What increases tyramine? A guide to foods and factors

December 10, 2025 •

4 min read

According to Mayo Clinic, tyramine levels in foods increase as they age or ferment. This naturally occurring compound, derived from the amino acid tyrosine, is typically processed by an enzyme in the body called monoamine oxidase (MAO). For most people, consuming tyramine-rich foods poses no problem, but for individuals taking certain medications or who are sensitive to the substance, it can trigger adverse health effects.

Quick Summary

Tyramine levels increase primarily through food aging, fermentation, and improper storage. Medications like monoamine oxidase inhibitors (MAOIs) can also disrupt the body's ability to metabolize tyramine, causing dangerous levels to build up.

Key Points

Aging and Fermentation: As foods like cheese, cured meats, and fermented vegetables age, microbial enzymes break down proteins, increasing tyramine content.
Medication Interaction: Monoamine Oxidase Inhibitors (MAOIs) block the enzyme that metabolizes tyramine, leading to its accumulation in the body and a risk of hypertensive crisis.
Spoilage and Improper Storage: Poor food handling and storage practices, such as consuming expired or improperly refrigerated foods, promote bacterial growth and raise tyramine levels.
Ripening of Fruits: The tyramine content of some fruits, including avocados and bananas, increases as they become overripe.
Individual Sensitivity: Some people, particularly those with a history of migraines, may be more sensitive to tyramine and experience adverse reactions at lower concentrations.
Food Variety: High-protein foods like meats and cheeses generally accumulate more tyramine as they age, while fresh, unprocessed foods remain low in this compound.

How Food Processing Methods Increase Tyramine

The most significant factor influencing tyramine content is how food is processed, stored, and prepared. The formation of tyramine is a natural byproduct of bacterial fermentation or decomposition, where the amino acid tyrosine is converted into tyramine. This process explains why certain food groups consistently contain higher levels of this compound.

Fermentation and Aging

Many popular foods and beverages owe their distinct flavor profiles to fermentation and aging, which also raises their tyramine content. This includes:

Aged and fermented cheeses: Hard, aged cheeses like cheddar, blue cheese, Swiss, parmesan, and gorgonzola contain high levels of tyramine due to the aging and fermentation process. Fresh, pasteurized cheeses like ricotta, cottage cheese, and cream cheese have very little.
Cured and processed meats: Salami, pepperoni, summer sausage, and other cured, smoked, or processed meats undergo fermentation or aging, which concentrates tyramine.
Fermented foods and beverages: Sauerkraut, kimchi, miso, soy sauce, and kombucha are all high in tyramine. Fermented alcoholic beverages, particularly tap beer, red wine, and sherry, also contain significant amounts.

Improper Food Storage

Spoilage and improper storage can drastically increase tyramine levels in protein-rich foods. When protein-containing foods like meat, poultry, and fish are not properly refrigerated or are eaten past their freshness date, bacteria multiply and break down the proteins, leading to a build-up of tyramine. This is why eating only fresh foods is recommended for those on a low-tyramine diet. Leftovers should be refrigerated promptly and consumed within a day or two, or frozen for longer storage.

Overripening of Fruits

Some fruits naturally contain tyramine, and the concentration increases as they ripen. Overripe fruits, including bananas (especially the peels), avocados, and certain tropical fruits, are known to have elevated tyramine content. While fresh, ripe fruit is generally fine for most people, overripe versions should be avoided by those with a sensitivity.

Medications That Increase Tyramine Effects

For most people, the monoamine oxidase (MAO) enzyme breaks down tyramine efficiently, preventing it from reaching high levels in the body. However, certain medications can block this enzyme, causing ingested tyramine to accumulate to potentially dangerous levels, a reaction known as the "cheese effect" or tyramine pressor response.

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs are a class of antidepressants that block the monoamine oxidase enzyme. This was one of the first antidepressants discovered, but due to its severe dietary interactions, it is now primarily reserved for patients who have not responded to other treatments. If you are taking an MAOI, you must strictly follow a low-tyramine diet. Common MAOIs include isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), and tranylcypromine (Parnate). The interaction can cause a rapid and dangerous spike in blood pressure, potentially leading to a hypertensive crisis.

Other Drug Interactions

In addition to MAOIs, other medications can affect tyramine levels or interact negatively with it. These may include certain pain medications, cold and allergy medicines, and herbal supplements. The risk of these interactions varies, and it is crucial to consult a healthcare professional about potential drug and food interactions.

Tyramine and Migraine Headaches

For some individuals, tyramine is a well-known migraine trigger, especially when consumed in large quantities. While the exact mechanism is not fully understood, one theory suggests that tyramine causes nerve cells to release norepinephrine, which can cause a chain reaction of blood vessel constriction and dilation in the brain, leading to a migraine attack. A low-tyramine diet may be recommended to help identify and manage this trigger.

Comparison of High and Low Tyramine Foods

To help manage tyramine intake, here is a comparison of common foods based on their tyramine content:


Food Category	High-Tyramine Examples	Low-Tyramine Examples
Dairy	Aged cheeses (cheddar, blue, parmesan)	Fresh cheeses (cottage, ricotta, cream cheese)
Meat/Protein	Cured meats (salami, pepperoni) and smoked fish	Freshly prepared poultry, beef, pork, or fish
Fermented Goods	Sauerkraut, kimchi, miso, soy sauce	Fresh vegetables, most beans and lentils
Fruits	Overripe bananas, avocados, and some citrus fruits	Fresh apples, peaches, grapes
Beverages	Tap beer, red wine, sherry	Canned beer, gin, vodka, water, decaf coffee

Conclusion: Managing Your Tyramine Intake

Tyramine levels are increased by the aging, fermentation, and decay of foods. While harmless for most, this increase can be dangerous for individuals taking MAOIs and a potential trigger for those prone to migraines. The best way to manage tyramine intake is to prioritize fresh, unprocessed foods and be mindful of aging and fermentation processes. Proper food storage is also essential to prevent spoilage and the subsequent increase in tyramine. If you have a known sensitivity or are on specific medication, consulting a healthcare provider or dietitian is crucial for creating a safe and effective dietary plan, such as a low-tyramine diet, to prevent adverse reactions. Learning about your personal food sensitivities can empower you to manage your health proactively.

For more information on dietary management, consult the National Headache Foundation's resources on low-tyramine diets for migraine patients.

Frequently Asked Questions

For most people, the body's monoamine oxidase (MAO) enzyme breaks down excess tyramine. However, if this enzyme is blocked (e.g., by MAOI medication) or you have a sensitivity, too much tyramine can cause a spike in blood pressure, potentially leading to a hypertensive crisis.

Aged and fermented cheeses generally contain the highest tyramine levels. Examples include aged cheddar, blue cheese, Swiss, parmesan, gorgonzola, and feta.

Yes, Monoamine Oxidase Inhibitors (MAOIs), a type of antidepressant, prevent the body from breaking down tyramine, which allows it to build up to dangerous levels when consumed, causing a potentially fatal hypertensive crisis.

Yes, fermentation is a key process that increases tyramine content. Fermented foods like sauerkraut, kimchi, soy sauce, and miso all contain elevated levels of tyramine.

No, tyramine is not an issue for everyone. Most healthy individuals can metabolize tyramine without any problems. However, people taking MAOIs or those prone to migraines should be mindful of their intake.

Improper food storage and spoilage can significantly increase tyramine levels. When protein-rich foods are not properly refrigerated or are consumed past their freshness date, bacteria break down the proteins, forming tyramine.

For individuals sensitive to it, tyramine is a known trigger for migraines. It can cause a release of certain chemicals in the brain that affect blood vessels, leading to a migraine attack.