In 2017, a study was published which revolutionized the approach to migraines. The study revealed that approximately 87% of migraine episodes were a consequence of histamine accumulation caused by the low activity of the Diamine Oxidase (DAO) enzyme.
Migraine is a chronic neurovascular disorder characterized by an intense, throbbing headache, with hypersensitivity to external stimuli (light, noise, smell, movement, etc.), usually located on one side of the temples and sometimes accompanied by nausea, vomiting, loss of appetite and feeling hot or cold. A migraine episode is highly variable in frequency, intensity and duration; it can last up to 72 hours and it occurs at certain time intervals between which no pain occurs. This disorder affects more than 15% of the adult population, with a greater predisposition in women.
Recommended treatment and prevention strategies for migraine in recent decades have been largely pharmacological, failing to achieve a cure or significant improvement without adverse effects on sufferers. Some of the most commonly used are antidepressants, anti-inflammatories, analgesics and triptans. Other less common methods, but also used, are botox, a toxin that temporarily paralyzes the muscles, or monoclonal antibodies, which block the calcitonin gene related peptide (CGRP), a protein involved in pain processes and vasodilation. It should be noted that the key role of histamine in migraine dates back to the 1980s, when Krabbe AA carried out a study in which he observed that, when he injected histamine intravenously into 48 patients, more than half ended up with a migraine or with headaches, due to the muscle contractions they suffered.
In recent years, the origin of this neurological symptom has been actively studied and more and more research groups are suggesting the potential histamine’s role in the pathogenesis and treatment of migraine. In this sense, its appearance has been related to an accumulation of histamine, mainly due to a deficiency of the intestinal Diamine Oxidase (DAO) enzyme, whether due to a genetic, pathological or pharmacological factor. Histamine ingested through food is distributed through the bloodstream, until it accumulates in different body tissues; one of them, the cerebral arteries. As a consequence, histamine causes vasodilation and, therefore, the appearance of symptoms.
If you suffer from a migraine and the doctor has not yet been able to find its origin and alleviate the pain with hardly any medication, you may have an histamine excess due to an DAO enzyme activity deficiency.
Thus, migraine dietary treatment due to DAO deficiency is essential. This is divided into different phases and encompasses many aspects: getting to know the person, their lifestyle, seeing how far their changed habits can go, etc. The combination of a low-histamine diet with the DAO enzyme supplementation allows the number of migraine attacks, their duration, and their pain intensity to be improved more quickly. However, to achieve a positive evolution in the treatment, it is essential to work on other aspects, but closely related to histamine’s role, such as sleep cycles, the menstrual cycle, stress and fasting, among others. When all the factors related to its appearance are learned and integrated globally, the patient gains control of their migraine. For this reason, it is important to personalize and individualize the general recommendations according to each case with the help of a professional.
If you want us to advise you in a personalized way, either in our Barcelona nutrition centre or by video conference from anywhere in the world, contact us and we will help you
Bibliography
Duelo A, Berbel M, Mantecon-Laviguerie H, Comas-Basté O, Latorre Mariluz, Veciana-Nogués MT, et al. Low-histamine diet supplemented with exogenous Diamine Oxidase enzyme is useful for treating migraine in patients with DAO deficiency. 2018.
Izquierdo-Casas J, Comas-Basté O, Latorre-Moratalla ML, Lorente-Gascón M, Duelo A, Vidal-Carou MC, Soler-Singla L. Low serum diamine oxidase (DAO) activity levels in patients with migraine. J Physiol Biochem. 2018 Feb;74(1):93-99. doi: 10.1007/s13105-017-0571-3. Epub 2017 Jun 17. PMID: 28624934.
Izquierdo-Casas J, Comas-Basté O, Latorre-Moratalla ML, Lorente-Gascón M, Duelo A, Soler-Singla L, Vidal-Carou MC. Diamine oxidase (DAO) supplement reduces headache in episodic migraine patients with DAO deficiency: A randomized double-blind trial. Clin Nutr. 2019 Feb;38(1):152-158. doi: 10.1016/j.clnu.2018.01.013. Epub 2018 Feb 15. PMID: 29475774.
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