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titer of 1:1280 with speckled/homogeneous pattern/goiter/pain

I have been struggling with this situation for over a year now.  Dr's don't know what is going on. all the tests are becoming expensive and I'm so tired of  "no answers".   Recently I have started having thyroid issues which include severe swelling to where if I don't take 1000 mg of ibuprofen than I cannot even pass my own saliva without pain and distress.  I just went for an ultrasound on the neck.  My levels on my thyroid aren't super high or super low but they recently went from 1.76 to over 3.9-    Dr. did note a lrg goiter that I pointed out to her. I have severe pain in my joints lately and my lower back, to the point it hurts to walk/sit/write/or even pick things up.  This is becoming harder and harder since I am such an independent person and my job requires me to sit for 8 to 10 hrs a day pulling and pushing.   I've also read that my swelling could be caused by kidneys and that has me a little worried since I have always had ki ney issues from the time I was in elementary school.  
Anyone with simular issues or suggestions on what to do. or what tests I should ask for???
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1756321 tn?1547095325
Test for Hashimoto's thyroiditis which is the most common cause of hypothyroidism in developed countries.  TSH, free T4, free T3 and thyroid antibodies - thyroid peroxidase antibodies - TPOAb and thyroglobulin antibodies TgAb.
1756321 tn?1547095325
I have also read this info: "Some women demonstrate a mixed pattern of speckled/homogeneous. These same antibodies appear positive in women with lupus, rheumatoid arthritis, Crohn’s disease and other autoimmune diseases." You might want to see a rheumatologist for a full work up.
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