For years we have been receiving requests for collaboration from students who decide to do their final Bachelor’s or Master’s theses on the DAO deficiency and it is exciting. Surely my TFG and TFM were among the first on the subject and I think that’s where it all started.

This month, Maria Mascaró, from Mallorca, finishes her work on the DAO deficiency and I was able to answer very necessary questions that I share with everyone:

• • What are the most common signs and symptoms you see in patients with DAO deficiency?
    The most common are digestive functional disorders such as abdominal distension or intestinal irregularities. But itchiness, fatigue and migraine are also common. The latter is actually a set of symptoms, one of the most disabling.

• • What approach do you take when designing eating plans for patients with DAO deficiency? Is there a particular strategy or approach you’ve found effective?
    After 13 years of visiting patients with DAO deficiency the basis of treatment is a low histamine diet, without a doubt. It is very effective and after a few weeks of starting the patient begins to improve. In any case, I find the diet to be overly limiting if it is prolonged in its strictest version. Therefore, we suggest complementing it with exogenous DAO enzyme supplementation.

• • Based on your experience. Diagnosing the disease affects patients mostly in a positive or negative way?
    Many may be surprised, but the diagnosis is positive. Knowing the origin of the symptoms generates relief. Most of the patients we see have already been through a lot of professionals and are a little tired. But the diagnosis, thanks to their perseverance, they live it with motivation and adhere well to the treatment.

• • What are the most common challenges people with DAO deficiency face in their daily diet?
    Undoubtedly combine it with life outside. Most restaurants are still not ready to offer safe low histamine dishes and this leads the patient to frustration and to stay at home. From our experience we recommend going out to eat after the first 4 weeks of treatment, choosing a trusted restaurant with fresh produce and not being afraid to talk to the cooks.

• • From your clinical experience, have you observed any relationship between ADHD and DAO deficiency in your patients? If so, how do you think diet and nutrition can influence the management of both disorders in an integrated way?
    Totally! We have more and more families with children diagnosed with ADHD and ADD. And in recent years, boys and girls diagnosed with ASD have also arrived. In each case the evolution is different, but after a few months you notice a beastly cognitive-behavioural change! There is still a lot to study and learn as professionals, but I think we are on the right track. There is certainly a relationship with histamine and its ability to be metabolized by the DAO enzyme.

• • Have you found that there is a significant level of ignorance about this disease among your patients or in the wider community?
    Fortunately it is no longer like 2011 when we started. Back then, there was less evidence compared to now, and even our professional colleagues questioned our work. In the last decade more than 100 scientific articles have been published, representing 70% of the total, so science and clinic are moving forward. As I frequently emphasize, ignorance often arises from a lack of willingness to stay informed, a responsibility that every healthcare professional should uphold.

Thank you Maria!