Tyramine is a biogenic amine, meaning it is a byproduct of amino acids that forms during fermentation. People taking certain medications need to avoid eating foods containing tyramine, as they may cause a range of adverse effects.

Additionally, some research suggests that tyramine may play a role in the development of migraine attacks.

Tyramine may be present in foods such as certain cheeses, cured meats, and chocolate. The substance may cause physiological effects in the body and lead to negative symptoms.

This article explains what tyramine is in more detail. It also discusses who should limit tyramine in their diet, tyramine-free and low tyramine foods to try, foods to limit, and when to consult a healthcare professional.

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Tyramine is a compound naturally present in foods, animals, and plants. In a biochemistry context, the substance is a trace monoamine or biogenic amine that can cause specific effects in the body.

Trace monoamines, such as tyramine, have less presence in body tissues than their similar counterparts — which include dopamine, serotonin, epinephrine, and norepinephrine — that act as neurotransmitters. However, it is important to note that while tyramine can act similarly to neurotransmitters, it is not a neurotransmitter.

Tyramine mimics the effects of certain components in the sympathetic nervous system, which exerts the fight, flight, or freeze response and is part of the autonomic nervous system. The autonomic nervous system is a complex network of cells that controls the body’s internal state.

The compound indirectly releases catecholamines, which are chemicals the brain releases in response to stress. They affect the heart if people consume them in very large amounts, potentially leading to hypertensive crisis. Scientists believe it may also affect the immune system.

Fermented and cured foods can contain high amounts of tyramine due to microbial enzymes in the food breaking down an amino acid called tyrosine and converting it into tyramine.

Healthcare professionals advise that a person taking monoamine oxidase inhibitors (MAOIs) needs to avoid consuming foods that contain tyramine and tyrosine.

MAOIs are a type of drug that doctors may prescribe for Parkinson’s disease, depression, and other nervous system disorders. These medications block monoamine oxidase, which is an enzyme that breaks down neurotransmitters and tyramine. Therefore, MAOIs allow the levels of tyramine and neurotransmitters to build up in the body.

People should need to avoid eating foods containing tyramine and tyrosine while taking MAOIs because they may cause the following adverse effects:

Foods that contain tyramine may also trigger migraine attacks. Although scientists do not completely understand why this occurs, tyramine’s effects on the sympathetic nervous system may be responsible.

However, a 2022 review article notes that modern hygiene and production standards mean that tyramine levels may be lower in most foods and drinks. The article suggests that a low tyramine diet may involve few or no changes for many people taking MAOIs who already eat balanced meals.

According to the National Headache Foundation, the following foods are fine to eat on a low tyramine diet for headaches and migraine:

  • whole or skim milk
  • eggs
  • freshly prepared meat, poultry, and fish
  • certain cheeses, including:
    • cream cheese
    • ricotta
    • low fat processed cheese
    • cottage cheese
  • cereals
  • pasta
  • products leavened with baking powder, such as cakes and biscuits
  • commercially prepared yeast
  • most vegetables, including:
    • spinach
    • pumpkin
    • carrots
    • asparagus
    • squash
    • cooked onions
    • potatoes
    • soybeans
    • navy beans
  • fruit juices
  • decaffeinated coffee
  • club soda
  • caffeine-free carbonated drinks
  • some fruits, such as:
    • apricots
    • peaches
    • cherries
    • apples
  • white vinegar
  • all cooking oils
  • commercial salad dressings

Foods to eat with caution

Additionally, the National Headache Foundation advises that people may consume the following foods cautiously, as these have smaller amounts of tyramine:

  • hot dogs, bacon, sausages, ham, and luncheon meat with added nitrates
  • half a cup a day of citrus fruit or pineapple
  • chocolate-based puddings and products
  • wine vinegar and other fermented vinegars
  • avocados, bananas, passion fruit, papaya, figs, raisins, dried fruit, and red plums
  • half a cup per day of yogurt, buttermilk, and sour cream
  • 2 teaspoons of Parmesan or Romano cheese
  • homemade yeast-leavened bread and cakes
  • sourdough bread
  • raw onion
  • canned soups with autolyzed or hydrolyzed yeast, monosodium glutamate, or meat extracts

However, if a person is taking MAOIs, they can speak with their doctor about eating limited amounts of these foods.

Many foods that are fermented, aged, or cured may contain higher levels of tyramine. These include:

  • beer and wine
  • chocolate
  • nuts
  • aged cheeses such as cheddar, mozzarella, and Stilton
  • fermented vegetables such as sauerkraut and kimchi
  • soy sauce and Worcestershire sauce
  • cured or salt-dried meats
  • pickled or dried fish or shrimp
  • coffee
  • certain fresh produce, which may include avocado, beetroot, and grapes

If someone suspects they experience adverse reactions to tyramine foods, they can speak with a doctor who can advise whether following a low tyramine diet may be appropriate and how to do so safely.

People taking MAOIs may need to follow a low tyramine diet. A healthcare professional can help identify which foods a person needs to limit. They can also help create a meal plan.

However, individuals should not make significant changes to their diet without first consulting a doctor.

Many foods contain tyramine, including fermented, aged, or cured products and certain fresh produce.

Tyramine can cause adverse effects, especially in people taking MAOIs. It affects the sympathetic nervous system, which may cause cardiovascular symptoms and headaches.

People can speak with a doctor about whether following a low tyramine diet may benefit them. A doctor can advise which foods to include and which to limit.