Which of the following is not seen in subacute thyroiditis?

The patient usually presents with a painful and enlarged thyroid, sometimes accompanied by fever. There may be features of thyrotoxicosis or hypothyroidism, depending on the phase of the illness. The patient characteristically evolves through three distinct phases over about 6 months: Thyrotoxic phase, Hypothyroid phase, and Recovery phase. In the thyrotoxic phase, T4 and T3 levels are increased; reflecting their discharge from the damaged thyroid cells, and TSH is suppressed. The diagnosis is confirmed by a high ESR and low radioiodine uptake.