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Histamine Intolerance & DAO Enzyme Deficiency Some individuals with MCAS also have histamine intolerance, meaning their body struggles to break down histamine due to a deficiency in diamine oxidase (DAO), the enzyme responsible for histamine degradation

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These typically improve gradually as drug levels decline, though some patients report a temporary worsening of nausea during the first week after discontinuation before improvement occurs

Brit J Pharmacol