My tsh w/reflex to ft4 results are 15.44. what does this mean?

HYPOTHRYOID: Your thyroid gland is underactive it is not producing enough thyroxine. The pituitary gland is working overtime to try to get the thyroid gland to produce enough thyroxine which regulates the bodies metabolic rate. You need supplementation of what your gland produces. You also need to be checked for autoimmune thyroiditis, see your doctor.