Is Sauerkraut High in Tyramine? Understanding Your Dietary Risks

December 31, 2025 •

4 min read

Studies have shown that tyramine levels in sauerkraut vary widely depending on the preparation and storage time. This makes it crucial to understand whether is sauerkraut high in tyramine and what that means for your health, especially if you take certain medications.

Quick Summary

Sauerkraut contains tyramine, with levels influenced by fermentation, aging, and storage. It is often restricted for those on MAOI medications or susceptible to tyramine-related side effects like migraines.

Key Points

High Potential: Sauerkraut, as a fermented food, can contain high levels of tyramine, particularly as it ages.
MAOI Danger: Individuals on MAO Inhibitor medications must strictly avoid sauerkraut due to the risk of a dangerous hypertensive crisis.
Migraine Trigger: For those sensitive to tyramine, consuming sauerkraut can be a trigger for severe migraine headaches.
Variable Content: The amount of tyramine in sauerkraut is not fixed and varies based on fermentation time, bacterial strains, and storage duration.
Storage Matters: Longer stored or aged sauerkraut contains higher tyramine levels than fresher versions.
Preparation Type: Homemade or uncontrolled fermentation often results in higher tyramine compared to some commercially inoculated or sterilized products.

What is Tyramine and Why is it a Concern?

Tyramine is a naturally occurring amino acid produced during the aging, fermentation, pickling, or spoiling of certain foods. For most healthy individuals, the body has an enzyme called monoamine oxidase (MAO) that effectively breaks down and metabolizes tyramine, preventing any adverse effects. However, for specific populations, consuming high-tyramine foods can be dangerous.

MAO Inhibitors and the 'Cheese Effect'

People taking a class of antidepressants known as Monoamine Oxidase Inhibitors (MAOIs) must follow a strict low-tyramine diet. MAOIs block the enzyme responsible for breaking down tyramine. If a person on MAOIs eats a high-tyramine food, tyramine can build up in the body and trigger a hypertensive crisis—a dangerous spike in blood pressure. Symptoms can include a severe headache, stiff neck, rapid heart rate, and chest pain. Sauerkraut is explicitly listed on restricted food lists for individuals taking MAOIs.

Tyramine as a Migraine Trigger

Beyond medication interactions, tyramine is also a well-known trigger for migraine headaches in some sensitive individuals. While the exact mechanism is still being studied, it's thought that elevated tyramine levels may cause nerve cells to release norepinephrine, which can cause changes in the brain that lead to headaches. For those prone to migraines, keeping a headache diary and monitoring tyramine intake is a common recommendation.

The Tyramine Content in Sauerkraut

Sauerkraut's tyramine content is not static; it is directly tied to its fermentation process and age. Cabbage itself contains very little tyramine, but the bacterial fermentation process that creates sauerkraut breaks down the amino acid tyrosine into tyramine, causing levels to rise significantly.

Factors that increase tyramine levels in sauerkraut:

Extended Fermentation: The longer sauerkraut ferments, the more time there is for tyramine to accumulate.
Prolonged Storage: Even after commercial processing, storing sauerkraut for a long time can lead to a gradual increase in tyramine.
Homemade vs. Commercial: Homemade preparations often have more varied and potentially higher levels of tyramine due to less controlled fermentation and storage conditions. Some commercial producers, however, inoculate their products with specific bacteria strains that produce lower levels of biogenic amines, including tyramine.
Sterilization: Sterilized sauerkraut, which is typically canned, will have had its bacteria killed, halting the tyramine production process. This can result in lower tyramine content compared to live, refrigerated sauerkraut.

Comparison of Tyramine Levels in Common Foods

To put sauerkraut's tyramine levels into perspective, the following table compares it with other known high-tyramine foods. It's important to remember that these levels can vary widely based on processing, storage, and freshness.


Food Category	Example	Typical Tyramine Level	Notes
Fermented Vegetables	Sauerkraut	Moderate to High	Levels increase with fermentation and storage time.
Aged Cheese	Aged Cheddar	Very High	Levels increase with aging.
Cured Meats	Salami, Pepperoni	High	Tyramine increases during curing and processing.
Fermented Soy Products	Miso, Soy Sauce	Moderate to High	Fermentation process increases tyramine.
Alcoholic Beverages	Red Wine, Tap Beer	Moderate to High	Especially home-brewed and unpasteurized varieties.
Overripe Fruit	Overripe Bananas, Avocados	Moderate	Ripening process increases tyramine.

Safely Navigating Tyramine in Your Diet

For most people, the tyramine in sauerkraut is harmless. The concern arises for individuals with specific medical conditions or medication requirements. If you are not in these categories, you can enjoy sauerkraut and its probiotic benefits without worry. However, if you are concerned, there are steps you can take.

If You Need to Limit Tyramine

Check with Your Doctor: Always consult a healthcare provider before making significant dietary changes, especially if you are on an MAOI.
Choose Fresh Over Aged: Opt for the freshest sauerkraut possible. The tyramine content is lowest in recently produced batches and increases over time.
Understand Labels: Check for refrigerated, unpasteurized products versus canned, sterilized ones. Sterilized versions often have a lower tyramine content.
Start Small: If you have tyramine sensitivity, introduce a very small amount of sauerkraut to test your tolerance before consuming a full serving.
Look for Specific Strains: Some manufacturers are beginning to use bacterial strains that produce lower biogenic amines, though this requires careful reading of product information.

Conclusion

So, is sauerkraut high in tyramine? The answer is yes, it can be. As a product of bacterial fermentation, sauerkraut contains tyramine, and its concentration is highly dependent on how it's prepared and stored. While this is not a concern for the general population, it presents a significant health risk for individuals taking MAOIs and can be a migraine trigger for others. Careful consideration of your health status and the type of sauerkraut you consume is essential to enjoy this fermented food safely. When in doubt, always prioritize fresh, commercially produced versions and consult your doctor.

For additional information on MAO inhibitors and dietary restrictions, you can read the National Institutes of Health's resource on Monoamine Oxidase Inhibitor Toxicity.

Frequently Asked Questions

No, the tyramine content can vary widely. Factors like the specific bacteria used for fermentation, how long the sauerkraut has been stored, and whether it's homemade or commercially prepared all influence the final tyramine level.

Even fresh, refrigerated sauerkraut contains tyramine due to the fermentation process. For those on a strict low-tyramine diet, it is generally recommended to avoid all versions of sauerkraut.

Consuming high-tyramine sauerkraut while taking an MAOI can cause a hypertensive crisis, a dangerous spike in blood pressure. This is a severe medical emergency that can lead to headaches, chest pain, and other serious health problems.

There is no simple way to check the exact tyramine content at home. The best approach is to follow general dietary guidelines, avoid prolonged storage, and consult with a doctor or dietitian if you are on a restricted diet.

Not all fermented foods are equally high in tyramine. While many, like aged cheeses and cured meats, are high, the concentration depends on the aging and fermentation process. However, people on restricted diets should be cautious with all fermented items unless advised otherwise by a doctor.

For a crunchy, cabbage-based side dish, you can use fresh cabbage slaw with a vinegar-based dressing. You can also explore fresh vegetables and non-aged cheeses, which are typically low in tyramine.

Cooking does not reliably reduce tyramine levels in food. The tyramine is already formed during the fermentation process and will remain present even after heating.