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RECOMMENDATION 1 The etiology of thyrotoxicosis should be determined. If the diagnosis is not apparent ... determination of the radioactive iodine uptake (RAIU), or (3) measurement of thyroidal blood flow on ultrasonography

Where expertise is available, ultrasonography with color flow Doppler can distinguish thyroid hyperactivity (increased flow) from destructive thyroiditis (48). Quantitative Doppler evaluation requires careful adjustments to prevent artifacts and measures the peak systolic velocity from intrathyroidal arteries or the inferior thyroidal artery (49). This test may be particularly useful when radioactive iodine (RAI) is contraindicated, such as during pregnancy or breastfeeding. Doppler flow has also been used to distinguish between subtypes of amiodarone-induced thyrotoxicosis (see Section [V2]) and between GD and destructive thyroiditis (see Section [W2])

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