Having bad neck pains because of the goitre, t4 is 80.4, but my doctor said i can't have surgery until the t4 goes down to 18, what should i do?

Hyperthyroidism: Your question shows labs that indicate you are hyperthyroid. In other words, you make too much thyroid hormone. Graves' disease is a common problem that causes hyperthyroidism. Surgery is a treatment option, but with your T4 that high, you could have thyroid storm and get very sick. Other treatment is radioactive iodine. Usually before either if these, ptu (propylthiouracil) or Methimazole are used.