I am a 28 yr old female 5'3 108lbs. I have had extreme fatigue for several years and horrible pms. I saw a hollistic dr and she came across my high tpo levels. That was almost 2 years ago and I have received no treatment based on normal thyroid levels (tsh, t3, t4). I moved to another city and just started seeing an endocrinologist. I had lab work done last week and my tpo is almost 600 (should be less than 35). My tsh, t3 and t4 are all normal. Today I woke up with a goiter and it feels weird to swallow/pressure. I went back to my endo and she said it's normal to have goiters and to take an over the counter for inflammation. Still no thyroid medication...is this the protocol? The last few weeks I all of a sudden have developed anxiety, hot flashes, memory loss, brain fog, EXTREME fatigue (worse than it has ever been). Today I am cold and shaky. I feel like my physical body has bipolar mood swings, not my mental health. Can someone please help? How do I get rid of this goiter?