Foods That Are High in Tyramine and Should Be Avoided

According to the Mayo Clinic, a hypertensive crisis can occur when individuals on MAOI medication consume foods high in tyramine, leading to a dangerous spike in blood pressure. This makes it critical to understand which foods are high in tyramine to maintain health and safety.

Quick Summary

A comprehensive guide to high-tyramine foods, outlining categories such as aged cheeses, cured meats, fermented products, and certain fruits. The guide is particularly relevant for those taking MAOI antidepressants or experiencing tyramine-triggered migraines.

Key Points

• Aged Cheeses Are High: Cheeses like cheddar, blue, feta, and parmesan develop high tyramine levels during the aging process.

• Cured Meats Pose a Risk: Cured, smoked, and processed meats, including salami, pepperoni, and bacon, are rich in tyramine.

• Fermented Foods are Key Sources: Products such as sauerkraut, soy sauce, and miso have high tyramine content due to fermentation.

• Overripe Fruits are Problematic: The tyramine content in fruits like bananas and avocados increases significantly when they are overripe.

• Certain Drinks Should Be Avoided: Tap or home-brewed beers and red wine are high in tyramine and should be limited or avoided.

• MAOIs Require Strict Dietary Control: Individuals taking MAOI medications must follow a strict low-tyramine diet to prevent dangerous blood pressure spikes.

Understanding Tyramine and Its Effects

Tyramine is a naturally occurring amino acid, produced from the breakdown of the amino acid tyrosine. For most people, the enzyme monoamine oxidase (MAO) effectively breaks down tyramine, preventing it from accumulating to unsafe levels. However, certain individuals, such as those taking Monoamine Oxidase Inhibitors (MAOIs), lack this enzyme's full functionality. MAOIs are a class of medications, including certain antidepressants, that can cause tyramine to build up in the body. This can trigger a dangerous increase in blood pressure, known as a hypertensive crisis, which can lead to severe headaches, heart palpitations, and even stroke. Additionally, some people are naturally more sensitive to tyramine and may experience migraines after consuming tyramine-rich foods.

The Culprits: A Detailed Look at High-Tyramine Foods

High levels of tyramine are typically found in foods that have been aged, fermented, cured, or improperly stored. The longer a food is processed or stored, the higher its tyramine content is likely to be.

Aged and Fermented Dairy Products

Aged cheeses are among the most notorious sources of tyramine, as the aging process is a major factor in tyramine production. Avoid these cheeses:

• Cheddar
• Blue cheese
• Feta
• Gorgonzola
• Camembert
• Swiss
• Parmesan

In contrast, non-aged, pasteurized dairy products like milk, cottage cheese, cream cheese, and ricotta have low tyramine levels and are generally safe.

Cured and Processed Meats

Meats that are salted, cured, or smoked contain high levels of tyramine. Examples include:

• Salami
• Pepperoni
• Bologna
• Hot dogs
• Bacon
• Corned beef
• Pickled or smoked fish
• Dried sausages

Opt for fresh meat, poultry, or fish that is properly stored and consumed promptly to minimize tyramine exposure.

Fermented Vegetables and Soy Products

The fermentation process can introduce significant amounts of tyramine. Be mindful of these items:

• Sauerkraut
• Kimchi
• Pickles
• Miso soup
• Soy sauce and teriyaki sauce
• Fermented tofu and tempeh

Certain Fruits and Vegetables

While most fresh fruits and vegetables are low in tyramine, some can develop higher levels when overripe or processed. Be cautious with:

• Overripe bananas
• Overripe avocado
• Certain beans, specifically fava and broad beans
• Some citrus fruits, like oranges and grapefruits, can contain moderate levels

Alcoholic Beverages

Fermented alcoholic drinks are known to be high in tyramine, particularly:

• Tap or home-brewed beer
• Red wine
• Sherry and vermouth

Distilled spirits like vodka, gin, and rum typically contain lower levels.

Other Foods and Condiments

• Yeast extracts (Marmite, Vegemite)
• Soy sauce and fish sauce
• Chocolate
• Sourdough bread

Comparison of High vs. Low Tyramine Foods

Food Category	High-Tyramine Examples	Low-Tyramine Alternatives
Dairy	Aged cheddar, blue cheese, feta, Parmesan	Milk, yogurt, cottage cheese, cream cheese
Meats/Proteins	Cured salami, pepperoni, dried sausages	Fresh beef, chicken, pork, fish, eggs
Fermented Goods	Sauerkraut, kimchi, miso, soy sauce	Fresh or frozen vegetables, ketchup, fresh herbs
Fruits/Veggies	Overripe bananas and avocado, fava beans	Fresh fruits and vegetables (e.g., apples, fresh berries)
Beverages	Tap beer, red wine	Bottled or canned beer, gin, rum, vodka, water, coffee

Tips for Limiting Your Tyramine Intake

To effectively manage your intake of tyramine, particularly if you are on MAOIs or sensitive to it, follow these guidelines:

• Prioritize Freshness: The fresher the food, the lower its tyramine content. Consume meats and other perishables within 48 hours of purchase.
• Read Labels Carefully: Many packaged and processed foods contain fermented ingredients or yeast extracts. Always check the ingredients list.
• Avoid Leftovers: Tyramine levels increase as food sits in the refrigerator, even when cooked. Eat canned or frozen foods immediately after opening.
• Proper Storage: Always refrigerate and handle protein-rich foods properly to prevent spoilage, which increases tyramine levels.
• Cook Thoroughly: While cooking doesn't eliminate tyramine, it can help prevent bacterial growth that contributes to its formation.
• Consult a Professional: If you are on an MAOI or experience frequent migraines, consult a healthcare provider or a dietitian to create a personalized low-tyramine meal plan.

Conclusion

Understanding which foods are high in tyramine is an essential component of a low-tyramine diet, especially for individuals taking MAOI medications or those who suffer from tyramine-induced migraines. By focusing on fresh, unprocessed foods and being mindful of how products are aged and fermented, you can effectively manage your intake and reduce the risk of adverse reactions. Always prioritize freshness, proper storage, and careful label reading to stay safe and healthy while controlling your tyramine consumption. For the most accurate and personalized advice, speaking with a healthcare professional is always the best course of action.

Visit the Mayo Clinic for more information on MAOIs and diet

Frequently Asked Questions

What is tyramine and why is it important to know which foods contain it?

Tyramine is a naturally occurring amino acid found in certain foods, and it can affect blood pressure. For most people, it's harmless, but individuals on MAOI medication or who are sensitive to it must be aware of high-tyramine foods to avoid adverse reactions, such as severe headaches or dangerously high blood pressure.

Why do aged cheeses contain high levels of tyramine?

Aged cheeses contain high levels of tyramine because the aging and fermentation processes used to create them cause the amino acid tyrosine to break down into tyramine. The longer a cheese is aged, the higher its tyramine concentration will be.

Can cooking reduce the amount of tyramine in food?

No, cooking does not destroy tyramine. The tyramine content in a food remains unchanged even after it is cooked. Proper food handling and consumption of fresh products are the most effective ways to manage tyramine intake.

Are all fermented foods high in tyramine?

Many, but not all, fermented foods contain high levels of tyramine. Examples include miso, soy sauce, and sauerkraut. However, some products, like commercial yogurt or pasteurized cheeses, are lower in tyramine due to controlled manufacturing processes.

What kind of meats should be avoided on a low-tyramine diet?

On a low-tyramine diet, you should avoid meats that are cured, smoked, or processed. This includes items like salami, pepperoni, and hot dogs, as the processing methods increase tyramine content. Fresh meat, poultry, and fish are safe alternatives.

How can I tell if a fruit is too ripe and high in tyramine?

The riper a fruit, the higher its tyramine content. For fruits like bananas and avocados, excessive ripeness is often indicated by dark spots, a very soft texture, or an overly sweet smell. To be safe, opt for fresh, firm fruits on a low-tyramine diet.

Is it safe to drink alcohol on a low-tyramine diet?

Alcoholic beverages, especially tap or home-brewed beer and red wine, can be high in tyramine. Some distilled spirits, like gin or vodka, generally contain lower levels. However, it is always recommended to consult a doctor, especially if you are taking medication, as alcohol can also affect tyramine absorption.