Major uses of I include the treatment of thyrotoxicosis (hyperthyroidism) due to Graves disease, and sometimes hyperactive thyroid nodules (abnormally active thyroid tissue that is not malignant). The therapeutic use of radioiodine to treat hyperthyroidism from Graves disease was first reported by Saul Hertz in 1941. The dose is typically administered orally (either as a liquid or capsule), in an outpatient setting, and is usually 400–600 megabecquerels (MBq). Radioactive iodine (iodine-131) alone can potentially worsen thyrotoxicosis in the first few days after treatment. One side effect of treatment is an initial period of a few days of increased hyperthyroid symptoms. This occurs because when the radioactive iodine destroys the thyroid cells, they can release thyroid hormone into the blood stream. For this reason, sometimes patients are pre-treated with thyrostatic medications such as methimazole, and/or they are given symptomatic treatment such as propranolol. Radioactive iodine treatment is contraindicated in breast-feeding and pregnancy