The tyramine-free diet is a way of eating that eliminates consumption of tyramine-containing foods. Tyramine is a substance derived from the amino acid tyrosine and commonly ingested as a component of a variety of foods, particularly aged cheese and wine. In normal quantities and without interference from other chemicals, consumption of tyramine does not produce any bothersome symptoms and helps to sustain normal blood pressure.
Tyramine is metabolized by an enzyme called monoamine oxidase (MAO). Certain individuals taking MAO inhibitors (MAOIs) such as phenelzine (Nardil) and isocarboxazid (Marplan) for depression or other psychiatric conditions are not able to metabolize dietary tyramine and are therefore instructed to avoid all tyramine-containing foods to prevent hypertensive crisis.
Excessive amounts of tyramine may initially cause headache, heart palpitations, nausea, and vomiting and may lead to a hypertensive crisis that can be fatal.
Migraine sufferers often link headache episodes to consumption of foods rich in tyramine. The National Headache Foundation has published tyramine-free diet guidelines for this population of patients. Although few well-designed clinical trials exist studying the effects of tyramine intake in patients suffering from migraine headaches, clinicians often recommend the tyramine free diet to patients if other treatment methods have failed.
4-hydroxy-phenethylamine, diet, MAO, MAOI inhibitor, MAOI, monoamine oxidase, monoamine oxidase inhibitor, para-tyramine, p-tyramine, tyramine.
In the tyramine-free diet, individuals do not consume any foods that contain tyramine. Examples of tyramine containing foods include anchovies, avocados, bananas, bean curd, beer (alcohol-free/reduced), caffeine (large amounts), caviar, champagne, cheese (particularly aged, processed, or strong varieties such as camembert, cheddar, and stilton), chocolate, dry sausage/salami/bologna, fava beans, figs, herring (pickled), liver (particularly chicken), meat tenderizers, papaya, protein extracts/powder, raisins, shrimp paste, sour cream, soy sauce, wine (particularly chianti), yeast extracts and yogurt.
Identifying and avoiding ingredients containing tyramine is often a challenge. The table below includes some examples of foods that are considered safe to eat as well as foods that are typically avoided. A qualified healthcare provider should be consulted before making decisions about diets and/or health conditions.