Background

The tyramine-free diet is a way of eating that eliminates consumption of tyramine-containing foods. Tyramine is a substance derived from the amino acid tyrosine and commonly ingested as a component of a variety of foods, particularly aged cheese and wine. In normal quantities and without interference from other chemicals, consumption of tyramine does not produce any bothersome symptoms and helps to sustain normal blood pressure.

Tyramine is metabolized by an enzyme called monoamine oxidase (MAO). Certain individuals taking MAO inhibitors (MAOIs) such as phenelzine (Nardil) and isocarboxazid (Marplan) for depression or other psychiatric conditions are not able to metabolize dietary tyramine and are therefore instructed to avoid all tyramine-containing foods to prevent hypertensive crisis.

Excessive amounts of tyramine may initially cause headache, heart palpitations, nausea, and vomiting and may lead to a hypertensive crisis that can be fatal. Additionally, migraine sufferers often link headache episodes to consumption of foods rich in tyramine. The National Headache Foundation has published tyramine-free diet guidelines for this population of patients.

Safety Safety definitions

Pregnancy And Lactation: There is insufficient reliable evidence about the safety of the tyramine-free diet. However, there is no reason to expect safety issues.

Effectiveness Effectiveness definitions

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

Dosing & administration

Adverse effects

Interactions with pharmaceuticals

None known.

Interactions with herbs & supplements

None known.

Interactions with foods

None known.

Interactions with lab tests

Interactions with diseases

Mechanism of action

When present in large quantities, in theory, tyramine displaces noradrenaline, which activates the sympathetic nervous system. This may theoretically lead to possible increases in blood pressure and constriction of blood vessels. The tyramine-free diet is followed to avoid these consequences in cases when tyramine may be present in excess.