Cluster headaches are unusually intense headaches characterized by excruciating, one-sided pain accompanied by tearing and redness of the eye on the involved side of your head. Runny nose, eyelid swelling and facial redness and sweating are additional symptoms of cluster headaches. Most sufferers are agitated or restless during an attack. Cluster headaches occur episodically, with "clusters" lasting anywhere from a week to a year. If you have cluster headaches, you may have discovered specific dietary triggers, but it is unlikely that food-borne tyramine contributes to cluster headaches.
Cause
According to a February 2005 "American Family Physician" review, positron emission tomographic scans performed on the brains of cluster headache patients consistently reveal heightened hypothalamic activity during acute episodes. The hypothalamus is believed to be the "pain center" in your brain. Presumably, abnormal impulses from your autonomic nervous system trigger the inappropriate production of trace amines -- chemical relatives of dopamine, epinephrine and serotonin -- in your hypothalamus, which leads to increased pain perception, dilation of arteries in your head and reflexes that produce many of the symptoms of a cluster headache.
Trace Amines
Tyramine, octopamine and synephrine are trace amines that have been implicated in the genesis of primary headaches, such as migraines and cluster headaches. A study published in the May 2004 issue of "Neurology" showed that blood levels of trace amines are higher in cluster headache patients than in other people, including migraine sufferers. This reinforces the notion that cluster headaches are triggered by autonomic imbalances and disrupted neurotransmitter metabolism.
Dietary Tyramine
A January 2007 review in "CNS Spectrums" reported that dietary tyramine is extensively metabolized by two intestinal enzymes, monoamine oxidase A and monoamine oxidase B. MAO-A prevents at least 90 percent of dietary tyramine from entering your bloodstream, and MAO-B -- found in your liver as well as your intestine -- essentially inactivates the remainder. Thus, it is unlikely that dietary tyramine plays a significant role in triggering your cluster headaches.
Considerations
Cluster headache sufferers tend to have higher blood levels of tyramine and other trace amines, but these substances are produced by your own nervous system and released into your bloodstream. The role this "endogenous" tyramine plays in generating cluster headaches is unclear; it is probably one of several participants in a cast of characters that trigger your headaches. Dietary tyramine is normally inactivated by enzymes in your intestine and liver before it reaches your bloodstream. If you have identified specific dietary triggers for your headaches, avoidance of these foods is an important means of prevention.
References
- "American Family Physician"; Management of Cluster Headache; E. Beck, et al.; February 2005
- "Neurology"; Elevated Levels of Circulating Trace Amines in Primary Headaches; G. D'Andrea, et al.; May 2004
- "CNS Spectrums"; Effects of a Tyramine-Enriched Meal on Blood Pressure Response in Healthy Male Volunteers with Selegiline Transdermal System 6mg/24 Hour; L.F. Blob, et al.; January 2007
