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The care team can review symptoms, outside labs, prior treatment plans, and whether a same-day B12 shot is appropriate before treatment is given

[6] [8] Estradiol cypionate is contraindicated during pregnancy because exogenous estrogen has no therapeutic role in gestation and in utero exposure could theoretically disturb fetal endocrine development or contribute to structural anomalies, although robust human teratogenicity data are limited

This is qualitatively different from what anti-inflammatory medications produce, because the tissue itself is changing rather than just the symptom signal being blocked

Journal of Medicinal Chemistry, 57 (22), 9220-9231

A higher step can deepen suppression again, followed by another partial fade over several weeks