Thursday, February 20, 2020


Description, Report Modification

Test code: 1571

Effective update from 26/02/2020



Interpretation of results:
High incidence of histamine intolerance:
< 3.74 U / mL (<40 HDU)

Possible incidence of histamine intolerance: 
3.74 - 12.54 U / mL (40-80 HDU)

Low incidence of histamine intolerance:
> 12.54 U / mL (> 80 HDU)        
HDU: histamine degradation unit
      Histamine is a molecule present in almost all foods, and each individual's capacity to metabolise and eliminate it is different. This capacity is essentially determined by the activity of the diamine oxidase (DAO) digestive enzyme. In people with normal DAO activity, the histamine in their diet is rapidly broken down. However, in people with low activity, a histamine excess is produced in the blood, which increases the likelihood of different symptoms appearing. Symptoms which are derived from what is known as DAO Deficit, food-induced histaminosis or histamine intolerance.
      The symptoms associated with DAO deficit vary greatly and represent highly prevalent chronic pathologies in the population (see table 1). Those affected by this deficit do not necessarily present with all of the described symptoms, although most generally present with 3 and migraine is especially prevalent among them. The appearance of symptoms is not related to the consumption of any food in particular but may rather be associated with a wide range of foods with variable histamine content. The appearance of symptoms is not immediate either as there is no direct time relationship between eating food with a high histamine or histamine releaser content and clinical diagnosis of DAO deficit.
     Both circumstances therefore make it difficult to establish a direct relationship between the food and the symptoms, and therefore a clinical diagnosis of DAO deficit. Identifying low DAO enzyme activity as an intrinsic factor in triggering clinical symptoms of DAO deficit allows effective preventive treatment of the illness and the improvement of the patient's quality of life.
      DAO enzyme activity does not always correlate with the concentration of the enzyme, so the analysis of its concentration is not useful in assessing the cause of the symptoms. Considerable placental synthesis of the DAO enzyme occurs during pregnancy, therefore the analysis is not recommended for pregnant women.

      DAO enzyme activity may be permanently low due to genetic factors, which is what happens to patients with DAO deficit. However, it may also be temporarily low due to the use of inhibitors (such as alcohol and many drugs) or pathological situations (for instance after intestinal surgery., etc.). Drug-induced inhibition is a relatively important possible cause as it has been indicated that more than 90 medicines are capable of inhibiting DAO activity (see table 2).         
      Table 1
      The clinical states currently associated with DAO deficit are:
      - Migraine and other vascular headaches
      - Gastrointestinal disorders: especially those associated with Irritable Bowel Syndrome, such as constipation, diarrhoea, satiety, flatulence or a bloated sensation
      - Dermatological disorders: such as dry skin, atopy and psoriasis
      - Bone disorders: such as osteopathic pain
      - Muscular problems: such as muscular pain, frequently diagnosed as fibromyalgia
      - Chronic Fatigue
      - In infancy and adolescence this has been related to attention disorder hyperactivity and with Cyclic Vomiting Syndrome.
      Table 2. Drugs capable of inhibiting the DAO
      (Veciana-Nogués y Vidal-Carou, 2008)
      Group             Active ingredient
      Analgesics        Metamizole 1,2
      Antihistamines    Diphenhydramine 4 
                        Cimetidine 1,3
      Antiarrhythmics   Quinidine 4 
      Antiasthmatics    Theophylline 4
      Antibiotics       Clavulanate 1,3 
                        Cefotiam 1,2 
                        Cefiroxina 1,2 
                        Cycloserina 4
                        Chloroquine 1,3 
                        Framycetin 4 
                        Pentamycin 1,4
      Antidepressants   Amitriptyline 1,4
      Antihypertensives Dihydralazine 1,3 
                        Verapamil 1,3
      Cardiotonics      Dobutamine 1,3
      Anti-rheumatic    Acemetacin 1,4
      Antiseptics       Acriflavine 4
      Antituberculars   Isoniazide 1,3
      Bronchitics       Aminophylline 1,3
      Diuretics         Amiloride 1,5 
                        Furosemide 4
      Mucolytics        Acetilcisteine 1,4 
                        Ambroxol 1,4
      Neurolépticos     Haloperidol 4
      Prokinetics       Metoclopramide 1,3
      Tranquilizers     Diazepam 4
      Muscle Relaxant   Pancuroni 1,4
      (1) Mainz i Novack (2007); (2) Sattler y col, (1985); (3) Sattler i Lorenz (1990); (4) Steneberg, A (2007), (5) Novotny y col, (1994); (6) Wantke (1998).
      Maintz L, Novak N. Histamine and histamine intolerance. American Journal of Clinical Nutrition 2007, Vol.85, No. 5, 1185-1196.
      LABCO is a member of the Spanish DAO Deficit Society.
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     See attached report
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