Diagnosed with Hypothyroidism Nov 2009 at 54 years with TSH 11.98,FT4 0.9. Symptom leading to diagnosis was abnormal vaginal bleeding in menopause. Have multi-nodular goiter. Started on levothroxin 50mcg. Had heart palpitations, prescription changed to 25mcg and non-generic, synthroid. By Jan 2010 TSH 1.07,FT4 1.1. August 2010 recheck showed TSH 8.47. Prescription changed to synthroid 50 mcg. October 2010 recheck showed TSH 2.5. January 2011 felt my concentration impaired, also beginning in November 2010 started experiencing lower back pain when standing to dry hair in morning and when walking in mall, sitting down brings relief of pain. Also for over a year, my mouth/throat feels funny in lower wisdom teeth area, tongue feels swollen at times. Jan 2011 blood work shows TSH 4.2, FT4 1.2. Vitamin D insufficiency (29 ng/mL). Doctor prescribed Vitamin D 50000, take 1 per week for 8 weeks. Should I be concerned about fluctutation in TSH? Is my medication working and at right level? My calcium is 9.5. How would I know if I have hyperparathyroidism? How often should my TSH be checked?