thing I like is pizza!! I eat it plain… with garlic powder… I would take pizza over chocolate cake.

What about sweets?

A: I like sweets only on my birthday. I only like dry cake. No icing. I don’t like boiled eggs. The skin and yolk are rubbery. I like them cooked in the pan.

Mom: He used to eat pencil lead and paint on the wall. Last year he ate an eraser.

How is your health?

A: This year I got throat scratch. We went away to Bangladesh and it started in November after we came back.

When does your throat bother you?

Sometimes at night it itches but my Mom and Dad didn’t even know it. They were watching TV and I went to bed and I didn’t say anything to them. Sometimes when I do my homework it gets scratchy. Not with the Math homework, the other stuff.

Mom: I’m trying to understand when it happens. I don’t see a pattern to it. If he is busy he doesn’t think about it. If I sit with him or lay down with him he will tell me. It comes and goes.


A: Like a mosquito. I want to scratch inside.

Do you have dreams?

I had a dream I was in a cemetery and then the dead people turned to zombies and I killed them. I wasn’t afraid.

Mom: He said in the dream he saw his parents both die. And he took care of his younger brother.

A: I had to live with BIG strangers! They were bullies. And then there was a stepmother and stepfather, and he kept killing me. I killed them but not the bullies. And then the bullies kept punching me but I didn’t beat them at all. They were big and strong.

I also dreamed a bully took me to school and put me on the sidewalk and I got punched everywhere… in the lunchroom, in the classroom, everywhere. When I was leaving he punched me also. And at my friend’s house, my friend kicked me out of his house. He saw I was punched everywhere. When he saw my face punched everywhere he took me out of the house and there were bullies everywhere. [All this was recounted with a lot of gusto.]

Do you know any bullies? PAUSE.

In school maybe?

Yes. Not in my 4th grade class. From my second grade class. Last year, too.

What is a bully?

A bully is someone who is mean to you. Even this year it happened. There is one kid in my class who bullies me. He calls me bad names. He says I’m gross. I ignore him. He was with me in 2nd, 3rd, and now 4th grade.

You aren’t afraid of anything?

A: Afraid of tests, bigger tests!! This year I am really scared. It’s going to be harder this year. I’m just getting good at science work but don’t know if I am getting good at science tests. I want to do well.

Are you afraid of bullies?

I’m not really scared of anything.

Do you ever get sick while riding in the car? Yes. My stomach gets sick. When we were going to the airport to say goodbye to Grandma and Grandpa it hurt . It hurts when the car drives a long way home. When I was a baby I didn’t like playing on the swing. Now I like it. I was scared of the swing but then when my Dad lifted me up and I felt like I was flying…

Mom: He liked being rocked when he was sick.

How would you describe yourself?

I am serious not joking.

Mom: One of his friends says A. is very gentle and very quiet in class which is why teachers like him.  He doesn’t like to meet new people. He is very shy. He usually takes a lot of time.

I observe, “He has been very open during this appointment.”

Mom: I think because we are here. He has our support.

Analysis and Rubric Selection from Complete 2015 Repertory

A. is a 10 year old boy who was recently diagnosed with an underactive thyroid. His premature birth by Caesarian was related to his mother’s thyroid issues before and during the pregnancy. Given the family history, I am looking for a remedy with an affinity for the thyroid gland.

neck; thyroid gland (175)

He had the usual childhood throat and ear infections up until 5 years old. In fact, his health was generally robust until now.

Recently A. has been experiencing bouts of fatigue not ameliorated by sleep. He perspires from his head with the slightest exertion, and feels warm much of the time. There is a recurring tickle in his throat that he would like to scratch from the inside. In the last 6 months he has gained 5 pounds.

generalities; weakness; exertion; agg.; slight (117)

generalities; obesity (199)

perspiration; exertion; slight, during (146)

head; perspiration (255)

throat; tickling (224)

His academics have suffered. Math is easy while subjects requiring more than short bursts of concentration like Language Arts with its “long stories, long pages and long questions” are challenging. He sincerely wants to do well.

mind; reading; ailments from, agg. (192)

mind; reading; difficult, is (27)

mind; ambition; ambitious (99)

He gets headaches on the weekends after watching two hours of television. He describes it “like his brain has a crack on it”. The pain is on the sides, top, and back of his head.

head; pain, headache; bones, skull (126)

generalities; pain; broken, as if (207)

Notable are his gastronomic preferences: garlic powder on plain pizza and pencil erasers!

generalities; food and drinks; inedible things; desires (38)

His mother says of his milestones, “Everything was slow.” She describes him as shy. Socially “he usually takes a lot of time”. SLOWNESS is an important theme in this symptom picture. It can be seen in the underactive thyroid as well as other aspects of his story.

mind; cautious (53)

mind; timidity; bashful (78)

extremities; walk, late learning to (46)

rectum; constipation; children, in (68)

The theme of slowness is contradicted by the fact that he was talking precociously at 9 months. His mother attributes this to the nurturing environment of her large extended family. I found it noteworthy that he stopped all talking at 15 months when they left the family home and came to the US.

generalities; development arrested (68)

Similarly, almost a decade later, A. began complaining about tiredness and sweating after returning from their annual trip to Bangladesh. When asked if he ever gets carsick, A. answered in the affirmative. He reported experiencing a bad pain in his stomach on the way to the airport after saying goodbye to his grandparents.

stomach; motion; agg. (132)

This brings us to the other theme of this remedy. I had observed to his mother that, contrary to her description of his behavior with strangers, he was quite open and forthcoming with me. What she replied goes to the heart of the matter. She said, “ I think because WE are here. He has our support.”

This is a child who thrives with support. This can be seen in his choice to sit down between his parents.  Having good solid support explains why A. was able to talk precociously at 9 months, and inversely, when support was withdrawn, why he stopped talking until he was 2 ½ months. A significant reaction to a perceived loss of support plays out again just before coming to see me when he again leaves his family in Bangladesh.

We see the theme of support in other aspects of his story as well.  His fear of the playground swings was overcome with the help of his father. He enjoyed being held and rocked as a child. And I might hypothesize, that car sickness is also related in some way, maybe a feeling of loss of support from the ground.

It is interesting that his throat didn’t itch while he was doing Math homework but only when he experienced the stress of working on the “long” assignments.

His dreams express feelings of vulnerability. In them, he can’t find a place of safety or people who will protect him. I don’t like to use an incomplete rubric but thought these two in the Mind section describe the feeling of the dreams.

mind; protection, constantly wants mothers (3)

mind; dependent; mercy of others, at (13)

mind; dreams; frightful, nightmare (534)

mind; dreams; frightful, nightmare; terrible (18)

However, he quite enjoyed describing the violence of the scenes, how he killed the zombies and ‘stepmother and stepfather’. The big strong bullies punched him in the face, yet he asserts that he isn’t afraid of them or of anything. When his parents die in the dream, he takes care of his brother.

mind; dreams; dead; people, of (170)

In a similar heroic vein, but less dramatic, A. tells us that some nights he doesn’t tell his parents about his itchy throat and bears his suffering alone. Sitting between his parents in my consulting room, feeling their generous support, A. demonstrates a childish bravado.

mind; boaster, braggart (33)


I am sure all who read this have guessed the remedy. It was a clear choice of Calcarea carbonicum, the mineral substance prepared from the protective shell of the oyster, a soft stationary animal anchored to its bed for all its life. Shell formation equals calcification, a concept symbolic of stagnation and in its extreme, death. As the main element present in bones and teeth, it is essential to early development. Presence in the blood stream regulates hormonal activity, muscular contraction including smooth muscle, blood pressure, and so much more.

The immaturity of Calcium salts is best expressed by Massimo Mangialavori in an Essential Elements lecture: “As long as they have a clear idea that they are supported, they can move. They can do a lot.” Indeed they have strong egos. They want to shine. They want to achieve. They want to be independent. In the extreme expression of their vulnerability, they are fearful for themselves, thinking ‘I cannot protect myself. I cannot defend myself.’ This is the dance they do with themselves at different junctures of their lives.

Developmental slowness is an arena of this polychrest’s action especially where there is a nutritional component as often seen in premature infants. Those needing this remedy perversely choose non-foods in their desire to be strong.

Typical of the sea creature remedies is a strategy of shutting down and withdrawal producing non-reaction and indifference in all spheres of being.


A took Calc-c 30C two times a day for 5 days. Two weeks later his mother reported that he had not complained of fatigue since taking the remedy. Also, his headaches were less frequent.

A few weeks later, we repeated in a 30C. Within 10 days, A. was perspiring less. His throat was less itchy. However, his mother was very anxious about a call she received from A.’s teacher who was doubtful about his promotion to the next grade in June. This was early March 2013. We repeated the remedy in a 200C.

His mother checked in to say his stool was very hard. She said that he was uncharacteristically emotional. By the end of March 2013 his blood work had greatly improved. His thyroid had reduced to its normal size. His mother reported that he has been reading and writing with more ease. We repeated the remedy two more times, and I am happy to say that in June he was promoted with honors to the next grade.

In January of 2014 A. experienced symptoms of constipation. One dose resolved it. In October, the family returned from their annual trip. A. had contracted TB and was taking a 9 month course of medication. In late December 2014, his mother called to say he was tired and sweating. This time I gave Thyroidinum, keeping its characteristic car sickness in mind and his mother’s morning sickness. Could it be a better fit? When there was no change I prescribed Calc-c. Once again his symptoms resolved quickly.

We repeated Calc-c in various potencies in November 2016, September 2017, February 2019, and September 2020. Symptoms clear up nicely in an average of a few days. Yet, each time I hear from his mother I review my thinking. I ask myself, can this be a good case if the symptom picture returns at intervals? Can I do better? Or could this be a success, in view of A.’s family medical history? Academically, A. continues to exceed expectations.

Generally I don’t repeat a remedy until the symptom picture or partial symptom picture returns. However, in keeping with his particularly strong need for support, I am suggesting he take Calc-c at regular intervals for the next 6 months along with Tissue Salts #21,26, and 15 for additional thyroid support.

About the author

Shawn Vale

Shawn Vale, CCH, RSHom (NA) is a Certified Classical Homeopath, author, and lecturer residing in Staten Island. A graduate of The School of Homeopathy New York, Shawn has been in family practice in New York City since 2006. In 2005 Shawn was invited by Abhalight, a charitable organization serving Kenya’s poorest communities, to help establish a network of mobile clinics. Two years later, post graduate studies took Shawn to the Bombay School of Homoeopathy in Mumbai, India. In 2014, he was privileged to collaborate with Master Homeopath Dr. Massimo Mangialavori on his book, The Milks. Shawn continues to write and speak about the energetic principles of health and wellness, and especially about her passion for homeopathy. Her dream is to see this venerable medical art restored to its former good standing in this country. Today, with the advent of Tele-health, Shawn continues to expand her practice and the reach of homeopathy.

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