Foods containing tyramine
This is a list of foods containing tyramine. Tyramine is an amine which causes elevated blood pressure and tachycardia by displacing norepinephrine from storage vesicles. Tyramine is generally produced by decarboxylation of the amino acid tyrosine during fermentation of food products. All protein-rich foods which have been matured will contain more tyramine depending on the temperature and how long they have been stored. Properly refrigerated foods will not be affected.
The amount required to cause a 30mmHg increase in diastolic blood pressure is referred to as TYR30, and generally averages around 500mg in an unmedicated, healthy individual. A class of antidepressants called MAOIs (monoamine oxidase inhibitors) can increase the sensitivity to tyramine if taken orally. If sufficient quantities of tyramine are ingested, hypertensive crises may occur, potentially causing stroke or cardiac arrythmia. There is significant evidence that tyramine may trigger migraines in sensitive individuals.
This list is for informational purposes only; it is neither all-inclusive nor does it go into any particular depth. If you plan to avoid tyramine in your diet, you are urged to seek professional guidance. Note that the exact increase in sensitivity will depend on the MAOI used, and its dose.
All tap beer and ale should be avoided, as lack of hygiene and proper maintenance may allow tyramine-forming bacteria to grow. Domestic bottled beers are generally safe in small quantities. Red wine and white wine are acceptable as long as no more than 120 ml is ingested. Chianti and vermouth, however, should be avoided
Most aged cheeses should be avoided. While there are some, such as cream cheese and cottage cheese, that have little to no notable amounts of tyramine, most aged cheeses have high concentrations of tyramine. It is therefore wise for people that are sensitive to tyramine to avoid all aged cheeses, if at all possible.
Regular cheese of the kind typically used on bread and pizza can safely be consumed in normal amounts.
Cheese syndrome, which the name is derived from the story of the British pharmacist who first noted the effect, is the name of a condition that is commonly associated with the usage of monoamine oxidase inhibitors (MAOIs), a class of anti-depressants. It is caused by a buildup of tyramine, an amino acid that is involved in blood pressure regulation.
Avocados contain tyramine, especially overripe fruit. Avocados may be eaten in moderate quantities, provided that the fruit is not overripe. Banana peels contain significant levels of tyramine and dopamine.
All other fruits should be eaten in moderation, since overripe and dried fruit will contain more tyramine. Common fruits that may contain relevant levels of tyramine include: eggplant, figs, grapes, oranges, pineapples, plums, prunes and raisins.
Many processed foods should be avoided, due to high tyramine levels. A few processed foods that contain high amounts of tyramine include, but are not limited to: vegemite, sauerkraut, and shrimp paste.
Fresh liver has no significant levels of tyramine, but old liver contains high amounts. Like liver, fresh meat and fish are safe, and old meat is risky. Caution is recommended in restaurants or with any other uncertain source of meat. Traditionally, meat from game birds and wild animals is hung in a cool place to improve flavour and tenderness, but this significantly increases the tyramine content. Processed meats, cured or pickled meats, and meat by-products and broths often contain large amounts of tyramine.
All soy products contain high levels of tyramine. Aside from soybeans themselves, commonly consumed soy products include: soy sauce, tofu, miso, and teriyaki sauce. The quantities of these products should be limited.
Chocolate does not contain appreciable amounts of tyramine, but does contain other active ingredients that are potentiated by MAOIs. Accordingly, chocolate should be limited to moderate quantities to avoid risk of nausea, headaches, temperature changes and psychosis.