Foods containing a compound called tyramine are ordinarily fine for healthy people, but can cause serious side effects for those who are sensitive to it or who are taking certain types of medications. In such cases, doctors prescribe a diet low in tyramine. If your doctor has placed you on this diet, know which foods and drinks have high levels of tyramine so you can avoid potentially serious complications.
Identification
Tyramine is a blood-pressure regulating amino acid found naturally in some foods, plants and animals. It can also be a byproduct of food manufacturing, including the aging, curing and fermentation of foods. It is also created via the spoilage of produce, dairy and meats. Monoamine oxidase inhibitors, or MAOIs, are a class of antidepressant drugs prescribed for the treatment of depression and Parkinson's disease that break down excess tyramine in your body.
Significance
If you are taking a MAOI and eat foods high in tyramine, your body won't be able to break down the tyramine, which can lead to a buildup in the blood, causing a release of excess amounts of the neurotransmitter norepinephrine, constricting the blood vessels and raising blood pressure to dangerous levels. Symptoms can include a severe headache, blurred vision, difficulty thinking, chest pain, nausea, vomiting, seizures, strokes and even death. Tyramine can also cause migraine headaches in some people who aren't on MAOIs.
Tyramine in Food
In general, the longer a high-protein food ages, the larger the amount of tyramine it contains. Aged cheese has the highest levels, as does beer and wine; cured meats such as sausage, pepperoni and salami; fermented soy produces like miso, tofu, soy sauce and sauerkraut; yeast extracts such as brewer's yeast pills or liquid; pickled herring or smoked fish; and pods from broad beans like fava or Italian green beans. The amount of tyramine varies even among these foods due to different processing, storage and preparation methods.
Considerations
Storing foods at room temperature can increase tyramine levels, so it's best to purchase fresh foods and either eat them right away or freeze them. Foods should be thawed in the refrigerator or microwave and avoid any food that has spoiled. Heat doesn't destroy tyramine, so cooking foods won't lower their tyramine content. If you stop using MAOIs, you'll still need to avoid high-tyramine foods for two to three weeks following. One type of MAOI, selegiline, is delivered through a patch placed on your skin and may not require you to be as strict with your diet.
References
- Vanderbilt University Medical Center; Meal Ideas and Menus: Avoiding High-tyramine Foods Made Easy; Kathrynne Holden, MS, RD
- Drugs.com; Low Tyramine Diet; 2011
- National Headache Foundation: Tyramine
- MayoClinic.com; I just started taking MAOIs for depression. Do I really need to follow a low-tyramine diet?; Daniel K. Hall-Flavin, M.D.; September 2010
