(An article written in August 2022 and updated in May 2024)

We know that the Diamine Oxidase (DAO) enzyme is the main responsible for metabolizing a molecule that we ingest through the diet called histamine. This biogenic amine that we find in many foods has not any functions in our body (unlike the one we generate ourselves) and, for this reason, we eliminate it thanks to DAO. The process begins in the small intestine, but there are people who do not have enough DAO or it is not very active at the intestinal level and that is when different symptoms can appear.

The most frequent symptoms, which we had been mentioned in different articles, appear because of an accumulation of histamine in tissues due to the activation of different histamine receptors. These symptoms can be very diverse, such as: migraine, swelling, diarrhea and/or constipation, hives, rhinitis and muscle and/or joint pain, among others.

In the last 17 years, it has been shown that the most appropriate treatment for these patients with DAO deficiency is to follow a low-histamine diet prescribed by a specialized dietitian and supplemented with DAO enzyme of animal origin, more specifically from pig kidney protein extract. However, in countries like Spain, Germany or France, vegetal origin DAO enzyme is already a reality. It represents a step forward to be able to recommend this enzyme to people who follow a vegetarian/vegan diet or who for sociocultural reasons do not consume pork.

Currently, the main differences between the two origins are:

The researcher PhD Oriol Comas-Basté carried out a study on lyophilised legume sprouts as a functional ingredient for the supplementation of the diamine oxidase enzyme in the year 2020. It was concluded that certain edible legumes proved to be a source of DAO enzyme, which confirms the potential suitability of this food for the formulation of DAO supplements for the treatment of DAO deficiency. As a result, it was shown that the germination of legume seeds for 6 days in the dark provided the plant matrix with the maximum histamine-degrading capacity. Specifically, the raw legumes that showed histamine-degrading activity were alfalfa, broad bean, common bean, lentil and white lupine. Among them, the highest enzyme activity was detected in dry lentil seeds. On the other hand, lyophilised legume sprouts, practically all the samples analyzed showed histamine-degrading capacity in vitro, although with great variability between the different legume species. Bean and mung bean sprouts did not show this enzyme activity. Lyophilized green pea and grass pea sprouts showed the highest DAO activity, followed by lentils, soybeans and chickpeas. In contrast, lyophilized alfalfa, broad bean and white lupine sprouts showed the lowest enzymatic activity values.

In this sense, although the lyophilization of legume seedlings can be considered a suitable process to obtain a plant tissue ready to formulate, the storage stability of its enzymatic activity is still limited to the freezing or refrigeration of the product.

There is still research to find the optimal formulation to guarantee the shelf-life stability of the DAO activity of plant origin. However, we must not forget that we have in our hands good dietary management accompanied by supplementation, always customizing in each case and situation with the help of a health professional.

The International Institute of DAO deficiency has designed a new DAO enzyme product called GoDAO®. It is the most active and stable enzyme on the market. Furthermore, due to its gastro-resistant protection, it guarantees the complete arrival of the enzyme to the intestine, which is where it acts. From our experience, the need arose to create a format which had 90 mini tablets so that 1 box lasts an entire month of treatment. You can buy it here.

Bibliography

Comas-Basté, O., Latorre-Moratalla, M.L., Rabell-González, J., Veciana- Nogués, M.T., Vidal-Carou, M.C., Lyophilised legume sprouts as a functional ingredient for diamine oxidase enzyme supplementation in histamine intolerance, LWT – Food Science and Technology (2020), doi: https://doi.org/10.1016/j.lwt.2020.109201.

Comas-Basté O, Sánchez-Pérez S, Veciana-Nogués MT, Latorre-Moratalla M, Vidal-Carou MDC. Histamine Intolerance: The Current State of the Art. Biomolecules. 2020 Aug 14;10(8):1181. doi: 10.3390/biom10081181. PMID: 32824107; PMCID: PMC7463562.

Intolerancia a la Histamina, de los indicios a la evidencia – FESNAD 2020 | AD Dietistas. [online] Adrianaduelo.com. Available at: https://www.adrianaduelo.com/intolerancia-a-la-histamina-de-los-indicios-a-la-evidencia-fesnad-2020/