What to do if i had a blood test done and my tsh reflex to free t4 is 4.53 .50-4.30 miu/l is that bad?

Further workup: A TSH above normal indicates that your brain is telling your thyroid it needs better thyroid function. Have your free T4, free T3 (liothyronine), (liothyronine) Reverse T3 (liothyronine), (liothyronine) thyroglobulin and TPO antibodies, Ferritin, and SHBG levels checked to ensure the thyroid and tissue utilization/conversion to active thyroid is occurring. Furthermore, these levels should be optimized...TSH 3.6, low Rev T3 (liothyronine)

Thyroid labs: Hi. That's probably early, subclinical hypothyroidism. It should be repeated with a free T4 and thyroid autoantibodies before any consideration is given to treatment. Go Hawks! Good luck!

Mildly abnormal: That TSH is mildly high, implying that you may have mild hypothyroidism. The free T4 is likely to be in the lower range of normal. Most people with these numbers will have no symptoms at all. If you have hypothyroid symptoms and evidence for chronic thyroid disease, it would be reasonable to take thyroid hormone. Otherwise, you should have repeat levels in a few months.

I agree to a point!: Tsh slightly elevated. Your body thinks your thyroid is low. The most common cause for hypothyroidism is hashimoto's thyroiditis, which can be indentified by the presence of anti-thyroglobulin antibodies and anti-TPO antibodies. Have these tests. If positive, i would place you on thyroid immediately. I would also have my free-t3 checked as well. Some do not convert T4 to t3!