DAO (Diamine Oxidase) supplements are being used increasingly often by people afflicted with chronically high histamine levels. It's become one of the most popular histamine intolerance supplements, in part because it's now being used as a sort of home test for histamine intolerance— if it lessens your symptoms, you're on the right track.
Symptoms of histamine intolerance (chronically high histamine levels) include migraine headaches, recurrent headaches, nasal congestion, gastrointestinal problems, sneezing, shortness of breath, cardiac arrhythmias (heart rhythm abnormalities), hypotension (low blood pressure), anxiety, and flushing and itching of the skin.
The rest of this article is focused upon what DAO is, how to increase DAO naturally, and how to find the best DAO supplement or DAO-boosting activities for your needs.
Medical Disclaimer: as with everything on this site, this article is provided for information only. I strongly urge you to speak with your doctor or a licensed medical professional in order to assess whether or not you should incorporate a DAO enzyme supplement into your regimen.
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What is the DAO Enzyme?
DAO is an enzyme essential for histamine degradation; it's normally produced in the kidneys, the lining of the intestines, and the thymus. Enzymes are a type of protein molecule which catalyze or accelerate the speed of chemical reactions in the body, while chemicals known as co-factors assist these enzymes in the execution of such reactions.
The co-factors vitamin B6, vitamin C, and copper are essential for the production and proper functioning of DAO. The enzyme's main function is to metabolize (digest) and cause the breakdown of excess amounts of histamine in the body, whether ingested or produced internally.
This breakdown results in a vast reduction of histamine intolerance symptoms, and generally within a half hour. It also works in conjunction with another enzyme known as histamine methyl transferase (HNMT) to reduce the levels of two toxic byproducts of histamine breakdown called N-methyl histamine and imidazole acetaldehyde.
DAO supplements have quickly become one of the most commonly-used supplements to treat a histamine reaction, especially when caused by dietary histamine.
DAO & Histamine Intolerance
As you'll quickly learn, "intolerance" isn't the most accurate description of what's going on inside the body of someone with histamine intolerance. The better term would be "histamine overload" or "histamine toxicity," as the symptoms of the illness are due to the overabundance of histamine in the body.
But to backtrack a bit, why does this overabundance of histamine cause symptoms which mimic a food allergy or food intolerance? The connection lies in the immune system.
Histamine is a nitrogen-containing biogenic amine found in most tissues of the body. This means that it's not only very important to the functioning of most bodily systems, but it can also have a huge effect on them.
Molecules of histamine are produced and stored in histamine-containing granules that are found in mast cells as well as in a type of blood cell called basophils, both of which are integral parts of the immune system.
Histamine release is stimulated as an important part of the body’s inflammatory response to allergens, such as certain foods, pollen, insect bites, various drugs, and dust. The effect of histamine release is incredibly similar to the symptoms typical of an allergic response, in addition to anxiety, dysautonomia, and even mood swings.
Reactions can occur in response to endogenous histamine (produced) or to exogenous histamine (consumed), but high histamine food is the number one reported trigger. Being able to clear histamine from the digestive tract is a major tool in your arsenal, and that's where DAO comes in.
What is DAO Deficiency?
DAO deficiency occurs when the body’s levels of diamine oxidase have dropped low enough that your body is unable to eliminate unnecessary histamine, resulting in buildup.
Once DAO deficiency occurs, your body's histamine level will naturally continue to rise, leading to all the physical symptoms of excess histamine referenced above. Causes of DAO deficiency include:
- Excess alcohol consumption
- Overgrowth of the bacteria normally found in the intestines (SIBO) or Leaky Gut Syndrome
- Consuming large amounts of high histamine foods
- Genetic mutations which impair your body's ability to make DAO or make use of its cofactors
- Hormonal imbalances
- Certain types of medications which function as DAO blockers (including drugs such as chloroquine, isoniazid, and verapamil)
- Chronic gastrointestinal disorders such as Irritable Bowel Syndrome (IBS), Crohn’s disease, or Ulcerative Colitis
- Heavy metal poisoning (such as copper toxicity or lead poisoning)
Some of these causes of low DAO can take decades to build up and express themselves. For example, DAO deficiency can be due to genetic polymorphisms that reduce the normal activity of DAO, or even by a reduction in the available amounts of the cofactors needed for DAO production.
As you get older, DAO production decreases, so any minor genetic mutations may increase in effect as you age. DAO deficiency is usually treated with DAO supplements, but it's also important to make sure you consume a balanced diet, so that you're healthy enough to produce enough DAO on your own.
Major side effects of DAO supplements are rare, but they have occurred, mainly in people with autoimmune and inflammatory diseases. So always talk to your doctor before starting a new regimen or changing your existing one.
Possible side effects of DAO consist of nausea, headache, lethargy, hives, and symptoms similar to those of the flu— so basically the same as those of histamine intolerance.
Best DAO Supplements
DAO supplements are more widely available than ever, but they should not be your first defense against histamine. Their purpose is just to temporarily enhance the level of DAO enzyme in the body, in order to better metabolize high histamine foods and reduce the symptoms of histamine intolerance.
If taking a "magic pill" were all that's needed to clear everyone's histamine symptoms, we wouldn't even be here. So before diving into DAO supplementation, I want to once again state that I am not a medical professional and that you should always speak with your doctor before trying something like DAO.
That said, once you've done an elimination diet and ruled out other possibilities, like gluten intolerance or an allergic reaction, then you should consider DAO supplements. Every brand will contain varying concentrations, but they're widely available over-the-counter.
Even high doses don't require a prescription. One study has indicated that a helpful dose of supplementary DAO is roughly 4.2 mg, taken ideally right before meals.
One more popular histamine intolerance supplement with this amount of DAO is Seeking Health Histamine Block (formerly Seeking Health Histamine Digest), which I've never used, but is apparently very effective.
I personally prefer to consume whole foods when possible, even in supplements, which is why I started with and continue to use Ancestral Supplements' Bovine Kidney.
The DAO content in whole kidney will vary a bit by brand. But I've found it to be the best DAO supplement for histamine intolerance, helping ease my reactions even more than stinging nettle or quercetin have.
This may be because all the best DAO supplements contain some amount of kidney, usually derived from grass-fed cattle that have been allowed to graze freely. Pea sprouts are another great source of DAO, but they must be consumed fresh for the DAO to be used by the body.
One great way to do this is by adding them to your next smoothie. I've learned from experience that taking your source of DAO approximately ten to fifteen minutes before consuming a high histamine meal can help metabolize histamine from any food or drink source.
Though this only helps if DAO deficiency is to blame for your histamine sensitivity. For those who have a type of mastocytosis or a mast cell activation disorder (MCAD), additional DAO may not help unless you figure out your non-food triggers, as well.
The best DAO supplements for histamine intolerance will have been thoroughly tested for heavy metals and potential contaminants, with all levels well within the range safe for human consumption. They should also be fully tested by a third party laboratory.
Most companies will have results posted on their website, and should not contain any unnecessary fillers. A high quality diamine oxidase supplement will also be free of any GMOs, and formulated based on the latest scientific research.
Histamine blocking supplements often contain vitamin C, which helps to normalize the level of DAO long-term, and aids in the normal breakdown of histamine. In addition, histamine intolerance is often due to problems with the normal bacterial flora of the gut.
So many of the top DAO supplements also contain probiotics, which help to restore intestinal balance. Regardless, studies have found that DAO supplementation by itself does help in the improvement of symptoms of patients who have histamine intolerance, so find what works for you.
How to Increase DAO Enzymes (Naturally)
Now that we've looked at supplements, let's look at how to boost DAO levels without adding more pills to your day. There are a number of different ways to increase DAO enzymes naturally, which you can do in place of or in addition to DAO supplements.
You should begin by starting a low histamine diet. To start eating low histamine, first you must eliminate foods that are known to be high in histamine, such as fermented foods and drinks. You can also increase your DAO enzymes naturally by carefully balancing your low histamine diet.
Consider asking your doctor to run a blood test to check your levels of copper, iron, vitamins B6 & B12, and vitamin c (ascorbic acid), especially if they're not familiar with histamine intolerance.
All of these nutrients are necessary for the proper breakdown of histamine by DAO, so make sure they're present in your regular diet and that if you have a deficiency, it gets addressed. It's also important to balance the different types of protein and fat you're intaking.
This means decreasing your intake of Omega-6 fatty acids, such as those contained in highly processed foods, and increasing your intake of healthier fats, like Omega-3 and Omega-9 fatty acids. An often-cited study into rats found that oleic acid in particular— an Omega-9 fatty acid found in olive oil— increases the amount of DAO secreted into the blood stream.
Changing the types of protein you're eating can also naturally increase the amount of DAO released by the gut. Particularly eating organic plant proteins and grass-fed meats can help to naturally increase DAO levels in the body.
Avoiding additives, artificial preservatives, and pesticide-laden foods has also been found to increase DAO. Though it's more likely that those substances themselves are DAO blockers, artificially inflating histamine levels.
Finally, lowering your overall stress has been found to naturally increase DAO, most likely by reducing systemic inflammation and decreasing demand for DAO.
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Carol Marcucci says
Excellent article!
lowhistamineeats says
Thank you!
Cath says
I am so grateful to have found this info. I have ordered supplements ans will be eating fresh kidney soon. Hopefully this helps!
Keep searching, never give up!
lowhistamineeats says
I also really hope this helps you! I know it's a long journey, but never giving up is indeed the key to getting to the end!!
Mish says
Excellent article, thank you for your well-articulated wisdom!
lowhistamineeats says
Thanks, Mish!
Dan says
what was your dosing of the Kidney product that worked for you and I know everyone is different
lowhistamineeats says
Yes indeed, everyone is different, but I find that dosing dependent upon the amount of histamine in a meal works best for me. I will usually take 1-3 capsules with a meal, with 3 for example, with pizza, but only one with a single cookie. These days I may even be able to tolerate a gluten-free cookie or two without any, though, so healing is possible.
Holly says
@lowhistamineeats, the capsules you take are Ancestral Kidney or any other brand? I tried HistDao, it seems to bring me side effects such as constipation.
lowhistamineeats says
Only Ancestral Kidney, so far.
Matt says
Thanks for this, Are you saying that you don't think it's wise to use DAO supplements before an elimination diet in order to assess potential usefulness? I'd recently added a lot of fermented foods based on recent research, but it seems as though the dietary (anti-) inflammation index foods are practically the opposite of the (low) histamine diet!
lowhistamineeats says
You're very welcome, Matt! And yes, that's exactly correct-- I believe that people should try the elimination diet for at least four weeks before considering DAO supplements, otherwise you run the risk of trying them too early when your gut is still inflamed and all the DAO in the world couldn't get rid of the irritation. This is because DAO just clears histamine and several other inflammatory substances, but it won't soothe your digestive tract, fix your gut dysbiosis, or do anything other than increase the amount of DAO in your stomach.
It's certainly frustrating how contradictory things can seem, but they're also two ways of approaching inflammation-- one assumes that excess histamine in particular is your issue (whatever the root cause), while the other assumes that your gut isn't diverse enough and that adding more bio into your microbiome will help with the balance. So once you dive it it all it makes more sense, but it's definitely intimidating!
Matt says
@lowhistamineeats, Thank you. Makes sense. I believe that fermented foods have increased the diversity of my gut biome, but that I'm not reaping any benefit in the way I feel. So I'm going to start with putting down the Kimchi, Kombucha and Yogurt, and avoid some of the other no brainer foods that are blacklisted on both the DII and the Histamine diets.
lowhistamineeats says
That sounds like a very measured, logical approach. I hope it gains you some results and insights!
C says
@Matt, try the AIP diet.
SPR says
Hello,
So is the Ancestral Supplement considered a "natural form of a DAO Supplement?
Thank you for your time your putting in on the information provided!!
lowhistamineeats says
Hi! You're very welcome. 🙂
I would still consider the Ancestral Supplements pills as a supplement (even though the kidney is simple whole kidney), but eating cooked kidney or pea sprouts would be a "natural form of a DAO Supplement," as it's a food, but probably not a food you would normally eat with every single meal. I hope that helps!
Holly says
Your article is a great help for me to find a temporarily solution for my severe HIT I recently figured out that I have been suffering from my whole life. I wonder you have ever had constipation and dry mouth after taking DAO supplement?
lowhistamineeats says
I'm sorry you've been suffering, but I'm glad to help provide some relief! I'm never had constipation or dry mouth after DAO, but the histamine-induced inflammation does seem to sometimes cause me to alternate between diarrhea and constipation in times of great stress, so it's possible your situation is unrelated to the DAO.
Holly says
@lowhistamineeats, Thank you for your reply and it is a great relief as well. I am grateful I can connect with someone out there in the world finally. I had a severe vertigo in late February and went to ER. No doctors knew what had happen to me. I went to see countless doctors for my vertigo and dizziness which I had every day and have been treated as stroke in my brain, Meniere disease and food poisoning (I can’t eat nuts, eggs, even meats anymore that contains high proteins which make my symptoms worse). In my country, no one ever heard of histamine intolerance. When I feel like I am dying, I came across your article. What a bless!
Can I ask you if you take Vitamin 6 and Zinc? If so, what brand are you taking and dosage you are using?
lowhistamineeats says
Holy cow, that sounds like a terrifying experience! I'm sorry you went through that, and for so long with nobody pointing you in a helpful direction. I'm glad to offer any direction I can, though I'm certainly not a doctor. So this isn't medical advice, but I do take 25mg Vitamin B6 most days and sometimes 15mg of zinc if I feel a tickle in my throat. I'm not at home right now so I can't check the brand, but Designs for Health and Pure Encapsulations are two reputable brands.
Mark A says
@Holly, I had the same symptoms for nearly 20 years……yes, 20! Have a naturopath order a Mycotox panel from Great Plains Lab and also order a Marcons nasal swab test. If you can afford it ….please do it! Don’t suffer like I did for so long. Hope this helps.
niella says
The kidney supplements gave me palpitations. 🙁 I was using the One Earth Health brand.
Max says
That may be a histamine reaction; you may need to take a plant-based DAO, or add pea sprouts into your meals. There are alternatives, but I'm sorry you're having heart palpitations with the kidney form. :/
niella says
@Max, Maybe it's the gelatin capsules?
Max says
It's certainly possible, but both are animal sources, so could be hard to differentiate. :/
niella says
@Max, Now I'm learning that some people need to freeze the capsules. 🤔
Max says
Really?? I've never heard of such a thing, but I'd love to hear your experiences, if you try it!
Ann says
@Max, Can you recommend a plant based DAO supplement? I am allergic to beef. It will even cause a flare in my eczema.
Max says
Hi, Ann! From my experience, then, you may want to start adding pea shoots to your regular diet, but I haven't personally tried any plant-based DAO supplements. However I think that at MastCell360 they have their own formulation that may be vegan-friendly.
Ken says
@Ann, I’ve used a vegetarian based DAO called NaturDAO. I believe it’s from Spain, but you can order it from Amazon.com
Mandy Parker says
Thank you for your help 🙏🏻 This is a whole year now since my first attack it was the most horrendous experience ever in my life which resulted me whisked off to a&e with suspected stroke thankfully it wasn’t but was anaphylaxis caused by food intolerance and I have been on elimination diet since and diagnosed Vestibular Migraine brought on by foods I cope well whilst at home with my own cooking but eating out is huge problem I take vitamins C, D, E, Iron, Iodine, Antihistamine all work well without any problems and a Sumatriptan for when I feel an attack starting
usually after eating something when dining out. But now I want to start taking a DAO supplement your article is the first most helpful and understanding of this miserable debilitating disease I have read and gives me hope that the supplements you recommend will help me more in my long journey of food intolerance recovery Thank you so much #grateful #hopeful
Max says
That sounds like a horrifying experience! I'm so sorry you've been dealing with that, Mandy, and I'm glad that at least at home you've gotten a handle on what your triggers are. Being 'out in the world' is always hard, because it turns out most people don't know what's in the food they're serving-- scary, right? But I try to think on the bright side of things, and choose to see it like my body making me pay closer attention to what I put in my body, and hopefully enjoy it more. I hope you get even more of a handle on it soon, and I'm glad to try to connect you with any of the knowledge you need on the subject!
Mark A says
@Mandy Parker, I had the same symptoms for nearly 20 years……yes, 20! Have a naturopath order a Mycotox panel from Great Plains Lab and also order a Marcons nasal swab test. If you can afford it ….please do it! Don’t suffer like I did for so long. Hope this helps.
Suki says
@Mandy Parker,
Hugs to you Mandy! Sorry to hear of your scare.
Kevin says
I have MCAS. I am having a blood test to determine my DAO level. If a supplement worked would I need to take it for life?
Max says
No, if a supplement worked indefinitely, it would mean you had chronically high histamine levels and that your doctor wasn't getting at the root of your issues. Because DAO only addresses high histamine in the meal that you're eating; it wouldn't help you with histamine release due to MCAS reactions.
If you have MCAS, you should determine which foods and environments trigger you & avoid them to the best of your ability, as well as work with your doctor to find a daily antihistamine and maybe mast cell-stabilizing medicine regimen that would help support your natural DAO pathways and get the MCAS symptoms under control. MastCell360.com does a better job at explaining the difference between taking DAO & making your own in some of her resources, but I'll have to work on a post addressing that. Thank you for your question, Kevin!
A. Walker says
All DAO in the U.S. comes from the same distributor.
Max says
That may somehow be true, but being distributed through the same sources doesn't mean that they're made from the same materials. Some come from pig & some come from bovine sources, and they're all made in various different places.
Bas says
I've never tried the Ancestral Supplements because I assumed they would be high in histamine (it's from an animal source, an it's inside those capsules for a long time).
Clearly it's not causing problems for you though. Do you think the DAO in the kidney is offsetting the histamine? Or maybe that no histamine is formed due to the processing of the product?
Max says
I'm not convinced that no histamine is formed or present in the 500mg of kidney in each capsule, but I am convinced that there's more than enough active DAO in each capsule to offset any histamine in there, yes.
Jill says
Thank you so much. Your explanations are fantastic. So glad I subscribed to your site!
Max says
Thank you for the kind words, Jill! I'm glad you found everything easy to understand. 🙂