How concerned should i be if my lymph nodes in my neck, armpits, elbows, and groin have been swollen for a year+? along with always being tired/sick.

Enough to go in: This is something you should go in and have evaluated. Lymph nodes activate when they are working and their swelling suggests extra work/problems. In most simple regional or systemic issues they would enlarge and later shrink back to resting size in a 608 week cycle. Resistance suggests a chronic illness that needs to be investigated.