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Tyramine

What is tyramine?

Tyramine is a monoamine substance derived from the amino acid tyrosine.

Functions of Tyramine in the Human Body

Tyramine may stimulate the sympathetic nervous system [1].

Tyramine-Drug Interactions

In sensitive people, eating foods high in tyramine along with certain drugs may trigger a marked increase in blood pressure, called hypertensive crisis, “cheese effect”, “cheese reaction” or “cheese syndrome”; symptoms may include severe headache, blurred vision, nausea, vomiting, difficulty thinking, rapid hear beat, chest pain and seizures. Complications may include stroke or even death.

Do not take the following drugs along with foods high in tyramine [4]:

  • Monoamino oxidase inhibitors – MAOIs (medications for depression, such as isocarboxazide, phenelzine, safrazine, selegiline, tranylcypromine)
  • Antibiotics: ethambutol, isoniozid, linezolid, rifampin

Foods Rich in Tyramine

Tyramine in potentially dangerous amounts (for people who take abovementioned drugs) may be found in [2,3,4]:

  • ANIMAL FOODS:
    • Aged cheeses: 4 oz or more of American processed, blue, brick, brie, cheddar, colby, mozzarella, Swiss, roquefort, stilton, parmesan, provolone or emmentaler
    • Dry sausages, such as pepperoni, salami, mortadella, pastrami and summer sausage, and other cured meats
    • Spoiled, pickled, smoked, dried or marinated meat, poultry, chicken liver, fish, shrimps or caviar
  • PLANT FOODS:
    • Broad (fava) beans, natto, sauerkraut, soy sauce, shoyu, snowpeas, soups with meat extracts (miso soup, bouillon), soybean, tamari, tempeh, teriyaki, tofu
  • OTHER FOODS: vermouth, tap beer, nonalcoholic beer, Korean beer, kim chee or kimchi (fermented Korean condiment), yeast extracts, sherry, liquers

Heating (cooking) does not lower the amount of tyramine in foods [8].

Tyramine and Migraines

Some people believe that tyramine-rich foods can trigger migraines. In some studies, tyramine consumption was, but in others was not associated with migraine attacks [6,7].

  1. Tyramine  PubChem
  2. McCabe Sellers BJ et al, 2005, Tyramine in foods and monoamine oxidase inhibitor drugs: A crossroad where medicine, nutrition, pharmacy, and food industry converge  US Department of Agriculture
  3. 2007, Low-tyramine diet for migraine  National Headache Foundation
  4. Avoid Food-Drug Interactions  US Food and Drug Administration
  5. Walker SE et al, 1996, Tyramine content of previously restricted foods in monoamine oxidase inhibitor diets  PubMed
  6. Jansen SC et al, 2003, Intolerance to dietary biogenic amines: a review  PubMed
  7. D’Andrea G et al, The role of tyrosine metabolism in the pathogenesis of chronic migraine PubMed
  8. Naila A et al, 2010, Control of Biogenic Amines in Food—Existing and Emerging Approaches  PubMed Central

One Response to "Tyramine"

  1. Hannah says:

    Our 14 mos old was put on INH and had horrible reactions for 10 days and switched to rifampin for the next 7 months. Our PCP nor the Infectious disease doctor who ordered the medicine never mentioned these tyramine foods to avoid and treated us like we were exagerating her symptoms. She had numerous strong food reactions (i.e. screaming in pain) that we simply learned to avoid things over the next several years. Now she is speech delayed at 7 years old, getting better finally, but still. She has a mast cell disorder and EDS, but we didn’t know this then. Unbelievable that we have to get our answers elsewhere than from our doctors. Still steamed.

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