Behind episodes of migraines and headaches, annoying digestive disorders and skin problems, you can find an undiagnosed metabolic disorder. It’s about DAO deficiency.a metabolic disorder that causes an inefficient functioning of the enzyme DiAmino Oxidase (DAO), responsible for the metabolism of histamine, a molecule that fulfills a wide variety of functions in our body and is also present in foods that are eaten regularly .
In those patients who suffer from DAO deficiency, this molecule is not metabolized correctly, which produces an accumulation in the blood that can cause various symptoms. In fact, when there is a disproportion between the histamine that we ingest in food, or that released by the cells that store it in the body, and our ability to metabolize it, the accumulation of histamine in plasma occurs. That is when adverse effects appear in many areas of our body.
Thus, patients with DAO deficiency can see their central nervous system affected, in addition to the cardiovascular, epithelial, digestive, muscular and bone systems. This translates into various health problems such as headaches, migraines, skin conditions such as hives and redness, abdominal pain and swelling, digestive and muscular disorders, fatigue and joint pain, among many others. In some people these pictures can be present at the same time, but they do not have to be aware of them simultaneously.
“The most frequent symptom is digestive. Patients often present with dyspepsia or indigestion, intestinal irregularities such as constipation and gastroesophageal reflux, along with vascular headaches and even migraine. Other people have skin or locomotor symptoms and recent research also links them to ADHD, especially in children”, explains Adriana Duelo, director of AD Dietistas and the Clinical Institute of DAO Deficiency.
Many people who suffer from DAO deficiency do not find a clear answer to their discomfort after having consulted their discomfort countless times. Between 12 and 15% of the world population has DAO deficiency and almost 80% of cases are of genetic origin
“The patient’s profile is complex because they come from different medical services without having found the clear cause of their problems. He does not know what is happening to him, because they are very diverse symptoms and they do not seem to have anything to do with each other, although we were finally able to verify that this deficit is the origin, ”says Duelo. Many people who suffer from DAO deficiency do not find a clear answer to their discomfort after having consulted their discomfort countless times. “In any case, at least two of the listed symptoms must be met,” he adds.
As this expert points out, it is estimated that between 12 and 15% of the world population has DAO deficiency and almost 80% of cases are of genetic origin. Then there is a smaller percentage of patients who suffer from this disorder due to a secondary origin or also called acquired, either because they have taken drugs that block the enzyme or because they suffer from chronic inflammatory bowel diseases, such as celiac disease, ulcerative colitis or Crohn’s disease .
After carrying out the appropriate tests for this metabolic disorder, the specialists will indicate the most appropriate treatment depending on the causes and origin of the DAO deficiency.
“According to our clinical experience, for every ten women who come to see us for consultation, three men come. These figures also match the prevalence of migraine in the world”, explains Duelo. Yes, 80% of migraine patients suffer from DAO deficiency, according to data recently provided by the International Society for DAO Deficiency. Hence the importance of attending to the symptoms, to treat more effectively not only the disorder, but also the neurological pathology.
Experts advise that those who suspect they have DAO deficiency Go to a specialist as soon as possible and explain the symptoms you suffer from, especially if you suffer from two or three symptoms at the same time. To find this deficiency, they will usually have a blood test to detect the levels of the DiAmino Oxidase enzyme in the body or even a very simple genetic test. This last test only requires a sample of the buccal mucosa to be able to identify the variants in the gene responsible for the low activity of the enzyme.
The most effective treatment: diet and supplementation
Specialists highlight the efficacy of preventive dietary treatments with DiAmino Oxidase enzyme and a low-histamine diet as a therapeutic option to address this deficiency. In a first phase, the low-histamine diet will be quite restrictive, ruling out some foods that would be part of a healthy diet, such as canned fish (canned tuna or sardines), tomato, spinach, avocado and citrus in general. Others such as alcoholic beverages, Manchego-type cured cheeses and soft Camembert or Brie-style cheeses and sausages are also ruled out.
“Sometimes the histamine content is not what most influences symptoms when manifesting, but its frequency of consumption,” says the clinical nutritionist, who gives the following example: “a cured cheese has much more histamine than orange or the cocoa. But if every morning for breakfast we drink orange juice, however natural it may be, or every night before going to bed an ounce of chocolate, it will generate a small accumulation of daily histamine and the appearance of symptoms. Then, from the second or third month of the diet, some foods are usually reintroduced little by little, without forgetting supplementation.
For Duel, it must be very clear that it is not curable, that it is not a food allergy, nor are the same symptoms always inherited in the same family. “If you are a woman, you have at least two of the problems that we have pointed out and during menstruation, which is when histamine is also triggered, your symptoms worsen, you are very likely to suffer from this disorder,” she warned. After proper diagnosis and treatment, it can be controlled and its symptoms avoided in the day-to-day life of any patient.
Adverse effects of DAO deficiency
Source: International Society for DAO Deficiency
Respiratory system: nasal congestion, asthma
Cardiovascular system: hypotension, hypertension, arrhythmias
Epiletal system: urticaria, atopic skin, psoriasis
Central nervous system: migraine, headaches, hangover, dizziness
Digestive system: irritable bowel syndrome, constipation, satiety, stomach pain, vomiting
Muscular system: fibromyalgia, muscle pain
Skeletal system: osteopathic pain