Hello I have gone through your question. I can understand your concern. I m glad to know that she take regurarly the treatement and have a rigorous follow up of the thyroid condition ,this is the most important think if she want to control the disease. Apart treatment for thyroid disease, whether hypothyroidism, hyperthyroidism or any other condition of thyroid gland,another important think is cleansing of the system and adoption of a rational diet thereafter, combined with adequate rest and relaxation. The patient may adopt a well-balanced diet consisting of seeds, nuts and grains, vegetables and fruits. Certain foods and fluids are extremely injurious for thyroid patients and should be avoided by them. These include white flour products, white sugar, flesh foods, fried or greasy foods, preserves, condiments, tea, coffee and alcohol. Iodine is undoubtedly most helpful in many cases, but it should be introduced in organic form, all foods containing iodine should be taken liberally. These are asparagus, cabbage, garlic, onion, oats, pineapple, whole rice, tomatoes, watercress and strawberries. So,like we discussed earlier ,many nutritional factors play a role in optimizing thyroid function. However, both nutrient deficiencies and excesses can trigger or exacerbate symptoms.So,yuor friend must be careful with the diet. Her symptoms of last days feeling sleepy and dark skin) may be due to a possible hormonal imbalance.For this reason i suggest to do the tests: -TSH,free T3,freeT 4(to see if the dose of thyroid medication is right or needs to be adjusted.) -Measuring her blood levels of sodium, potassium, cortisol and ACTH gives an initial indication of whether is an adrenal insufficiency that is causing her signs and symptoms. Hope i have answered to your question.If you have other doubts than feel free to ask .I will be happy to help.You can contact me at HealthCareMagic at my private link: bit.do/hcm-Dr-Xhardo. Thank you for using HCM. Wish you good health