Frequently asked questions about DAO Deficiency
DAO deficiency occurs when there is a deficiency in the activity of the metabolizing enzyme DiAminoOxidase (DAO) or when there is an unbalanced ratio between the histamine ingested with food and the ability of the enzyme to metabolize it. As a result, histamine is not sufficiently metabolized and degraded, passing into the bloodstream and triggering the various symptoms.
The usual reactions to DAO deficiency are:
- Migraine or other headaches. It has been shown that 87% of migraine attacks are caused by DAO deficiency.
- Widespread muscle pain and fatigue, commonly associated with fibromyalgia. More than 75% of cases are due to DAO deficiency.
- Digestive disorders, such as constipation, diarrhea, bloating or bloating, nausea, heartburn or reflux.
- Skin disorders such as urticaria, eczema or atopic skin.
- Chronic non-allergic rhinitis, nasal congestion and asthma.
- ADHD (Attention Deficit Hyperactivity Disorder). 78% of ADHD cases in children are due to DAO deficiency.
The primary origin of DAO Deficiency is due to genetic factors (variants of the DAO gene associated with low enzyme activity) therefore, it is diagnosed by means of the Diamine Oxidase (DAO) activity molecular genetic study (AOC1-V). It can be found in pharmacies specializing in DAO deficiency and specialized laboratories.
The secondary origin of DAO deficiency may be due to the consumption of drugs that inhibit the DAO enzyme, the ingestion of foods rich in histamine and/or other biogenic amines, or the ingestion of foods that inhibit DAO, such as alcohol. Certain pathologies affecting the intestinal mucosa, such as Crohn’s Disease, Ulcerative Colitis and intestinal operations are also at the origin of DAO Deficiency. For the diagnosis of these secondary causes, a plasma DAO activity test is performed. This test can be ordered and performed in public and private hospitals.
DAO is the main enzyme in the metabolism of ingested histamine. It is mainly located in the
intestinal epithelium, where histamine ingested in the diet is degraded, preventing its passage into the bloodstream.
Histamine is a vital molecule, involved in numerous physiological functions such as the balance between sleep and wakefulness, secretion of gastric juices, neurotransmitter or participation in the autoimmune system.
It belongs to the group of biogenic amines, which are present in most foods as well as naturally inside the body’s cells. Dietary histamine has no physiological function, and its consumption does not usually cause any problems as it is rapidly metabolized by the enzyme diamine oxidase (DAO) in the small intestine.
Histamine is present to a greater or lesser extent in all foods, whether of animal or plant origin. Foods that undergo long maturation or are stored for a prolonged period have a particularly high content of histamine and other biogenic amines that are also degraded by the DAO enzyme. These include, for example:
- Raw, pasteurised milk and dairy products.
- Citric fruits, strawberries and bananas.
- Seafood, oily fish and fish sauces.
- Raw sausage, such as salami, chorizo or bacon.
- Some vegetables, such as tomatoes, spinach or aubergines.
- Alcoholic beverages, especially red wine.
DAO deficiency should be addressed primarily from a dietary point of view. A diet low in histamine and other biogenic amines that also favors its accumulation should be followed. The recommendation is to consult expert nutritionists who can recommend the best diet adapted to the requirements of everyone.
Frequently asked questions about DR Healthcare products
Foods for special medical purposes are intended to meet all or part of the dietary needs of patients whose ability to ingest, digest, absorb, metabolize or excrete foods, nutrients or metabolites is limited, reduced or altered. Also, to comply with the dietary needs of patients who require other clinically determined nutrients, and whose dietary management cannot be achieved only by modifying the normal diet, by other foods for special feeding, or by both (1). They are not drugs nor food supplements.
Oral DAO supplementation is a key strategy in the dietary management of migraine and other pathologies associated with DAO deficiency, as histamine is present in many foods in the normal diet, and it is very difficult for a patient with DAO deficiency to eliminate histamine foods as its content is not normally specified by the manufacturers.
Special medical foods containing DAO prevent the systemic absorption of exogenous histamine, providing the patient with the necessary amount of DAO that complements the body’s own Enzyme. This strengthens the ability to break down histamine from food in the small intestine and restores the natural balance of histamine and DAO, thus reducing the symptomatology of concomitant pathologies (2).
Bibliography and links
- Foods for special medical purposes. Available in: https://www.aesan.gob.es/AECOSAN/web/seguridad_alimentaria/subdetalle/alimentos_usos_medicos.htm
- Izquierdo-Casas J, Comas-Basté O, Latorre-Moratalla ML, Lorente-Gascón M, Duelo A, Soler-Singla L, et al. Diamine oxidase (DAO) supplement reduces headache in episodic migraine patients with DAO deficiency: a randomized double-blind trial. Clin Nutr. 2019; 38: 152-158.
The results of dietary management (reduction in the duration and intensity of symptoms, increase in the period between them and improvement in the remaining gastrointestinal, skin and muscle symptoms caused by DAO deficiency) begin to be seen within 15 days of
supplementation and within the first 30 days.
It is recommended to have an objective diagnosis of DAO deficiency. Also, to follow a low histamine diet and take one capsule at least 3 times a day (take one capsule with water 20 minutes before each main meal).
Up to a maximum of 3 capsules can be taken before a meal, but it is advisable not to take more than 3 capsules a day. Thus, if 2 or 3 capsules are consumed before a meal rich in histamine on a given day, it is advisable that if 2 capsules have been consumed, only one more capsule should be consumed at the next meal during that day. If 3 capsules have been consumed, no more capsules should be consumed during that day.
DAOfood® contains only the enzyme DAO and is presented in tablet form. It is indicated for the dietary management of DAO Deficiency, in a generic form. DAOfood® plus, in addition to the DAO enzyme, contains vitamin C and quercetin. It is presented in capsule form and is indicated for the management of dermal, respiratory, and gastrointestinal symptoms associated with DAO Deficiency.
Each capsule or tablet should be taken with a small amount of water 20-30 minutes before each main meal (a total of 3 times a day: breakfast, lunch, and dinner). This allows time for the enzyme to reach the small intestine and be ready to metabolize the histamine in the food.
The Diamine Oxidase (DAO) enzyme in DR Healthcare products maintains its metabolic activity of dietary histamine for 4-5 hours after supplementation.
It can be taken indefinitely and is suitable for diabetics, celiacs and/or people with food
Intolerance. It does not contain allergens, gluten, lactose or histamine, and does not cause side effects, so it is recommended for the dietary management of migraine and chronic headaches and other gastrointestinal, skin and muscle diseases associated with DAO Deficiency.
Frequently asked questions about DAOfood® Plus
DAOfood®Plus is indicated for the dietary management of gastrointestinal, respiratory, and dermatological pathologies caused by DAO Deficiency.
Each capsule contains 0.3 mg of diamine oxidase enzyme (DAO) in two white/beige tablets (each gastro-resistant tablet contains 0.15 mg of DAO enzyme). It is recommended not to exceed a maximum daily dose of 12.6 mg of pork kidney protein extract rich in DAO enzyme, so it is advisable to take a maximum of 3 capsules a day (each capsule contains 4.2 mg of pork kidney protein extract rich in DAO enzyme).
Each capsule contains 20 mg of vitamin C in an orange-colored tablet. Vitamin C increases the metabolic activity of the enzyme DAO and quercetin.
Each capsule contains 40 mg of quercetin in a yellow tablet. Quercetin is a well-known flavonoid with antihistamine activity. Its immediate release acts in synergy with the DAO enzyme in the metabolism of dietary histamine.
Each capsule can be opened, and tablets can be removed if recommended by your doctor and/or nutritionist that are not necessary for the dietary management of your symptoms. The removal of the yellow quercetin and/or orange vitamin C tablets does not compromise the efficacy of the dietary management as they are adjuvant ingredients used to adapt to the medical and nutritional requirements of each patient.
Frequently asked questions about DAOfood®
DAOfood® contains DAO enzyme and is suitable for the dietary management of digestive disorders caused by DAO Deficiency such as constipation, diarrhea, bloating, heavy heartburn.
Each tablet contains 0.3 mg of Diamine Oxidase (DAO) enzyme. It is recommended not to exceed a maximum daily dose of 12.6 mg of pork kidney protein extract rich in DAO enzyme, so it is advisable to take a maximum of 3 tablets a day (each containing 4.2 mg of pork kidney protein extract rich in DAO enzyme).
Frequently asked questions about DAOhead®
DAOhead® contains DAO enzyme for the dietary management of migraine caused by DAO Deficiency, as well as group B vitamins and caffeine, which act as adjuvants.
Each capsule contains 0.3 mg of diamine oxidase (DAO) enzyme in 2 white/beige tablets (each gastro-resistant tablet contains 0.15 mg of DAO enzyme). It is recommended not to exceed a maximum daily dose of 12.6 mg of pork kidney protein extract rich in DAO enzyme, so it is advisable to take a maximum of 3 capsules a day (each capsule contains 4.2 mg of pork kidney protein extract rich in DAO enzyme).
Each capsule contains a combination of vitamin B12, vitamin B6 (pyridoxine) and vitamin B9 (folic acid) in the orange tablet. This set of vitamins is often deficient in people with migraine.
Each capsule contains 30g of caffeine in a red/pink tablet. Caffeine acts as a vasoconstrictor adjuvant in the relief of symptoms caused by migraine caused by DAO Deficiency.
Each capsule can be opened, and tablets can be removed if recommended by your doctor and/or dietician that are not necessary for the dietary management of your symptoms. The removal of the red caffeine and/or orange B-vitamin tablets does not compromise the efficacy of the dietary management, as they are adjuvant ingredients used to adapt to the medical and nutritional requirements of each patient.
Frequently asked questions about FibroDAO®
FibroDAO® contains DAO enzyme and magnesium, and is suitable for the dietary management of fibromyalgia, muscular pain and contractures, osteopathic pain and chronic fatigue caused by DAO Deficiency.
Each capsule contains 0.3 mg of diamine oxidase enzyme (DAO) in two white/beige tablets (each gastro-resistant tablet contains 0.15 mg of DAO enzyme). It is recommended not to exceed a maximum daily dose of 12.6 mg of pork kidney protein extract rich in DAO enzyme, so it is advisable to take a maximum of 3 capsules a day (each capsule contains 4.2 mg of pork kidney protein extract rich in DAO enzyme).
Each capsule contains 80g of magnesium in a lilac-colored tablet. Magnesium as an adjuvant in the relief of symptoms caused by fibromyalgia caused by DAO Deficiency.
Each capsule can be opened, and tablets can be removed if recommended by your doctor and/or nutritionist that are not necessary for the dietary management of your symptoms. The removal of the purple magnesium tablets does not compromise the efficacy of the dietary management, as they are adjuvant ingredients used to adapt to the medical and nutritional requirements of each patient.
Frequently asked questions about DAOkids®
DAOkids® contains DAO enzyme, and is suitable for pediatric use in the dietary management of Attention Deficit Hyperactivity Disorder caused by DAO Deficiency.
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Each tablet contains 0.3 mg of Diamine Oxidase (DAO) enzyme. It is recommended not to exceed a maximum daily dose of 12.6 mg of pork kidney protein extract rich in DAO enzyme, so it is advisable to take a maximum of 3 tablets a day (each containing 4.2 mg of pork kidney protein extract rich in DAO enzyme).