Well, as you can see, TSH of 20.250 is above the reference range and indicates that you have hypothyroidism. The most common cause of hypothyroidism is Hashimoto's, which is an autoimmune condition that eventually destroys the thyroid.
Hypothyroidism, simply, means that your thyroid isn't producing enough thyroid hormones. It doesn't mean that you have cancer or that there's any surgery looming in front of your. Thyroid cancer is, surprisingly, rare and so are the reasons to have any type of thyroid surgery...
All of that said, let's talk about your thyroid and what it does. Your thyroid controls metabolism, heart rate, body temperature, and other important functions. The most common symptoms of hypothyroidism are fatigue, sudden unexplained weight gain, constipation, cold intolerance, slow heart rate, muscle aches/pains, high cholesterol, hair loss, etc, though there can be others and not all of us get the same ones.
Along with TSH, your doctor should have tested the active thyroid hormones, Free T4 and Free T3. TSH is a pituitary hormone and doesn't necessarily correlate with actual thyroid hormone status.
You'll probably be prescribed a replacement thyroid hormone medication, such as Synthroid or Levothyroxine, then retested after 6-8 weeks. Next time, be sure to insist on tests for Free T4 and Free T3, along with the TSH. You should also ask for antibody tests to determine if you have Hashimoto's. The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb). You need them both, since they're both markers for Hashimoto's. A thyroid ultrasound will determine if you have nodules on your thyroid... nodules are also quite common and are, typically, nothing to worry about. They're usually, further indication of Hashimoto's and they should be watched.
Vitamin D deficiency is quite common in those of us with hypothyroidism. Typically, a prescription is given for something like 50,000 IU/week, but injections will do, as well. Once your levels have been brought up to normal, you will most likely be switched to an oral maintenance dose.