A
TSH of 6.5 is only mildly raised and this is called subclinical hypothyroidism. A single such value does not by itself mean you need
thyroid tablets, because TSH goes up temporarily with illness, poor sleep, stress or even a late night blood draw. The correct step is to repeat the test rather than start medicine. Please get a repeat TSH along with free T4, and add anti TPO antibodies which will tell whether this is autoimmune (Hashimoto's) and likely to progress. It is useful to do the sample in the morning while fasting, and if you take biotin containing supplements stop them 3 days earlier as they falsely alter results. Along with this get a CBC,
vitamin D,
vitamin B12,
HbA1c and
lipid profile, and if you are planning pregnancy or having irregular periods do mention it, because in pregnancy or when trying to conceive we treat even a TSH above 2.5. Treatment is generally advised if TSH is above 10, if antibodies are positive with symptoms, or if there is pregnancy planning; otherwise we simply monitor every 3 to 6 months. Meanwhile ensure iodised salt, adequate sleep, and treat any vitamin D or B12 deficiency. If you have neck swelling, hoarseness, difficulty swallowing, marked weight change or severe tiredness, please have it examined sooner. You may consult me here with your repeat reports (fee Rs 500) and I will tell you clearly whether tablets are needed.