By consuming certain foods and alcoholic beverages such as wine and beer, we take into our body, in the intestine, a nitrogenous organic compound called histamine, which is then absorbed by the intestine and participates in the functions of the immune system (mainly it can cause allergies...), the gastrointestinal system (it causes the secretion of gastric acid that breaks down food) and the Central Nervous System (i.e. it acts as a neurotransmitter).

It generally causes an inflammatory reaction in the body and causes blood vessels to dilate. This is part of a natural reaction of the body, but if histamine is not broken down quickly and effectively or is in too high a concentration, it can cause or worsen various symptoms of the body, such as allergies (the most well-known and annoying), redness and nasal congestion, hypotension, hives (itching) but also arrhythmias. From the Central Nervous System it causes dizziness, headaches and possibly migraine attacks.

In most people, histamine is rapidly broken down in the gut, before being absorbed by the body, by an enzyme called diamine oxidase (DAO), and so small amounts of histamine pass into the body.

We now know that 15% of the general population has a deficiency in DAO (due to heredity or alcohol consumption or inflammatory bowel diseases or due to medications such as painkillers).

In recent years, we have known that in patients with migraine, DAO levels in the blood are significantly lower than in people without migraine. Thus, in a 2018 study in a total of 198 patients with migraine, the deficiency in DAO was 87%, possibly due to the frequent use of painkillers… (Izquierdo-Casas J et al. 2018).

Aiming precisely at limiting this action of histamine in migraine patients who may have a deficiency of the DAO enzyme, there is now the possibility in Greece:

• First, the measurement of the level of the DAO enzyme in the blood of migraine patients. The measurement is easily done in the doctor's office with a finger prick. A special package (Diamin Kit) is made and sent to the Hygiene Laboratory of the Department of Medicine of the University of Thessaloniki, and the results are sent twice a month.
• If the results show low DAO levels, meaning the patient probably has high histamine in the blood, a preparation is now available and the patient can take one DAO capsule (4.2 mg) orally (pill) once a day 20 minutes before the main meal. It is also important to note that no side effects have been recorded to date from taking DAO in pill form.

So, aiming to treat this chronic and serious condition that is migraine, we have another harmless and important weapon!

References in international bibliography:

• Tobajas Y et al. Diamine Oxidase Interactions with Anti-Inflammatory and Anti-Migraine Medicines in the Treatment of Migraine. J Clin Med. 2023;12:7502
• Izquierdo-Casas J 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
• Meza-Velázquez et al. Association of diamine oxidase and histamine N-methyltransferase polymorphisms with presence of migraine in a group of Mexican mothers of children with allergies. Neurology. 2017;32(8):500
• Izquierdo-Casas J et al. Low serum diamine oxidase (DAO) activity levels in patients with migraine. J Physiol Biochem. 2018;74:93