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Low-Tyramine Diet 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, Parkinson’s 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 Diet

Food Category	Foods Recommended	Foods to Avoid
Grains	All commercial breads (except sourdough) All baked goods Hot and cold cereals Pasta, rice, grits	None
Vegetables	With 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 olives
Fruits	With the exception of those listed on the right, all fresh, frozen, and canned fruit (as long as they are not overripe or spoiled)	Banana peel
Milk	Plain milk Ricotta, cottage cheese, processed cheese (eg, American), and cream cheese Cultured milk products: yogurt, buttermilk, keifer, sour cream (limit to 4 ounces per day)	All cheese not on “recommended” list, aged cheese, cheese sauces
Meat 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 paté (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	Monosodium glutamate (MSG) Brewer’s yeast Bouillon and bouillon-based soup Chocolate	Lasagna, casserole, pizza, or other food made with meat or cheese on the "avoid" list Marmite spread Vegemite spread

Additional Suggestions

Limit caffeine intake. While there is no tyramine in caffeine, consuming too much caffeine can result in high blood pressure .
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 MAOI’s (or as directed by your physician).

RESOURCES:

American Dietetic Association http://www.eatright.org/
National Institutes of Health http://www.nih.gov/

CANADIAN RESOURCES:

Dietitians of Canada http://www.dietitians.ca/
Public Health Agency of Canada http://www.phac-aspc.gc.ca/

References

California diet manual. State of California website. Available at: http://www.dds.ca.gov/Publications/docs/DDSDietManual.pdf . Accessed January 4, 2010.
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.
Nutrition care manual. American Dietetic Association website. Available at: http://nutritioncaremanual.org/auth.cfm?p=%2Findex.cfm%3F . Accessed January 3, 2009.

Last reviewed March 2013 by Dianne Scheinberg Rishikof MS, RD, LDN

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