What Is Tyramine?
Tyramine is a naturally occurring amino acid derivative that is formed from the breakdown of the amino acid tyrosine during the fermentation, aging, or spoilage of food. For most healthy individuals, tyramine is broken down harmlessly by an enzyme called monoamine oxidase (MAO). However, for people taking monoamine oxidase inhibitor (MAOI) medications, this enzyme is blocked, preventing the body from processing tyramine effectively. This can lead to a potentially dangerous spike in blood pressure, known as a hypertensive crisis. Tyramine is also a known trigger for migraines in some sensitive individuals.
High-Tyramine Food Categories
Foods that have been aged, fermented, cured, pickled, or improperly stored tend to have the highest levels of tyramine. Knowing these categories is key to managing dietary intake effectively.
Aged and Fermented Cheeses
This category represents one of the most concentrated sources of tyramine, which is why adverse reactions were historically called the “cheese effect”. The longer a cheese is aged, the higher its tyramine content.
- High-Tyramine Cheeses: Aged cheddar, blue cheese, Swiss, parmesan, feta, gorgonzola, and provolone.
- Safe Alternatives: Fresh cheeses like cottage cheese, cream cheese, ricotta, and pasteurized American cheese contain minimal tyramine.
Cured, Smoked, and Processed Meats
Similar to aged cheeses, the curing and processing of meats increase their tyramine levels. These foods should generally be avoided by those on tyramine-restricted diets.
- High-Tyramine Meats: Salami, pepperoni, summer sausage, mortadella, cured ham, smoked fish (e.g., salmon), and bacon.
- Safe Alternatives: Fresh, properly stored meat, poultry, and fish contain low levels of tyramine. Examples include fresh chicken breast, beef, and fish that is consumed or frozen shortly after purchase.
Fermented and Pickled Foods
The fermentation process, which introduces bacteria, directly leads to increased tyramine content.
- High-Tyramine Fermented Foods: Sauerkraut, kimchi, pickles, and some sourdough breads.
- Fermented Soy Products: Miso, soy sauce, tempeh, and fermented tofu are also high in tyramine.
Alcoholic Beverages
The fermentation and aging of alcohol can also result in high tyramine concentrations.
- High-Tyramine Alcohols: Draft or home-brewed beers, red wine (especially Chianti), vermouth, and sherry.
- Safe Alternatives: Distilled spirits like gin, rum, and vodka contain much lower levels. Some bottled and pasteurized beers and commercial wines may also be safer options, but caution is advised.
Other Sources of Tyramine
Beyond the main categories, other products can contribute to tyramine intake.
- Fruits and Vegetables: Overripe fruits (especially bananas and avocados) and certain legumes (fava beans, broad beans) can contain significant tyramine.
- Yeast Extracts: Products like Marmite and Vegemite, which are concentrated yeast extracts, are very high in tyramine.
- Sauces: Some sauces, including bouillon-based, teriyaki, and fermented fish sauces, should be avoided.
- Caffeine: The tyramine content in coffee and other caffeinated drinks can also contribute to symptoms in sensitive individuals.
High vs. Low Tyramine Food Comparison
| Food Category | High-Tyramine Examples | Low-Tyramine Examples |
|---|---|---|
| Dairy | Aged cheddar, blue cheese, feta | Milk, cottage cheese, cream cheese, ricotta, American cheese |
| Meats | Salami, pepperoni, smoked salmon | Fresh meat, poultry, and fish (eaten promptly) |
| Fermented Foods | Sauerkraut, kimchi, miso, soy sauce | Plain bread, white rice, cooked pasta |
| Fruits & Vegetables | Overripe bananas, avocados, fava beans | Most fresh fruits and vegetables (eaten promptly) |
| Beverages | Draft beer, red wine, sherry | Bottled beer (pasteurized), vodka, gin, milk, water |
| Sauces & Spreads | Yeast extracts (Marmite), fermented fish sauce | Ketchup, mustard, most salad dressings |
The Role of Proper Food Handling
Beyond understanding which products are inherently high in tyramine, proper food handling is crucial for preventing tyramine buildup in otherwise low-risk foods. Tyramine levels increase over time, especially with improper storage.
- Freshness is Key: Consume fresh protein sources like meat, poultry, and fish as soon as possible after purchase. Freeze any leftovers immediately.
- Storage Matters: Refrigerate or freeze all perishable items promptly. Avoid thawing foods at room temperature.
- Leftover Management: Eat leftovers within 48 hours and discard any food showing signs of spoilage. Cooking does not destroy tyramine.
Conclusion: Which of the Following Products Contain Tyramine?
In summary, the products most likely to contain high levels of tyramine are those that are aged, fermented, cured, or improperly stored. This includes aged cheeses, processed and cured meats, many fermented soy products, certain pickled foods, and specific types of alcohol. While most people can process tyramine without issue, those on MAOI medications or who are prone to migraines should pay close attention to dietary restrictions involving high-tyramine foods. By understanding these food categories and practicing safe food handling, individuals can significantly reduce their risk of adverse reactions and manage their health effectively. For specific advice tailored to your medical condition, always consult a healthcare professional. You can read more about MAOIs and diet on the Mayo Clinic website.
