What is the upper high limit of tsh at which point clinical hypothyroidism should be considered? my. dr refuses to believe i could be. 1yr+

Available but varies: There is a reference range reported per laboratory. I was able to locate one TSH 3rd generation test online in Ireland reporting a reference range of TSH 3rd Generation reference range 0.40 - 4.50 mIU/L . You can confirm the range, by contacting the lab where your specimen was run. You can also request the report with the range. The can tell you what procedure is required to get your results.

Hypothyroidism: The upper limit of TSH is about 4, but it varies from lab to lab. Presumably you have symptoms that could be from subclinical hypothyroidism, but it is possible that these symptoms are from something else. If your TSH were consistently high, and you had symptoms, I would probably begin levothyroxine treatment, esp if there were other signs of thyroid failure (anti-TPO ab, goiter, family history)