Tyramine is produced naturally in foods from the breakdown of tyrosine, an amino acid. Tyramine levels are higher in aged and fermented foods and those foods that are stored for long periods of time. Under normal circumstances, tyramine is harmless. But individuals experiencing frequent migraine headaches and those taking certain antidepressants called monoamine oxidase inhibitors, or MAO-Is, are generally advised to limit tyramine in their diet. If your doctor advises you to restrict dietary intake of tyramine, there are general guidelines to follow.
Purpose
Tyramine can cause serious reactions if you take MAO-I medications, such as Zyvox, Nardil, Matulane and Parnate. These medications block monoamine oxidase, an enzyme that breaks down excess tyramine in your body. With this enzyme blocked, tyramine can reach dangerous levels. Symptoms include chest pains, nausea, vomiting and rapid heartbeat. A low-tyramine diet helps prevent reactions caused by excess tyramine.
General Guidelines
It is important to keep foods fresh, since tyramine levels rise as foods age. When you have leftovers, eat them within 48 hours or throw them away. You can limit leftovers by cooking the amount you can eat each day. Ensure freshness of foods when grocery shopping by checking expiration dates. In regard to beverages, fermented, aged and unpasteurized drinks are generally avoided on a low-tyramine diet.
Allowed Foods
Your doctor will provide a list of safe foods divided into categories. For example, in the dairy category, your safe choices include milk, cottage cheese, yogurt, ricotta and sour cream. In the meat category, you can have fresh meats, fish and shellfish. Fresh fruits and vegetables are low in tyramine and can be eaten freely on a restricted tyramine diet. It is important to follow a safe foods list when preparing daily meals to avoid excess tyramine.
Prohibited Foods
Your doctor will also provide an unsafe foods list for you to follow. Generally, all aged dairy products, such as Parmesan, romano and brie are prohibited. Any meats that are aged or leftover for more than 48 hours should be avoided, as well as fermented and over-ripe fruits and vegetables.
Tips
Eat five to six small meals spread evenly throughout the day. Remain on a low-tyramine diet for two weeks after discontinuing MAO-I medications. Check with your doctor before taking any non-prescription medications.
Special Considerations
If you suffer from migraine headaches while on a low-tyramine diet, you may have to restrict tyramine even further. For instance, your doctor may recommend restricting vegetables such as fava beans and snow peas. Discuss migraines with your doctor to make further adjustments to your low-tyramine diet.
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