hi there.thanks for writing to HCM. I read your query and understand you are concerned regarding your friend s thyroid condition. in the history,you could mentioned the following which would have helped in a better diagnosis and determining a suitable range of dosage. her thyroid function values? any other diseases? whether she has other symptoms like dry skin,neck swelling,weight gain,irregular menses or decreased flow? Coming to the query,high thyroid level usually means a high tsh or thyroid stimulating hormone which favours diagnosis of hypothyroidism which is quite prevalent . i would recommend to start on thyroxine of adequate dosage which has to be calculated based on her tsh values and T3 and T4 values .Thyroxine should be taken on empty stomach with a glass of water. Later on repeat the thyroid function test after a month and after three months to assess efficacy of dosage and adjust if needed.these adjustments are to be done by the doctor wrist pain ,swelling and stiffness are associated with hypothyroidism. Commonly the wrist pain is due to carpal tunnel syndrome,in which a nerve of the arm called median nerve is compressed by swollen membranes in carpal tunnel of arm giving rise to tingling,numbness and pain. Optimal control of tsh by thyroxine will minimise symptoms. other options are wrist braces,steroid injections at the site, anti-inflammatory drugs and if not relieved by all above,then surgery to remove the compression as last measure Hope i have cleared your query and hope it works out for your friend.good day