Common Foods that Contain Tyramine and How to Identify Them

Certain foods, such as aged cheeses and fermented meats, naturally contain tyramine, a compound that increases as food matures or spoils. For individuals with specific health conditions or on certain medications, understanding and identifying foods that contain tyramine is critical for safety and well-being.

Quick Summary

Tyramine is a natural compound that forms from the breakdown of the amino acid tyrosine during aging and fermentation. High levels are found in aged cheeses, cured meats, and fermented foods. Awareness of these food sources is crucial for those sensitive to tyramine or taking MAOIs to avoid adverse health reactions.

Key Points

• Aged Cheeses: Cheeses like aged cheddar, blue cheese, and Parmesan contain high levels of tyramine due to the aging process.

• Cured Meats: Processed and cured meats, including salami, pepperoni, and hot dogs, are significant sources of tyramine.

• Fermented Foods: Fermented products like sauerkraut, kimchi, soy sauce, and miso are rich in tyramine.

• Alcohol: Draft beer and aged red wines are typically higher in tyramine compared to bottled beer or clear spirits.

• MAOI Interaction: Taking Monoamine Oxidase Inhibitors (MAOIs) while consuming high-tyramine foods can trigger a dangerous spike in blood pressure.

• Freshness is Key: Tyramine levels increase with food aging and spoilage, so prioritizing fresh food over leftovers is recommended.

• Overripe Produce: Fruits like overripe avocados and bananas can contain higher concentrations of tyramine.

What is Tyramine?

Tyramine is a naturally occurring monoamine compound derived from the amino acid tyrosine. It's found in various plants and animals and is produced when foods age, ferment, or spoil. The body uses an enzyme called monoamine oxidase (MAO) to break down tyramine. For most people, consuming tyramine is not an issue, but for individuals taking monoamine oxidase inhibitor (MAOI) medications or those susceptible to migraines, high levels of tyramine can lead to a dangerous spike in blood pressure, known as a hypertensive crisis. A low-tyramine diet is often recommended in these cases.

Foods High in Tyramine

This category includes a wide range of products where the aging and fermentation process concentrates tyramine.

• Aged and Fermented Cheeses: This is one of the most common sources of high tyramine, often referred to as the 'cheese effect'. The longer a cheese is aged, the higher its tyramine content. Examples include:
  • Aged Cheddar
  • Blue Cheese
  • Gouda
  • Brie and Camembert
  • Feta
  • Parmesan
• Cured, Smoked, and Processed Meats: The curing and smoking processes increase tyramine levels. Always choose fresh meat over processed varieties. High-tyramine meats include:
  • Salami and Pepperoni
  • Bologna and Hot Dogs
  • Cured Ham and Bacon
  • Pickled or Smoked Fish, such as pickled herring and smoked salmon
• Fermented Vegetables and Soy Products: Fermentation is a key factor in increasing tyramine levels.
  • Sauerkraut
  • Kimchi
  • Soy sauce, Miso, and Tempeh
• Alcoholic Beverages: Certain types of alcohol, particularly those that are fermented or aged, contain higher tyramine levels.
  • Draft or Home-brewed Beer
  • Red Wine (especially Chianti and Burgundy)
  • Vermouth and Sherry
• Overripe or Specific Fruits: Tyramine levels can increase in fruits as they ripen.
  • Ripe Avocados
  • Overripe Bananas
  • Figs
  • Red Plums
• Other Sources:
  • Concentrated yeast extracts (Marmite, Vegemite)
  • Fava or broad beans
  • Certain sauces like fish sauce and teriyaki sauce
  • Improperly stored or spoiled foods

Comparison of High vs. Low Tyramine Foods

Food Category	High-Tyramine Examples	Low-Tyramine Alternatives
Dairy	Aged Cheddar, Blue Cheese, Parmesan	Cottage Cheese, American Cheese, Mozzarella, Ricotta, Fresh Milk
Meat & Protein	Salami, Pepperoni, Cured Ham, Smoked Fish	Freshly Cooked Beef, Chicken, Pork, Eggs
Fermented Goods	Sauerkraut, Kimchi, Soy Sauce, Miso	Unfermented vegetables, fresh herbs, commercial salad dressings
Beverages	Draft Beer, Red Wine, Vermouth	Bottled Beer, White Wine, Gin, Vodka
Fruits	Overripe Bananas, Ripe Avocados, Figs	Apples, Berries, Pears, Peaches
Bread	Sourdough Bread	Unfermented breads, pasta, rice

Practical Guidance for a Low-Tyramine Diet

Managing tyramine intake requires a few simple, yet important, lifestyle changes.

• Prioritize Freshness: Always opt for fresh foods over aged, fermented, or leftover items. Cooking fresh foods immediately after purchase helps minimize tyramine formation.
• Mindful Storage: Store all protein-rich foods, including meat and dairy, properly in the refrigerator and eat leftovers within 48 hours, or freeze them.
• Read Labels: Be aware of ingredients in pre-packaged foods. Yeast extracts and certain fermented sauces can be hidden sources of tyramine.
• Consult a Professional: For those on MAOIs or with severe migraine issues, it is essential to consult a healthcare provider or a registered dietitian to create a personalized low-tyramine diet plan.

Conclusion

Tyramine is a naturally occurring compound in many foods, with concentrations increasing through processes like aging and fermentation. While harmless for most, it can cause severe health reactions in individuals taking MAOI medication or those who are tyramine-sensitive. By understanding which foods contain tyramine—primarily aged cheeses, cured meats, and fermented products—individuals can make informed dietary choices to manage their health effectively. Always prioritize fresh foods, proper storage, and professional medical advice when necessary. MAOIs and Diet | Mayo Clinic

Frequently Asked Questions

What is tyramine?

Tyramine is a natural compound that forms from the amino acid tyrosine during the aging, fermentation, or spoilage of certain protein-rich foods.

Why do some people need to avoid tyramine?

Individuals taking Monoamine Oxidase Inhibitors (MAOIs) or those with tyramine sensitivities, such as some migraine sufferers, must limit their intake to prevent adverse reactions like a sudden increase in blood pressure.

Which cheeses are highest in tyramine?

Cheeses that are aged and fermented contain the most tyramine. Examples include aged cheddar, blue cheese, Swiss, Parmesan, and feta.

Are all fermented foods high in tyramine?

Many fermented foods are high in tyramine due to the fermentation process, but not all. Sauerkraut, kimchi, soy sauce, and miso are known sources, while other fermented products may have varying levels.

Does cooking food reduce tyramine content?

No, cooking food does not reduce its tyramine content. The concentration of tyramine is determined by the food's processing, aging, or fermentation, and is not affected by heat.

What are some low-tyramine cheese options?

For those needing to limit tyramine, safer cheese options include pasteurized and unfermented cheeses like cottage cheese, cream cheese, American cheese, and ricotta.

Can you eat leftovers on a low-tyramine diet?

It is best to consume leftovers quickly or avoid them entirely, as tyramine levels continue to increase over time with storage. For best safety, eat fresh or freeze leftovers immediately.