Did you have any Free T4 or Free T3 tests run? Free T4 and Free T3 are the actual thyroid hormones and without knowing what those levels are, it's next to impossible to treat adequately........TSH is a pituitary hormone and not really indicative of what the thyroid is doing.
I would agree that you need antibody testing to rule out/confirm Hashimoto's and/or Graves Disease.
I, too, have a "multi nodular goiter", but the nodules are small and don't require any action at this time. I had my first ultra sound in Nov 2008, along with the antibody testing and those 2 tests confirmed Hashimoto's Thyroiditis........ I will have another ultra sound in Nov to see what's going on.........By the way - my initial TSH was 55.51, with almost no Free T4, but my pcp would not test Free T3...... My ENT referred me to an endo, who DOES do Free T3 and Free T4 with every testing event and we've learned that I have a problem converting Free T4 to Free T3, which is the hormone the body actually uses....
Push for Free T4 and Free T3 tests and if you can, post the results..
I do not have the swelling in my neck, but otherwise my symptoms were very similar. My TSH was 13.2, low T4. I spent almost 4 weeks of no sleep before they put me on Synthroid. Now my symptoms have started to subside, but I still have to take Inderol for heart palps at night too. Once in a while I will have a bad night, but this problem just began in late May, so I don't have a lot of experience.
There are a lot of informative posts that you can read on this website that will increase your knowledge greatly about this. I wish I had all the answers, but I know you will find them here. The hard part is getting a good doctor.
Good luck.
What I could recommend since I had the same problems is to check your antibodies. Hope this helps.