The Tyramine-Migraine Connection
Tyramine is a naturally occurring compound found in many foods and is created from the breakdown of the amino acid tyrosine during aging, fermentation, and decomposition. While most people can process tyramine without issue, some individuals with migraines are sensitive to it. For these individuals, consuming tyramine can trigger the release of norepinephrine, a neurotransmitter that affects blood vessels and can lead to a migraine attack.
This sensitivity is linked to the enzyme monoamine oxidase (MAO), which breaks down tyramine in the body. People who have a deficiency in this enzyme may experience a buildup of tyramine, leading to a migraine. The connection was first noted in people taking MAO inhibitor medications, who experienced headaches and high blood pressure after consuming high-tyramine foods.
High-Tyramine Foods to Watch For
Identifying potential dietary triggers is a key step in managing migraines. It is important to note that individual tolerance varies greatly, and a food that triggers one person's migraine may not affect another's. Keeping a detailed food and headache diary is the most effective way to pinpoint your personal sensitivities.
Common high-tyramine foods include:
- Aged and fermented cheeses: Cheddar, feta, blue cheese, camembert, swiss, parmesan, and provolone are often cited as high in tyramine.
- Cured, processed, and fermented meats: This category includes sausage, salami, pepperoni, hot dogs, smoked fish, and deli meats. The longer these items are aged or processed, the higher their tyramine content tends to be.
- Fermented soy products: Soy sauce, miso soup, and tofu that has been fermented all contain significant levels of tyramine.
- Certain beverages: Alcoholic drinks, particularly red wine and tap or home-brewed beers, are common triggers.
- Concentrated yeast products: Spreads like Marmite and Vegemite are known to be rich in tyramine.
- Improperly stored or leftover foods: Tyramine levels increase as food ages, so eating fresh foods and freezing leftovers promptly is recommended for sensitive individuals.
- Some fruits and vegetables: Overripe bananas, citrus fruits, and fava beans may be problematic for some.
Managing Your Diet: High vs. Low Tyramine Foods
Adopting a low-tyramine diet involves being mindful of food freshness and processing methods. Here is a comparison to help you make informed choices.
| Food Category | High-Tyramine Foods (Avoid or Limit) | Low-Tyramine Foods (Typically Safe) |
|---|---|---|
| Dairy | Aged cheeses (Cheddar, Feta, Blue, Swiss, Parmesan), Yogurt, Buttermilk | Fresh dairy (Milk, Cream cheese, Cottage cheese), Non-fermented cheeses (e.g., American cheese) |
| Meat & Protein | Cured or smoked meats (Salami, Pepperoni, Bacon, Deli Meats), Smoked fish, Chicken livers, Aged leftovers | Fresh or frozen meat, poultry, and fish; Eggs; Legumes (most beans, peas, lentils, except fava) |
| Beverages | Red wine, Tap/home-brewed beer, Vermouth | Water, Decaffeinated coffee/tea, Certain liquors (Vodka, Gin), Club soda |
| Fermented Foods | Sauerkraut, Kimchi, Soy sauce, Miso, Pickles | Fresh vegetables and fruits, Whole grains, Pasta, Rice |
| Condiments | Meat tenderizers, Bouillon cubes, Concentrated yeast spreads | Ketchup, Worcestershire sauce, Fresh spices |
Important Considerations and When to See a Doctor
It is crucial to understand that tyramine sensitivity is not universal among migraine sufferers. Many people can consume these foods without any issues. Furthermore, tyramine is just one of many potential migraine triggers, which can also include stress, hormonal changes, and lack of sleep. A food diary is a vital tool to identify your unique triggers.
For those who are taking Monoamine Oxidase Inhibitors (MAOIs), a strict tyramine-restricted diet is necessary to prevent dangerous side effects like severely high blood pressure. Always consult your healthcare provider before making any significant dietary changes, especially if you are on medication.
Other compounds often found in high-tyramine foods, such as histamines and nitrates, can also be migraine triggers. It is therefore wise to approach these types of food with caution if you are susceptible. For more information on managing migraines, consider resources like the American Migraine Foundation.
Conclusion
While tyramine is a well-documented potential trigger for migraines in some sensitive individuals, it is not a universal culprit. High-tyramine foods, which include aged cheeses, cured meats, and fermented items, can cause a migraine attack in susceptible people, often due to a deficiency in the MAO enzyme. Managing potential tyramine-induced migraines involves being mindful of your dietary choices, prioritizing freshness, and maintaining a detailed food diary to track your personal triggers. Given the individual nature of migraine triggers, a personalized approach guided by a healthcare professional is the most effective strategy for managing your condition.
