I just got my thyroid stimulating hormone result back and it says value 4.491 and reference .440 - 4.210 what does it mean?

Doctor can check: Numbers are just numbers, with little meaning unless one can see the big picture. A TSH result above 3 can mean thyroid problems if a person is having symptoms of low thyroid. A TSH level above 4 means that situation is even more likely. However, there are some people who are normal with a TSH level up there. One's primary care doctor can evaluate the whole picture to see if treatment is needed.