by Maria Adams, MS, MPH, RD What Is Tyramine?Tyramine is found in many foods, including wines, ripe cheeses, and fermented or aged foods. Why Should I Follow a Low-Tyramine Diet?A low-tyramine diet is recommended if you are taking monoamine oxidase inhibitors (MAOIs), a type of drug found in certain antidepressants, Parkinsons medications, and antibiotics. Eating foods with high amounts of tyramine while taking MAOIs can cause a drug-nutrient interaction that produces side effects such as elevated blood pressure, headaches, heart palpitations, and chest pain. Eating Guide for a Low-Tyramine DietFood CategoryFoods RecommendedFoods to AvoidGrainsAll commercial breads (except sourdough)Hot and cold cerealsPasta, rice, gritsFresh or homemade yeast breads, sourdough breadsCrackersVegetablesWith the exception of those listed on the right, all fresh, frozen, and canned vegetables (as long as they are not overripe or spoiled)Fava beans, Italian broad beans, sauerkraut, Chinese pea pods, fermented pickles and olivesFruitsWith the exception of those listed on the right, all fresh, frozen, and canned fruit (as long as they are not overripe or spoiled)Bananas, overripe fruit, avocadosMilkPlain milkRicotta, cottage cheese, processed cheese (eg, American), and cream cheeseCultured milk products: yogurt, buttermilk, keifer, sour cream (limit to 4 ounces per day)All cheese not on recommended list, aged cheese, cheese saucesMeat and Beans
- Fresh or frozen meats, poultry, fish, and shellfish
- Eggs
- Legumes
- Nuts, peanut butter
- The following are allowed in limited amounts: fresh sausage and pepperoni, canned sardines, caviar and pat (limit to 1 ounce)
- Liver
- Smoked or dried meats
- Smoked, pickled, or dried fish
- Meat processed with tenderizers
- Meat extracts
- Salami
- Fermented and dry sausage
- Fermented soybean products
Oils
- Salad dressings without aged cheese
- Vegetable oils
- Nuts, peanut butter
- Olives
- Dressings made with aged blue cheese
Beverages
- Juice
- Milk
- Carbonated beverages
- Decaffeinated coffee and tea
- These are allowed, but should be limited: chocolate drinks; coffee, tea, and other caffeinated drinks; white wine; bottled or canned beer; and clear spirits (if approved by your doctor)
- Tap beer, ale, chianti and vermouth wines, sherry, champagne, and mixed drinks
Other
- Margarine, butter, mayonnaise
- Salt, pepper, spices, and herbs
- Sugar
- Potato chips, popcorn
- Sherbet, ice cream, and jello
- Hard candy
- Cookies, cakes, and other baked products (made without yeast)
- Limit chocolate desserts, candies, and syrups
- Teriyaki and soy sauce (limit to cup per day)
- Instant soup mixes and bouillon cubes (check ingredients for yeast), miso soup
- Cheese-filled dessert and cheesecake
- Imported chocolate
- Brewer's yeast
- MSG
- All aged and fermented products
Additional Suggestions
- Limit caffeine intake. While there is no tyramine in caffeine, consuming too much caffeine can result in high blood pressure.
- Check ingredient lists for the presence of tyramine-containing ingredients, such as marmite and yeast-extracts.
- Fresh food is less likely to contain high levels of tyramine.
- Promptly refrigerate or freeze foods.
- Use or toss leftovers within 48 hours.
- Eat allowed fresh meats within three days.
- Eat allowed cheese within three to four weeks.
- Do not eat combination foods that contain foods on the avoid list.
- Continue this diet for four weeks after stopping your MAOIs (or as directed by your physician).
RESOURCES:
American Dietetic Associationhttp://www.eatright.org National Institutes of Healthhttp://www.nih.gov/ CANADIAN RESOURCES: Dietitians of Canadahttp://www.dietitians.ca Public Health Agency of Canadahttp://www.phac-aspc.gc.ca/ References Low-tyramine diet. Northwestern Memorial Hospital website. Available at: http://www.nmh.org/nmh/patientinformation/lowtryaminediet.htm . Accessed June 24, 2007. Low-tyramine diet for use with monoamine oxidase inhibitors. University of North Carolina School of Medicine website. Available at: http://gcrc.med.unc.edu/investigators/diet/diet_maoi.html . Accessed June 24, 2007. MAOI diet facts. University of Pittsburg Medical Center website. Available at: http://patienteducation.upmc.com/Pdf/MaoiDiet.pdf . Accessed June 24, 2007. Last reviewed May 2008 by Maria Adams, MS, MPH, RDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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