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These patients had significantly reduced DAO enzyme levels and higher histamine levels during the day.[ref] Your Gut Microbes Produce Histamine: The gut microbiome significantly influences histamine levels

The resulting energy deficit and oxidative damage to mitochondrial DNA (mtDNA) and proteins further compromise neuronal function and survival [155]

16 It is widely expressed in metabolically active tissues, including the liver, heart, skeletal muscle, and adipose tissue, 2325 and is involved in diverse cellular processes such as metabolic homeostasis, antioxidant defense, autophagy, inflammation, and energy balance

It often occurs when fluid intake isnt keeping up with fluid loss

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