What Foods Inhibit MAO? A Guide to the Tyramine-Restricted Diet

October 13, 2025 •

4 min read

For individuals taking monoamine oxidase inhibitor (MAOI) medications, consuming certain foods can lead to a dangerous spike in blood pressure, known as a hypertensive crisis. It is therefore critical to understand what foods inhibit MAO, or more specifically, which foods contain high levels of tyramine, to prevent this potentially life-threatening reaction.

Quick Summary

Taking MAOI medications requires strict dietary restrictions due to a dangerous interaction with tyramine, a compound found in many aged and fermented foods, leading to hypertensive crises.

Key Points

Tyramine is the Primary Concern: The interaction between MAOIs and high-tyramine foods, not natural MAO inhibitors, is the primary cause of a dangerous hypertensive crisis.
Aged and Fermented Foods are Risky: Tyramine levels increase with age and fermentation, making aged cheeses, cured meats, and fermented soy products dangerous when taking MAOIs.
Fresh is Always Safest: Opt for fresh, frozen, or canned foods over aged, pickled, or fermented varieties to minimize tyramine exposure.
Alcohol Requires Caution: Certain alcoholic beverages, especially tap beer and red wines, are high in tyramine and should be avoided or consumed only with medical approval.
Proper Storage is Key: Since tyramine levels can increase over time, prioritize eating fresh food and avoiding leftovers, especially if not refrigerated immediately.
Consult a Healthcare Professional: Always seek medical advice for a complete list of foods to avoid and to clarify any concerns while on MAOI medication.

Understanding the MAO-Tyramine Interaction

Monoamine oxidase (MAO) is an enzyme that helps break down excess tyramine, a naturally occurring amino acid found in certain foods. When a person takes an MAOI medication, this enzyme is blocked, preventing the body from effectively metabolizing tyramine. This allows tyramine levels to build up, which can cause a severe and sudden rise in blood pressure. This serious condition, known as a hypertensive crisis, can be a medical emergency. The food-drug interaction is why a low-tyramine diet is a necessary and critical part of MAOI therapy.

The Tyramine Content Factor

The tyramine content of a food can increase as it ages, ferments, or spoils. Therefore, fresh, properly stored foods generally contain less tyramine than their aged or fermented counterparts. This is why leftovers, especially those stored at higher temperatures, should be consumed with caution or avoided entirely. Cooking does not significantly reduce the tyramine content of a food.

Foods to Strictly Avoid While Taking MAOIs

Adhering to a strict low-tyramine diet is non-negotiable for anyone on MAOI medication. The following categories and specific examples of foods should be completely avoided to prevent a hypertensive crisis.

Aged and Fermented Cheeses: This includes aged cheddar, Swiss, Parmesan, blue cheeses (Stilton, Gorgonzola), and cheese aged in brine like feta. Fresh, unaged cheeses like cream cheese, cottage cheese, and ricotta are generally safe in moderation.
Cured, Fermented, and Smoked Meats: Avoid dried sausages (salami, pepperoni), cured fish, smoked fish, and processed luncheon meats (bologna, pastrami). Fresh or frozen meats are usually safe.
Certain Fruits and Vegetables: Overripe or dried fruits such as raisins, figs, and avocados contain high levels of tyramine. Fava beans, broad beans, snow peas, and their pods should also be avoided.
Yeast Extracts: Products like Marmite and Vegemite, as well as brewer's yeast, contain concentrated tyramine.
Soy Products: Fermented soy products such as soy sauce, miso, and fermented tofu or bean curd are high in tyramine. Tofu and soy milk that are not fermented are acceptable.
Pickled and Fermented Foods: Sauerkraut, kimchi, and pickles are generally high in tyramine and should be avoided.
Alcoholic Beverages: Certain alcoholic beverages are notorious for their high tyramine content, including tap beer, red wine, sherry, and vermouth. Moderate intake of pasteurized bottled beers or limited amounts of other alcohols may be permitted, but should be discussed with a doctor.
Other: Liver, especially if not fresh, can spoil quickly and develop high tyramine levels.

Natural MAO-Inhibiting Properties in Foods

Beyond tyramine, certain plants and foods contain natural compounds that can inhibit MAO enzymes to varying degrees. While not typically as potent as prescription MAOIs, these natural inhibitors can still be a consideration, especially for those sensitive to their effects or those taking MAOIs. Some examples include:

Spices and Herbs: Black pepper, long pepper, and nutmeg have been shown to have some MAO-inhibiting effects.
Cocoa and Coffee: Both cocoa and caffeine in coffee can inhibit MAO enzymes. Caffeine acts as a reversible and competitive inhibitor for both MAO-A and MAO-B.
Fruits and Vegetables: Research has shown that certain fruits like kiwifruit, cherries, and bell peppers contain compounds, such as anthocyanins, that can inhibit MAO activity.

For individuals on MAOI medications, the focus remains on avoiding high-tyramine foods. However, those exploring natural health remedies should be aware that these foods and supplements could potentially have MAO-inhibiting properties. Always consult a healthcare professional, especially when mixing herbal supplements with MAOIs.

Comparison of High vs. Low Tyramine Foods


Food Category	High Tyramine (AVOID)	Low Tyramine (SAFE)
Dairy	Aged cheese (cheddar, parmesan, blue cheese), processed cheese	Fresh cheese (cottage cheese, ricotta, cream cheese), fresh milk, yogurt (limited)
Meat & Fish	Cured meats (salami, pepperoni), smoked or pickled fish, liver pâté, aged/spoiled meats	Fresh or frozen meat and fish, eggs, poultry
Fermented Goods	Sauerkraut, kimchi, soy sauce, miso, brewer's yeast, concentrated yeast extracts	Fresh vegetables, fresh beans, plain tofu
Fruits & Veggies	Overripe bananas and avocados, dried fruits (raisins, figs), fava beans, snow peas	Fresh or canned fruits and vegetables, fresh beans
Beverages	Tap beer, red wine, sherry, vermouth, some liqueurs	Bottled or canned beer (limited), limited wine, non-alcoholic beverages
Other	Yeast extracts (Marmite, Vegemite), fermented sauces	Unaged sourdough bread (commercial), fresh homemade bread

Conclusion: Navigating the MAOI Diet

Managing your diet when taking MAOI medications is a critical aspect of your overall health and safety. Understanding what foods inhibit MAO, or cause a buildup of tyramine, is not a simple guideline but a vital necessity. While the list of restricted foods can seem daunting, focusing on fresh, properly stored, and non-fermented items will help you navigate your diet safely. It is essential to communicate with your doctor or pharmacist about your dietary restrictions, as they can provide the most current and comprehensive list based on your specific medication and health profile. Adhering to these dietary guidelines protects you from the potentially fatal risk of a hypertensive crisis and ensures the effectiveness of your treatment.

For further information on MAOIs and dietary restrictions, consult your healthcare provider or visit the Mayo Clinic website.

Frequently Asked Questions

While it was previously advised to avoid bananas entirely, particularly the peels, overripe bananas and dried banana products are the main concern due to higher tyramine levels. Fresh, ripe bananas are generally considered safe in moderation.

No, only aged, fermented, and processed cheeses are restricted due to high tyramine content. Fresh, unaged cheeses like cottage cheese, ricotta, cream cheese, and fresh mozzarella are typically safe.

No, fermented soy sauce is high in tyramine and must be avoided. However, unfermented soy products like tofu and soy milk are considered safe.

Tyramine levels in food can increase as it ages or spoils, even with refrigeration. For this reason, it is recommended to consume fresh food instead of leftovers to minimize risk.

Certain alcoholic beverages, particularly tap beer, red wine, and sherry, are high in tyramine and should be strictly avoided. Limited, moderate consumption of other alcoholic drinks should only be considered after consulting with a healthcare provider.

A hypertensive crisis is a medical emergency characterized by a sudden and dangerous rise in blood pressure. In the context of MAOI use, it can be triggered by consuming high-tyramine foods and can lead to complications like stroke, heart attack, or organ damage.

While some natural compounds can inhibit MAO, the primary risk for a hypertensive crisis with MAOIs comes from the tyramine pressor response. However, those on medication should be mindful of interactions and always consult a doctor, especially when using herbal supplements.