What Causes An Thyroid Enlargement Along With Tingling Sensation In The Tongue?

My doctor was thinking I had hypothyroid. Blood work shows that my T4 levels are 4.6.CBC came back perfect. She decided that I had a goiter. I had an ultra sound yesterday on my thyroid. Today my nurse called and said that the ultra sound shows that I have an enlarged thyroid with increased blood flow without nodules. What does that mean? Other symptoms include High pulse rate, High blood pressure that it not responding to medication, tingling tongue and right thumb. the tingling comes and goes quickly. sometimes it will happen on and off throughout the day. other times it may not happen for months. It never happens while I am sleeping. I am also achy most of the time, tired and irritable. I am 38 years old with a family history of Diabetes, hypothyroid, severe arthritis and my Mother has Non-alcoholic fatty liver disease. Another symptom I am having is a dull pain just under my ribs/ right side that runs on into my back. Also the weight gain has been terrible, nearly 40 lbs in two years making me 5ft 2 in and 182 lbs. I have not changed my lifestyle or food intake. Its so hard to get motivated to exercise ( I have never been interested exercise or sports)