False about Factitious thyrotoxicosis?

In factitious illnesses, the patient consciously and voluntarily produces physical symptoms of illness. Diagnosis of Graves' disease is straightforward in a patient with biochemically confirmed thyrotoxicosis, diffuse goiter on palpation, ophthalmopathy, and often a personal or family history of autoimmune disorders. For patients with thyrotoxicosis who lack these features, the diagnosis is generally established by a radionuclide (99mTc, 123I, or 131I) scan and uptake of the thyroid, which will distinguish the diffuse, high uptake of Graves' disease from destructive thyroiditis, ectopic thyroid tissue, and factitious thyrotoxicosis.Ref: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 405 Disorders of the Thyroid Gland; Page no: 2295