What does a tsh of 5.280 (normal range: 0.45-4.500) indicate?

Depends on situation: The "reference range" for a lab result is sometimes called the "normal range," and thus confuses people into thinking that a person is normal if his lab value is within that range. Not quite what it means! Some normal people have results outside the reference range. Some abnormal people have results inside the reference range. Numbers are just numbers, thus the doctor looks at the whole picture.