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It means she needs to have antibody tests run, TPOab an TGab, and have her Free T3 and Free T4 levels checked. A full thyroid blood panel.
If she's above lab limit, say 7.0, she should start taking thyroid replacement hormones soon. If her TSH is 53.8, she should start taking them RIGHT away.
If her TSH is "high normal", high but still under the lab cut off, she should still have the other tests run.
Here's a web site that helps explain it too (with pictures, as an added bonus). Maybe it will help you and your wife have something to discuss with the doctor (hopefully an endocrinologist) when you go back for the full thyroid panel:
http://www.endocrineweb.com/hypo1.html