Pediatric dietary management of DAO deficiency / histamine intolerance.
Available in pharmacies specialized in DAO deficiency. It is also available in online pharmacies and on amazon.
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DAOkids® is a food for special medical purposes used in the management for Diamine Oxidase (DAO) enzyme deficiency. It is intended for children from 3 years of age.
The Diamine Oxidase (DAO) contained in DAOkids® serves as a supplement to the enzyme found in the body, which is in charge of metabolizing histamine. Taking one tablet of DAOkids® before each meal increases the amount of DAO in the small bowel and therefore also boosts histamine degradation. This accelerates in the digestive tract the processing of the histamine found in different foods, that triggers the symptoms.
The DAO enzyme contained in DAOkids® acts only in the intestine, it is not absorbed and has no systemic activity, hence it is considered a harmless product with no adverse effects.
Histamine is an essential molecule, a transmitter that belongs to the so-called group of biogenic amines and that is naturally present in many foods as well as inside our cells. Normally, the intake of histamine contained in food does not cause any problem, since it is quickly processed and metabolized by Diamine Oxidase enzyme (DAO).
DAO is the main enzyme for the metabolism of ingested histamine. It is mainly located in the intestinal epithelium, where it absorbs and degrades the ingested histamine preventing it from passing into the bloodstream.
It refers to a deficiency in Diamine Oxidase (DAO) metabolization activity or when there is an imbalance between the ingested histamine and the enzyme capacity to metabolize it. As histamine has not been properly metabolized and degraded, it passes into the bloodstream triggering different symptoms. The most common reactions of DAO deficiency are for example:
· Attention deficit hyperactivity disorder (ADHD).
· Digestive disorders such as bloated feeling, flatulence, diarrhea and cyclic vomitting syndrome (CVS).
· Dermatological disorders, such as dry or atopic skin.
· Non-allergic rhinitis.
Histamine is present in all food to a greater or lesser extent, whether plant or animal origin. Food undergoing a lengthy maturation or food stored for an extended period of time is particularly high in histamine and other biogenic amines also degraded by DAO enzyme.
These foods are, among others:
· Raw or pasteurized milk and dairy products.
· Citrus fruits, strawberries and banana.
· Seafood, oily fish and fish sauces.
· Raw cured sausage such as spiced sausage, chorizo or bacon.
· Some vegetables such as tomatoes, spinaches or aubergines.
What does DAOkids® contain?
DAOkids® contains 60 gastroresistant tablets with controlled-release of DAO in the intestine that avoid the acid pH of the stomach.
How should DAOkids® be used?
Take one tablet with water 20 minutes before the main meals (3 times a day). DAOkids® tablets have a gastro-resistant coating that allows the enzyme Diamine Oxidase not to be released in the stomach, but in a delayed manner in the small bowel, which is where the histamine ingested in the diet is degraded. Therefore, the tablets should not be chewed or split, but swallowed whole.
DAOkids® is not suitable for use as the only source of food. Use only under the supervision of a qualified practitioner, who shall recommend the dosage according to the symptoms. It is intended for children from 3 years of age. Keep out of reach of children. Store in a cool place. The tablets should be swallowed whole. It does not contain Histamine. Gluten free. Lactose free. Sugars-free.
DAOkids® contains Diamine Oxidase (DAO), a thermolabile enzyme (sensitive to temperature), and it is advisable to keep it away from heat sources. If it is consumed according to the recommended daily intake dose, it does not require special conservation, but if it is exceptionally consumed sporadically and stored for a long time, it is advisable to keep it in a refrigerator.
Ingredients: Bulking agent: cellulose microcrystalline and hydroxypropylcellulose; pig kidney protein extract with 7% diamine oxidase (DAO); glazing agent: ethylcellulose; potato starch; stabilisers: sodium alginate and magnesium salts of fatty acids; medium chain triglycerides; glazing agent: hydroxypropylmethylcellulose; stabilisers: oleic acid and stearic acid.
Histamine is a molecule that is present in all foods in the daily diet, is also produced endogenously in the body, and mediates many biological processes such as inflammation, allergies, gastric acid secretions, neuromodulation and regulation of immune function.
Under normal conditions, ingested histamine is degraded by the enzyme Diamine Oxidase (DAO) in the small intestine.
If the metabolic activity of the DAO enzyme is reduced (due to genetic, pharmacological and/or pathological factors), the ingested histamine cannot be degraded and passes through the intestinal mucosa into the circulation causing the onset of gastrointestinal, skin, neurological and muscular symptoms associated with DAO deficiency.
DAOkids® provides the exogenous DAO intake necessary to restore histamine metabolism. Proper DAO supplementation allows dietary management of your symptoms.
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 normal foods or certain nutrients or metabolites thereof is limited, impaired or impaired, or who are in need of other clinically determined nutrients, whose dietary management cannot be accomplished solely by modification of the normal diet, by other foods intended for special feeding, or by both (1). They are not drugs or food supplements.
Oral DAO supplementation is a key strategy in the dietary management of migraine and other pathologies associated with DAO deficiency, since histamine is present to one degree or another in many foods in the normal diet, and for a patient with DAO deficiency it is very difficult to suppress histamine foods since the histamine content is not normally specified by the manufacturers.
Foods for special medical purposes 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, strengthening the ability to break down histamine from food locally in the small intestine and restoring the natural balance of histamine and DAO, thus reducing the symptomatology of concomitant pathologies (2).
Bibliography & links
- Alimentos para usos médicos especiales. Disponible en: http://www.aecosan.msssi.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.
DAOkids® is used for the dietary management of neurological, gastrointestinal, muscular and dermatological pathologies caused by DAO deficiency / histamine intolerance in children from 3 years of age.
Although it is recommended to consume each tablet with a little water 20 minutes before each main meal (a total of 3 times a day: breakfast, lunch and dinner), because the DAO enzyme activity of DAOkids® is maintained for 4-5 hours, each tablet can also be consumed a maximum of 2-3 hours before each meal.
The Diamine Oxidase (DAO) enzyme in DAOkids® maintains its metabolic activity of dietary histamine for 4-5 hours after supplementation.
It can be consumed before a meal up to a maximum of 3 tablets, being advisable not to consume more than 3 tablets daily. Thus, if 2 or 3 tablets are consumed before a meal rich in histamine in one day, it is advisable that if 2 tablets have been consumed, only one more tablet is consumed in the next meal during that day, and if 3 tablets have been consumed, no more tablets should be consumed during that day.
The results of dietary management begin to show after 15 days of supplementation and within the first 30 days.
It is recommended to have an objective diagnosis of DAO deficiency, follow a low histamine diet and take one tablet at least 3 times a day (take one tablet with a little water 20 minutes before each main meal).
DAOkids® can be taken indefinitely and is suitable for diabetics, celiac and/or people with food intolerance, it does not contain allergens, gluten, lactose, histamine or sugars and does not cause side effects, so its use is indicated for the dietary management of gastrointestinal, cutaneous and muscular neurological pathologies associated with DAO deficiency / histamine intolerance.
Each tablet contains 0.3 mg of Diamine Oxidase enzyme (DAO). 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 per day (each tablet contains 4.2 mg of pork kidney protein extract rich in DAO enzyme).
The primary origin of DAO deficiency is due to genetic factors (DAO gene variants associated with low enzyme activity) and 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, online pharmacies and amazon.
The secondary origin of DAO deficiency may be due to the consumption of drugs that inhibit the DAO enzyme, the intake of foods rich in histamine and/or other biogenic amines, or the intake 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 assay is performed. This analysis can be requested and performed in public and private hospitals.
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