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(See Figure 4 for overall approach to treatment and prevention of gout.) Treatments used for prevention, such as allopurinol (see below) can actually make things worse if given during a flare, and so need to be held back until the flare has resolved for several weeks

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Indications: Used primarily to treat vitamin B12 deficiencies due to malabsorption, dietary inadequacies (e.g., in vegans), or certain medical conditions like pernicious anemia

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This can show up as symptoms such as delayed growth and development (failure to thrive), regression in neuromotor skills (such as losing the ability to roll over or grasp objects), failure to maintain eye contact (even in an infant who previous could do so), general muscle weakness, lethargy, excessive sleepiness, feeding difficulties, and even brain shrinkage