Living With a Low Tyramine Diet: Shopping & Cooking

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What is tyramine? Basics

Tyrosine is one of the ‘big twenty” amino acids used to build proteins in animals, plants, bacteria and effectively all living organisms. Tyramine is a natural break-down product of the amino acid tyrosine. 

There are 3 main ways high tyramine foods get into our diet.

  1. Some foods, like soy beans, snow peas, or tofu are naturally high in tyramine.
  1. But in most other foods, tyramine is generated through fermentation or aging. Smoked meats, pickled vegetables, aged, cured or fermented foods tend to be high in tyramine.  Common foods like vinegar, wine, beer, and soy sauce are fermented. Bacon, sausage and ham are aged or smoked. Corned beef, kimchi, and olives are pickled. Many savory sauces, like Worcester or barbecue, have anchovies in them. All natural cheeses – particularly dry cheeses like parmesan or blues – are aged. 
  1. When foods are at room temperature or even at refrigerator temperature for long periods, the levels of tyramine in the food increase dramatically. 

Being aware of which foods can contain high amounts of tyramine is important because many foods that trigger migraines are high in tyramine. 

How To Eat

Try to purchase frozen meat, poultry and fish.  If that is not possible, try to find the freshest cuts you can and freeze them as soon as you can when you get back to your house.  When you cook any meat, poultry or fish, if there are leftovers, wrap and freeze them directly as soon as you can after the meal. Do not let them sit in the refrigerator overnight. It makes midnight snacking a little more involved, but what are microwaves for?

Step away from the deli counter. All of the delicious roast beef, salami, pepperoni and smoked salmon has been sitting at a (cool) room temperature for days.  No.  Walk away.  Really.

I know, ‘everyone eventually gives in to cheese.’ Here’s the deal. Don’t. All aged cheeses like Parmesan, Edam, Camembert, Cheddars, and variations on Swiss are very high in tyramine. Don’t even get me started on the cheeses that are colored like twenty-dollar bills. All Stilton, Gorgonzola and Blue cheeses are just dripping in tyramine. I read somewhere once that an ounce of blue cheese had enough tyramine to trigger twenty migraines. That may be an overestimate?  But why would you want to trigger even one?  

So where do we go with that? We all want our cheese. This is one of those places where you have to go to substitutes that a lot of people will say, ‘But that’s not cheese.’ All I can do is shrug. American cheese, ricotta, cottage cheese, cream cheese and very fresh (think home-made) mozzarella, queso and paneer are relatively low in tyramine and work pretty well to blunt the cheese cravings.  If you are making a quiche, do as the French do.  Eggs and cream – and here maybe a sprinkle of no nitrite bacon – will give a lovely cream flavor you’d swear has cheese, but doesn’t. 

Most food from Central and Southeast Asia is right out.  Sorry.  There’s no way I can soft-pedal that, as much as I love all of it. Soy sauce (in all of its varieties), teriyaki (because it includes soy sauce), Nam pla, Worcestershire sauce (fermented anchovies), black bean sauce, all varieties of tofu (including all bean curds, tempeh and miso) are all high in tyramine.  When you think about that great Umami-taste? That’s what you are trying to avoid. 

If you cook your own?  There are some substitutes you can use.  Dark molasses can (sort of) replace some of that soy sauce flavor.  Fermented Kimchi and sauerkraut also rank high in tyramine.  But you’re done with Chinese Take-Away. 

Legumes. As if that wasn’t bad enough, then there’s the legumes. We’ve already talked about soybeans and what’s made from them. Snow peas are high in tyramine as well as Lima beans, Fava beans and their pods.  All ‘broad beans’ – those with flat pods. Snow peas. Who would have suspected that? 

Last, but not least, there’s brewing. Beer (especially home brewed beer) and red wine (and its derivatives; sherry, port and vermouth) are all high in tyramine. Sourdough bread (this is all just fermentation after all) is also suspect.

Like any diet, a low-tyramine diet takes a lot attention and work.  But it is do-able.  You don’t have to be perfect – tyramine is not an allergen. There is tyramine in almost everything we eat.  That’s okay. All you have to do is keep the level as low as possible.

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  • Tyramine Basics
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