Tyramine is an amino acid formed from the breakdown of proteins. It is most often found in foods that are aged, pickled, fermented or smoked. It can also develop in foods that are allowed to spoil. High levels of dietary tyramine can be problematic for migraine sufferers and for those taking monoamine oxidase inhibitor antidepressants, also called MAO inhibitors. Foods with high concentrations of tyramine can cause a sudden, dangerous increase in blood pressure and other neurological and physical symptoms.
Monoamine Oxidase Inhibitors
Monoamine oxidase is an enzyme that breaks down tyramine. MAO inhibitors impair the body's ability to break it down, resulting in a buildup of the amino acid. When this happens, any additional dietary tyramine can cause problems with neurotransmitter levels and lead to symptoms such as migraine headaches, paleness, nausea, neck stiffness, heart palpitations, profuse perspiration, confusion and dangerously high blood pressure. For this reason, a diet low in tyramine is often prescribed for people taking MAO inhibitors.
Protein Foods
Aged and preserved proteins foods contain the most tyramine. Aged cheeses and cured meats, such as pepperoni, hard salami and summer sausage, have high tyramine content. Pickled herring, shrimp paste and aged or salted fish and meat contain high levels, as well. Most liver and wild game meat have increased concentrations of tyramine due to improper storage or handling techniques. Game is often allowed to decompose partially as part of its preparation, and this practice adds to its tyramine content.
Fruits and Vegetables
The tyramine content of most fruits and vegetables is fairly low as long as the foods are purchased fresh and stored properly. Many food products that are high in tyramine have been aged or fermented. These include overripe fruit, particularly avocados; soybean products such as tofu, soy sauce and miso; nutritional yeast products; sauerkraut; and kimchi. Many foods and drinks with caffeine also contain tyramine, as do draft beer and ale. Large amounts of alcohol may also be problematic.
Warning
The longer food sits around, the greater the potential for it having a high tyramine content, even when refrigerated. In addition, foods with small amounts of tyramine can have an additive effect when large amounts are consumed at one sitting. To minimize dietary tyramine, know your ingredients. Read labels and avoid preserved foods. Do not use or purchase foods that are overripe or are close to their expiration dates. Check foods to ensure freshness, and discard those that might be spoiled.
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