Is it a “myth” that chocolate causes migraine? We are always being told about a list of food because patients described it, but the cause was unknown. Nutritionists do not like to talk about forbidden or recommended food because each one is different. Migraine is one of the effects caused by the accumulation of histamine in plasma.
What is histamine? Histamine is a molecule present in all food and its accumulation can trigger migraine.
Is it possible to know if I have histamine accumulation? It has been observed that 15% of western population has prevalence of
DAO deficiency, which is an enzyme we all have in the small bowel. The deficiency appears when this enzyme has decreased, does not work properly or has a low activity. There are two tests available: one measures the enzyme concentration, which is not useful, and the other measures the activity, whether this is passive or active. Having a low DAO activity means that it is more difficult for you to metabolize or eliminate histamine from food. When the upper limit is reached the symptoms appear: migraine, fatigue and weakness, atopic skin, intestinal disorders, difficult digestion, swollen feeling, ringing in the ears… It is migraine what makes the patient comes for consultation. Nearly 90% of patients with migraine have DAO deficiency.
How can we prevent it? We always recommend getting a diagnosis. When a patient has lack of iron or folic acid, we add it; so it is the same with the enzymes. It is that easy. We administrate capsules and recommend a low histamine diet, as a preventive treatment. The concept of low histamine diet involves many food that do not have it, such as orange. The future is prevention through nutrition.
And what about do not practice sport with empty stomach? That is correct, and I always recommend it. The intake of carbohydrates is essential before doing any physical activity, but especially for people with DAO deficiency. This is because the patient with DAO deficiency doing sport with empty stomach, releases histamine. We also have the same histamine molecule in the body, which is the one with physiologic function; and not the one present in food. Histamine present in the body is released when an allergic process appears; it is used as neurotransmitter and has many other functions. It is necessary, that is why we cannot say that histamine is harmful.
What happen then? During the fast, the histamine within the body is released in the blood stream and, therefore, if you already have histamine accumulation, the exercise increases it more and migraine crisis can occur.
We are what we eat, physical and mentally. Is an adequate nutrition the best medicine? There is an especial diet for each patient. If you think you have it, make an analysis and then visit a professional; we are a team of three: the doctor, the pharmacist and the nutritionist. The analysis is a specific one you have to ask to the doctor: the test for the activity of Diamine Oxidase enzyme. For example, it has also been observed that hyperactive children (ADHD) get better with a proper nutrition, as they receive high doses of medication.
Is it a wide symptom picture? It is, as it also includes bone pain, since histamine forms crystals and builds up in cervical and lumbar areas. It is an extensive picture, but the ongoing studies and the ones I have been involved in are related with migraine. The first study we developed was in 2009 with the University of Barcelona.
Therefore, we cannot make a list of food? Each patient is different and diets are personalized. I do not like to say “milk, orange or spinaches”. Moreover, those are quite new studies. Think about the fact that there is a prevalence of celiacs of 1% in the population versus the 15% of people with DAO deficiency. This deficiency is more frequent in women than in men; for example, during menstruation, DAO enzyme drops. I would like to see in the supermarkets the histamine level specified in the labels as it is in the case of gluten. – In Girona.