Tyramine is a naturally occurring amino acid present in many common foods. Cheese, sausage, lentils, snow peas, and soy. Deli meats, sauerkraut, nuts, wine, and beer. Yogurt and Cheetos. All have high levels of tyramine.
Because tyramine occurs when proteins age, virtually ALL leftovers are high in tyramine. For example, I might cook fresh chicken this evening. It is low in tyramine. Then I put the leftovers in the fridge. Tomorrow it will be high in tyramine. Because deli meats are cooked, stored, sold, and then kept in the fridge for days, they are ALL high in tyramine.
Dry aged cheeses, like parmesan, are also very high in tyramine, as is fresh yeasty bread. Pepperoni pizza – fresh crust, parmesan cheese, dried pepperoni sausage – may be the king of the tyramine world.
Tyramine intolerance can cause migraine, heart & GI problems, & vomiting
I first learned of tyramine when my son’s headache specialist put him on a strict low tyramine diet.
Although high levels of tyramine are common in many foods, most people have no trouble with them. A digestive enzyme – monoamine oxidase – breaks down excess tyramine, releasing only a modest amount of it into your system. That modest level of tyramine is important, as it plays a key role in regulating heart rate and blood pressure.
Unfortunately, some people are what is called ‘tyramine-sensitive’. They have low levels of monoamine oxidase in their intestines. This can be genetic or it can because of intestinal inflammation or damage. Because people with low levels of monoamine oxides (MAOs) can’t digest tyramine, it builds up in their system and causes problems.
Tyramine-sensitivity is much like lactose intolerance. Many people have the necessary enzyme to digest lactose and have no trouble drinking milk or eating dairy products. When those who are lactose intolerant drink milk, however, they become sick eating otherwise healthy food.
Same thing with people who are tyramine-sensitive. Because they have low levels of MAOs, otherwise health food makes them sick.
What happens with tyramine builds up in your system?
When tyramine builds up in your system, it can cause severe problems: heart palpitations, blood pressure fluctuations, vomiting, intestinal issues, migraines, and brain fog. The body responds to high levels of tyramine by releasing the neurotransmitters epinephrine and norepinephrine – stress hormones. These raise blood pressure and heart rate.
In extreme amounts, epinephrine and norepinephrine can trigger ‘serotonin syndrome’, a cardiac emergency. It can lead to stroke or to death and requires immediate emergency medical treatment.
Dopamine, serotonin, brain fog, and skipping hearts
Fortunately, serotonin syndrome from tyramine intolerance is quite rare, especially with modern diets and refrigeration techniques. Serotonin syndrome is most likely to occur when people are prescribed MAO inhibitors for depression or Parkinson disease.
However, systemic problems from tyramine are common.
Tyramine Is A migraine trigger
First, eating high tyramine food – blue cheese dressing, for instance, or a sausage pizza with a glass of wine – can trigger migraine. Most foods associated with migraines are high in tyramine.
Second, tyramine can have long term effects on neurotransmitter balance, which can be very problematic. Both my son and husband provide good examples.
At the time of my son’s first visit to a headache specialist, he had two serious problems. First were the severe migraine attacks. Second, was something that had crept up on him so slowly, we just thought it was part of being sick.
Profound brain fog
My son was disorganized. Not a little disorganized – like most middle schoolers.
He was constantly losing things – assignments, socks, baseballs. His school work would get done but left home. Needed books were left at school. Assignments he thought were done weren’t. And ones he didn’t remember doing were complete.
We met time after time after time with his teachers. Nothing changed.
Brain fog. All caused by high levels of tyramine.
The ability of focus and concentrate depends on the balance of two key neurotransmitters: dopamine and serotonin. This is where tyramine comes in.
Tyramine blocks dopamine receptors. When those receptors are blocked, the body responds by producing more serotonin to keep things in balance. Except you already have enough serotonin, so the serotonin levels get out of adjustment, which affects dopamine levels . . . .
The relationship between tyramine, dopamine, and serotonin – like all areas of neuroscience – is complicated and reciprocally related. Bottom line – the body’s neurotransmitters are no longer properly balanced. The result: profound brain fog and inability to focus.
A Low Tyramine Diet
As soon as my son’s doctor suggested it, our whole family went on the low tyramine diet to help with my son’s migraines.
Within days, my son felt a profound change in his ability to focus. Within weeks, he was sharp and organized.
The brain fog was gone. I felt I had my son back.
The pain was still there – unfortunately for my son, high tyramine could trigger his migraines but low tyramine did not alleviate them. But his brain was functioning.
The going family going on a low tyramine diet taught us something else: my husband was tyramine-sensitive as well.
As soon as we went on the diet my husband’s heart stopped skipping. Remember how tyramine regulates heart rate? If you can’t digest it, it raises your blood pressure and speeds up your heart, often causing it to skip?
Once we lowered it on our family’s diet, my husband’s blood pressure dropped and his heart went back to normal. And he felt MUCH less stressed.
Following a low tyramine diet: More than a list
There are two critical parts of eating a low tyramine diet:
- Avoid foods high in tyramine
- Eat food that is FRESH FRESH FRESH
The American Headache Foundation has a good list of high tyramine foods to avoid.
It’s trickier than it may look. Avoiding soy is critical, and it is in many many foods. You will become expert at reading labels.
Canned tuna often has soy sauce in it – even tuna canned in water. Bacon and dried sausage are out. Anything with MSG is gone – which includes a large number of canned soups. Cheese is a very common ingredient in snack foods. (Cheese is the hardest.) And, as Sean’s neuro always said – nachos, Cheetos, and ramen are the WORST for tyramine-sensitive folk.
No dried beans. No yogurt!
We find it easier to start with what you can eat and build up your menu from there. That’s basically all meats, grains, roots, and leafy vegetables. There’s a lot of fresh tasty healthy food out there.
And American cheese, butter, and cream can be decent substitutes in dishes when you really want that cheese flavor, without the tyramine. Similarly, molasses and salt can be used as soy sauce substitutes. Because so many people are lactose intolerant or have soy allergies, you can find a lot of substitutions on the web.
FRESH FOOD. No joke.
The most important thing to think about when undertaking a low tyramine diet is FRESHNESS.
If you’re on a low tyramine diet, you cannot buy meat at the grocer and leave it in the refrigerator a day or two before cooking. It’s been sitting thawed at the grocer. It sits in your fridge. All that time, its tyramine levels are rising. Deli meat is straight out. No bologna, salami. ham, or roast beef. No pepperoni.
Frozen meat and fish is your safest best – it’s usually fresh frozen when packaged. If you keep it frozen until cooking, it will be low in tyramine when it is served. You can also try to locate a good local butcher. That worked very well for us.
Cooking food does NOT change its tyramine content. In fact, slow cooking – in a crockpot or on the barbecue or low simmering stews – radically increases tyramine levels. We bought an electric pressure cooker – a QuickPot – because the high fast cooking keeps tyramine levels low in foods like ribs or soups.
You MUST freeze leftovers as soon as possible. Food cooked right after thawing and eaten within twelve hours are probably okay. But why wait? At our house, it comes off the table and gets frozen for later microwaving. Otherwise it sits on the refrigerator shelf and it’s easy to have it sit too long.
An empirical question
The nice thing about a low tyramine diet is that it is easy to try.
See if it helps. Most people can digest tyramine. If you try the diet STRICTLY for a week and it doesn’t make a difference, go back to eating like normal. This is not something you need to worry about.
But if it does help, you should see an increase in clarity and reduction in symptoms: brain fog, migraines, heart problems, vomiting, and GI issues.
As we say in our family, it’s an empirical question.
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