For many people with DAO deficiency, starting a low-histamine diet and taking DAO enzyme supplementation can lead to a noticeable improvement in symptoms. However, some people continue to experience migraine, headaches, digestive discomfort, skin reactions, nasal congestion or fatigue, among other symptoms, despite carefully following these recommendations.
So, why does this happen?
Food is only part of the equation
When talking about histamine intolerance associated with DAO deficiency, it is easy to focus exclusively on the histamine provided by food. Although reducing dietary histamine is a very important part of the treatment, it is not the only factor that influences histamine levels in the body.
Our body is also capable of producing and releasing endogenous histamine. This means that, even if you are eating a low-histamine diet, certain situations can stimulate the release of histamine from mast cells, potentially contributing to the persistence or worsening of symptoms.
Factors that can promote histamine release
Several internal and external factors have been associated with an increased release of endogenous histamine, including:
- Foods described as potential histamine liberators
- Stress
- Estrogens
- Intense physical exercise
- Temperature changes
- Fasting
- Certain medications
- Infections
- Allergies
- Mastocytosis & Mast Cell Activation Syndrome (MCAS)
The impact of these factors varies from person to person. Some individuals may notice that symptoms become worse during periods of high stress, while others may be more sensitive to hormonal changes, fasting or intense physical exercise.
Looking beyond the diet
For this reason, managing DAO deficiency often requires looking beyond food alone. A low-histamine diet is a key component of treatment, but it may not always be sufficient to achieve good symptom control if other triggers remain unaddressed.
A personalised approach is essential
Every person with DAO deficiency is different, and there is no single approach that works for everyone. Working with a healthcare professional who specialises in DAO deficiency can help identify the factors contributing to your symptoms and develop an individualised management plan to improve your quality of life.
Remember: feeling better goes far beyond simply avoiding certain foods. Identifying and managing factors that may trigger the release of endogenous histamine is also an important part of the overall approach to DAO deficiency.
If you would like personalised advice from either our central team or any healthcare professional within the DAO Institute, book an appointment and we will be delighted to help you.