A 28-year-old woman with severe obesity presents to a weight loss clinic. She admits to using DNP (2,4-dinitrophenol) purchased online for 6 weeks. On examination, she has a core temperature of 39.2°C, tachycardia (HR 112/min), and peripheral neuropathy. Which finding best distinguishes DNP toxicity from hyperthyroidism-induced thermogenesis?

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