Histamine intolerance, DAO deficiency and their impact on health in the context of migraine development and treatment: a review

Abstract

Introduction and purpose 

Migraine is a prevalent neurological disorder affecting up to 1 billion individuals worldwide. Histamine intolerance, caused by reduced activity of the diamine oxidase enzyme, has been increasingly linked to migraines, with headaches being one of its hallmark symptoms. Clinical studies reveal that migraine patients often exhibit significantly lower DAO levels compared to healthy controls. Genetic studies have further identified polymorphisms in the DAO gene as potential contributors to reduced DAO activity and heightened migraine susceptibility. Histamine may influence migraine pathophysiology through elevated plasma levels, which can activate nitric oxide and CGRP pathways, leading to neuronal sensitization and headache onset. Foods high in histamine are common migraine triggers in individuals with HIT or DAO deficiency.

Material and Methods 

A comprehensive literature review was conducted using the PubMed and GoogleScholar databases, focusing on articles published since 2020. The search included the keywords: “DAO”, “histamine intolerance”,“migraine”, “DAO supplementation” in varius combination. 

Results

DAO enzyme supplementation have demonstrated potential in reducing headache duration in episodic migraines, although their impact on migraine frequency and intensity remains inconclusive. Additionally, recent findings suggest that serum DAO levels in migraine patients may vary, indicating a complex relationship between histamine metabolism, genetic predisposition, and migraine pathophysiology.

Conclusions

The role of histamine and DAO deficiency in migraine development and underscores the need for further research into targeted dietary and therapeutic approaches. Improved understanding of histamine metabolism and its genetic underpinnings could offer new strategies for managing migraines in histamine-sensitive individuals.