Tyramine Intolerance and Its Role in Migraines, Depression, and Anxiety

Never heard of tyramine intolerance? It can lead to common health problems in certain people. The Rogue Scientist investigates what it is, what causes it, and how to deal with it.

Chances are, you’ve never heard of tyramine intolerance. Heck, you’ve probably never heard of tyramine. Most people haven’t.

Tyramine intolerance is a type of food sensitivity, where eating foods high in tyramine will bring on unpleasant symptoms.  

I would know. I have tyramine intolerance. More on that in a minute.

This article will cover what tyramine intolerance is, its symptoms and causes, and how it relates to migraine headaches, certain foods, and a specific type of antidepressants.

What is Tyramine?

Tyramine is a compound found in many kinds of foods, and is derived from the amino acid tyrosine. Tyramine is classified as a “biogenic amine.”

According to an excerpt from a Migraine and Diet book chapter, tyramine is “vasoactive” (it affects the diameter of blood vessels) and can increase blood pressure, sometimes to dangerous levels.

It can also cause constriction and then rebound dilation of blood vessels in the brain, leading to migraine, visual abnormalities, and nausea.

However, most people eat foods high in tyramine without experiencing any of these problems. Why? Because their bodies break down tyramine properly.

However, some people, myself included, do not.

Tyramine Intolerance

Most people have heard of lactose intolerance, mostly because it’s super common. Lactose intolerance comes down to lacking enough lactase (an enzyme) to break down the lactose commonly found in milk products.

This inability to break down lactose means the compound builds up in the gut and causes unpleasant symptoms such as bloating, gas, cramps, and diarrhea.

Tyramine intolerance works much the same way. Those who have tyramine intolerance don’t have enough of the enzyme that breaks down tyramine, so the compound builds up and causes symptoms, such as:

  • Headaches/migraines
  • Nausea
  • Sweating
  • Rapid heart rate
  • Chest pain

Many of these symptoms result from increased blood pressure, which in some sensitive individuals can reach dangerous levels.

It can also cause other symptoms you may not find on WebMD, but have been reported by those who are tyramine sensitive, such as mood disturbance (especially depression and anxiety) and brain fog. More on this below.

These symptoms often appear one to twelve hours after consuming tyramines. A flare can take many hours or even a full day to dissipate.

Nobody seems to know how prevalent tyramine intolerance is in the population, but I believe it’s one of those things a decent number of people have but don’t realize it.

The Rogue Scientist Discovers Tyramine

I didn’t know I was amine intolerant until my early forties. That’s when it got bad enough to mess me up. But the signs had been there previously:

  • Like the time I traveled to the Los Angeles area to visit family and visited an old favorite haunt for a pastrami sandwich. I felt so, SO spacy and fog-headed the rest of the day, like I couldn’t think.
  • Or on two separate occasions eating a ripe banana and getting a searing headache. I always remembered those times because I don’t like bananas and rarely ate them.
  • Or making a stew in the slow-cooker and curling up at home on a cold night… and feeling like crap afterward: headachy, hot, and agitated, like I could NOT relax.

In hindsight, these signs all pointed to tyramine.

Finally, once I realized my problems stemmed from food, I began keeping a food log. It took time, but I pieced it all together and started cutting out problem foods.

The Connection Between Tyramine and Migraines

Tyramine is notorious for causing bad headaches, including migraines.

Doctors with patients suffering from migraines may suggest the patient try a low-tyramine diet. Sometimes it helps a lot.

Not all migraine sufferers necessarily have tyramine intolerance. However, a low-tyramine diet can prove beneficial for some migraine sufferers because some high-tyramine foods are common migraine triggers, such as red wine, cheese, and pickled foods.

As far as we know, two things can cause tyramine intolerance:

  1. Your body doesn’t make enough of the enzyme that breaks down tyramine, or
  2. You take a medication that blocks the production of this enzyme.

Let’s start with number one.

The Monoamine Oxidase (MAO) Enzyme Breaks Down Tyramine

The enzyme monoamine oxidase (MAO) breaks down tyramine in the body. If MAO sounds familiar, you’ve probably heard of it because this important enzyme also breaks down the monoamine neurotransmitters serotonin, dopamine, and norepinephrine, all super important in mental health.

There are two types of MAO enzyme: MAO-A and MAO-B. Both appear to break down tyramine.

As with all proteins in the body, a gene codes for the MAO enzyme, and we all have an MAO-A gene and an MAO-B gene. However, we also have different versions of those genes, and some genotypes can code for a slow-acting enzyme.

If you have the genotype for a slow enzyme (it appears that I do), you’re more likely to have a difficult time breaking down tyramine. I’ll cover this in more detail in another article.

If your MAO enzyme works slowly, and you eat a plateful of high-tyramine foods, your body can’t work fast enough to break down the compound.

Result? Symptoms that make you feel like garbage.

Tyramine and Monoamine Oxidase Inhibitors (MAOIs)

The second cause of tyramine intolerance results from taking MAO inhibitors, a class of antidepressants that inhibit the action of the MAO enzyme, thus increasing neurotransmitter levels and relieving symptoms.

Scientists and doctors have known for decades that MAO inhibitors block those taking them from breaking down tyramine. It began when a British pharmacist noticed that his wife, who was taking an MAOI, got terrible headaches anytime she ate cheese.

(So many great discoveries have come from observing something that others miss, and then following it up.)

The good news: if your doctor prescribes MAOIs to you, they’ll tell you to avoid high-tyramine foods. Those who are merely sensitive often have to figure out their sensitivity after years of suffering.

Tyramine Intolerance and Depression/Anxiety

One thing I’ve noticed when I consume too many high-amine foods is it messes with my mood, big time. For me, the mood effect comes later, after the headache, agitation, and heat have dissipated, usually the next morning.

I will feel negative, irritable, flat, and like the world faded from color to some shade of gray. For no good reason. It lifts by lunchtime or afternoon.

Others report significant and even scary levels of anxiety with high-tyramine foods. For me, the agitation and not-relaxed feeling I get after a problem meal is anxiety, but it feels more physical for me than emotional.

The relation between tyramine and depression/anxiety makes sense. Too much tyramine can trigger release of norepinephrine, which will cause increase blood pressure, heart rate, and agitation, which are all physical manifestations of anxiety.

And tyramine gets broken down by the very enzyme responsible for breaking down serotonin, dopamine, and norepinephrine, the three neurotransmitters most implicated in mental illness and especially depression.

However, when searching for the relationship between tyramine and depression, I didn’t find much other than the MAOI issue. Which means I’ll have to dig and include my findings in a future article.

The Naughty List: Foods High in Tyramine

While tyramine occurs naturally in all kinds of healthy foods, some foods have very high levels and should be avoided by those who are sensitive or taking MAOIs. These foods include:

  • Aged cheeses (cheddar, swiss, parmesan, bleu, camembert, brie, etc.). For most, soft mozzarella, ricotta, and goat cheese are safe.
  • Processed, aged, or cured meats (aged beef, sausage and bacon, and most sandwich meats including salami, pepperoni, pastrami, etc.). Many can tolerate sliced turkey, especially if nitrate-free.
  • Most alcohol (especially wine and beer)
  • Overripe bananas and avocados (overripe or dried fruits can be a problem)
  • Anything aged or fermented (e.g. soy sauce, sauerkraut, miso)
  • Leftovers. Most tyramine-sensitive people freeze leftover food right after cooking it, and then defrost later.
  • Anything slow-cooked. Slow-cooking builds up amines.
  • Chocolate. Reports on chocolate vary, but many sensitive individuals (and migraine-sufferers) carefully control their chocolate intake (myself included), and can only tolerate small amounts.

Stuff They Don’t Tell You on WebMD

In addition to the depression/anxiety link, most medical sites don’t include some other useful information about tyramine intolerance, mostly because the topic hasn’t been well studied.

If you have tyramine intolerance or think you might, here are some facts I’ve learned from experience and interacting with others who deal with this:

The “Bucket” Idea

To prevent bad food reactions, it helps to think of tyramine like a bucket. Every time you eat food with tyramine, the bucket fills. If you eat too many of these foods before your body can break them down, your bucket will “overfill” and you get symptoms.

This is why you might eat cheese one day and feel fine, eat it the next and feel not so great, and by the third day you want to tear your head off. The bucket finally got too full.

The bucket effect also explains why it can take a long time to figure out you have this.

The trick with tyramine intolerance, like many food intolerances, is to prevent the bucket from overflowing. If I eat high-tyramine foods, I avoid them for a few days. You have to find your own limits.

Everybody Differs in What and How Much They Tolerate

Some sensitive people tolerate chocolate, others don’t. Some can eat certain types of aged cheese, others can’t. You have to find what foods you tolerate and don’t via experimentation.

Stress Makes Your Bucket Smaller

Stress makes everything worse, and tyramine intolerance is no exception. When I’m on vacation and super relaxed, I can get away with eating a decent amount of these foods. When I’m stressed, my tolerance goes to zero and I avoid them.

The Amount of Tyramine in Foods Varies

Tyramine, like all biogenic amines, varies from food to food. One tomato may have way more than another tomato.

Likewise, tyramine and other amines increase over time. Freshly picked or butchered foods have way fewer amines than those that are aged or stored for long periods.

It’s Not Just Genes

Although genetics certainly play a role in tyramine intolerance, they don’t explain everything. For one thing, most people I’ve seen appear to acquire it in their 30s or 40s, which means something else is impacting their ability to break down these foods.

Many with Tyramine Intolerance are Intolerant to Histamine and Other Amines

Most high-tyramine foods are also high in another common biogenic amine: histamine. Histamine intolerance has finally gained some recognition here in the US, and while different than tyramine intolerance, many people with tyramine intolerance find they react poorly to foods high in histamine and other amines.

I cover histamine intolerance in another article.

Want more? My Tyramine Intolerance Handbook is now available on all platforms! In it, I go into detail about TI and offer detailed food lists, recipe ideas, and more.

That’s all for now.

I would love your comments about this, especially if you have tyramine or other amine intolerance.

If you want to be notified anytime I publish a new article, sign up here.


Other Articles You Might Like

Tyramine Intolerance vs. Histamine Intolerance

The Tyramine Intolerance Handbook

The 4 Neurotransmitters That are Crucial to Mental Health

The Rogue Scientist

Christie Hartman is a writer and scientist specializing in science-based health. A biology major as an undergrad, she completed her PhD in behavioral genetics at the University of Colorado Boulder. Before starting her writing career, she worked as a scientist and professor at CU’s School of Medicine, where she studied the genetic contributions to substance abuse and antisocial behavior.

34 thoughts on “Tyramine Intolerance and Its Role in Migraines, Depression, and Anxiety”

  1. I guess I will not be seeing you eating any baloney, sauerkraut, pickle, and Swiss cheese sandwiches washed down with a glass of red wine and a banana for desert?

    Are there tests for tyramine intolerance?

    There are many excellent brands of vegan mock cold cuts and cheeses. Do they contain tyramines too?

    I’ve heard the bucket analogy for other food intolerances.

    I’ve been trying to work out some food intolerance issues. I can usually get away with a one off as far as consuming things I should not. It takes me about 3 days of consecutively eating bad things to get harsh symptoms. Whenever I have told that to doctors and other healthcare professionals they usually react like I told them the sky is blue. I guess it is a common phenomenon.

    I’ve read and heard that many people develop food issues later in life.

    I wonder if it is related to some sort of weakening of the digestive system, like less digestive acids and enzymes leading to a web of problems.

    Have digestive supplements helped you?

    1. Christie Hartman PhD

      Ha. Not a chance. Plus, bananas are gross. No tests for it; you have to do an elimination diet and then reintroduce somewhat aggressively to know for sure. True for most food sensitivities. Apparently tests for any food sensitivity are not that accurate.

      Not sure about the vegan brands. Many probably contain yeast extract or similar flavor enhancers, which are often problematic for the amine intolerant.

      Yeah, cause is interesting, other than genetic predispositions. Many report gut health plays a role, although I see this more among people with histamine issues than tyramine. For women it seems to be related to hormones too. Definitely is for me. I haven’t tried digestive enzymes in ages.

      1. Have you heard of the MRT test from Oxford Lab? I had this about 7 years ago through a functional medicine specialist and got a list of foods that were “red” and “yellow.” I’m not sure if I have an intolerance to those or if they just cause inflammation, which is what the test measures. Carrots and Soy came up red for me and after being gluten free for 10 years (celiac) and having a colonoscopy/biopsy still show positive for celiac, I realized I needed to take the soy more seriously. Tyramine was on the yellow list, and since then I’ve tried not to eat foods older than 20 hours unless they were frozen.

        I just came across your article today and was shocked how much more involved a Tyramine intolerance was than I’d thought. It’s all clicking for me after having some bad days following eating really ripe fruit. Are “causes inflammation” and “intolerance” the same thing in your opinin? I’m replying in hopes the MRT test can help Beforewisdom, above. It’s quite expensive but I’d planned to take it again to see what’s changed. I now have colitis in addition to celiac and have been a mess for a couple years. Fortunately, my symptoms don’t send me to the ER, but they’re debilitating, and I haven’t had the patience to do my own elimination diet. You do get a full work-up and eating plan to help you eliminate and start over, adding your “green” foods. Be prepared, as I did have a very bad response to a couple of my “green” foods last time (Amaranth, for example had me *running* to the bathroom). Several foods listed for me were very healthy vegetables, fish or spices I ate ALL the time. Somehow, I think my body develops an intolerance to anything I eat a lot of. Do you have any experience with that? It will be interesting to see if any of the new foods I eat often show up on an updated MRT test.

        I recently have added a B Complex and just feel better overall when I take it. After reading the other comments, I bet the riboflavin is helping. I find that my magnesium supplement helps tremendously with anxiety/mood also. As for digestive enzymes, I often wonder if I’m just missing them all… did they happen to work for you when you did take them? Which ones were successful?

        I’m going to add myself to your list. Look forward to reading about your other findings!

        1. Christie Hartman PhD

          I haven’t heart of that test, Marni. There are so many of them. I wouldn’t say “causes inflammation” and “intolerance” are the same, but it makes sense that intolerances can lead to inflammation if you ingest a problematic food. I’ve always wanted to get a blood draw during a flare to see what the inflammatory markers and other things look like. I took Mg for over a decade and it helped me. Now I no longer seem to need it. Also, sounds like you have food intolerance that goes beyond amines. You might find this podcast interesting; it includes info on the gut from a gastroenterologist who I found impressive: https://www.richroll.com/podcast/will-bulsiewicz-680/

  2. Trev Van Niekerk

    This is a great article. Thank you. How do I follow your findings, particularly interested in your findings.

    Thank You

  3. Excellent information. Thank you for sharing.

    My experience has been similar in some ways. I first started to notice food sensitivities in my early forties as well but with me it started with a gluten sensitivity that my father and at least one of my uncles on that side of the family also suffered with. Like my father, I would get headaches when I consumed something that contained gluten. In my case I am not sure I would call them migraines since I am fortunate to not experience the severe headaches that my father did. Even so, it was enough to have me adhere to a pretty strict gluten-free diet for years.

    Sometime after the gluten sensitivity manifested I began to notice other food sensitivities that I eventually determined to be due to tyramine. I was puzzled as to why I seemed to be developing headaches after eating things like watermelon and chocolate. Beer had also become a problem for me and wine seems to be the absolute worst. It sometimes seem that just smelling wine could result in an instant headache! Fortunately, I was never all that fond of wine so that was not a big loss for me. Chocolate, on the other hand, is an entirely different story and is something I would not want to do without!

    Fortunately, I stumbled on a solution that seems to work for me. I don’t seem to suffer from any other effects beyond headache when I indulge in either gluten or tyramine-containing foods so I can’t speak to whether it would be of any use to those who suffer with other unpleasant reactions.

    I had been reading the blog of a fellow named Nathan Hatch who had discovered that riboflavin greatly reduced or eliminated the negative effects of his gluten intolerance. Even though he seemed to experience different negative effects than he did when consuming gluten, I thought it might be worth a try. Was it ever.

    I ordered some riboflavin and put it to the test by taking a few capsules and then indulging in some gluten-heavy baked goods. To my surprise, a headache never developed! Although I rather felt like I was “on the verge” of one, it did not happen. I experimented with taking riboflavin at various times of the day and in various doses and worked out what seemed to do the trick for me. I suspect that varies a lot from person to person.

    Even though I had a solution to my gluten sensitivity problem I tried to keep from over-indulging and did not make it a regular part of my diet. I guess my reasoning was that gluten was something that my body seemed to react badly to for some reason and perhaps it is harmful to me in other ways beyond giving me headaches.

    As time went on I seemed to experience more problems with tyramine-containing foods. Particularly chocolate, and believe me, that was a big problem for me! I wondered one day if riboflavin could help me prevent the headaches I experienced from tyramine so I tried. Lo and behold, it did!

    These days, I can almost always prevent a headache from consuming chocolate. I have never really tested it with other tyramine-containing foods since it is not difficult for me to stay away from those. I suspect it would work.

    What works for me pretty well is to take around 500 mg of riboflavin an hour or so before I enjoy some chocolate (and when I do, I tend to enjoy a LOT of it) and then at least a gram of riboflavin about two or three hours later. For me that is usually right before I got to bed.

    One other thing I wanted to mention was another tidbit of information I came across a year or so ago. Someone online reported they had some friends with a gluten sensitivity but when he baked things with heirloom flour, his friends reported that it did not bother them at all. That seemed well worth investigating so I researched it a bit and ordered up some heirloom flour online.

    I ended up buying an heirloom flour called “Einkorn” that is produced by a company called Jovial. To my surprise, I discovered that eating things made with it did not result in a headache. Even though I am not sure I should be doing it, I now enjoy gluten-containing baked goods regularly. That suggests to me that it is something they have done with modern flours that makes them problematic for people like me. I presume that the heirloom flour contains gluten as well so there must be something about the way they have hybridized flour through the years that has resulted in a product that some people cannot tolerate very well.

    Hopefully this information can help someone else deal with their tyramine or gluten sensitivity like I did for me.

    1. Christie Hartman PhD

      Thanks so much for sharing your experiences, Dale. This is great. I keep finding here and there that B vitamins (sometimes riboflavin, but others as well) can be useful with food sensitivity. I love that you experiment (I have some lined up for myself as well, but I’ve been putting them off because I hate feeling crappy). And yes, the heirloom flour makes sense. Apparently today’s typical flour that you and I eat is much higher in gluten than what we used decades ago, and there are different kinds of flours depending on the kind of baking you do (high gluten for bread, lower for, say, biscuits). I’ve been wanting to look into this for an article.

  4. I am in my late 30s, I have always had headaches except for the year I ate mainly from my garden on a fresh vegetarian diet. When I was younger I always assumed my body was just sensitive to ALL headache triggers including lack of hydrating and sleep, not to mention stress. When I went back to eating low quantity of animal products the headaches returned. I did note the diet role but couldn’t pin point what exactly the problem was.

    Recently in the last 3 years, I changed my diet again to not include any factory animal products. (I eat and use fresh eggs from my chickens and will soon include products slowly from our dairy cow when she gives birth.)

    I started looking into tyramine when I ate more tempeh then I normally do one night and almost instantly a headache came on and I had pain in my chest. This was a scary experience for me so I started trying to figure out what was going on. Prior to that I had ate so much vegan nacho cheese (made from nutritional yeast) I had had a migraine for 3 days. (My urine was neon green from all the b12)

    I have gone back to a more fresh diet and I cut out fermented products and yeast. Tofu seems fine but no tempeh for me, it always grossed me out anyway, so it isn’t a loss for me. The weird thing most of the foods that are high in Tyramine I naturally do not like. Cheese has always tasted bad to me.
    I am currently trying to narrow down what kind of vegan products work for me. I am in the unique position of starting a small vegan food company with my husband who makes meat and cheese alternatives. So in our home cooking he tailors to my health needs.

    It was nice to read this and I am glad it is out there because most of the information I could find on Tyramine focuses on those who take certain medication. Since I am not on any medication it had me second guessing my new found hunch. I will be following, thank you!

    1. Christie Hartman PhD

      Thanks for sharing your experience, Teresa. Yes, a plant-based diet does seem to eliminate most tyramine foods, and evidence is piling up that it can lead to better health outcomes. Sounds like you’re doing all the right things. Although you’re the first person I’ve ever met who doesn’t like cheese, lol. Agree there isn’t enough info on this out there, so I’m going to investigate more here and plan on publishing a book on the topic.

  5. This is the one of the best articles on Tyramine sensitivity that I’ve come across. As someone who has dealt with periodic migraines with no discernible cause, I determined a couple of years ago that I might have a Tyramine sensitivity. I know some of the foods that cause my migraines and eat them in small amounts or avoid them all together. Cured meats, beef jerky, aged cheeses, etc, I can only eat in small amounts. Leftovers with meat are a no go after 1 day. Certain beers hurt worse than others as well.

    I appreciate the bucket analogy. I thought that it was a day to day thing, so that will help in my search to mitigate these periodic headaches.

    Do you know of any MAO supplements, or things I can do to increase my production of MAO? After reading the comments, I’m going to get some B Vitamins for sure just to see if that helps. Thanks for your work!

    1. Christie Hartman PhD

      Much appreciated, Mark. Definitely sounds like tyramine intolerance. As far as MAO goes, there are no supplements. It’s tricky b/c of the impact MAO has on the neurotransmitters. But I will do more research on that question for the book, which I will begin writing soon.

  6. Jennifer Pagliai

    I’ve know what I had for 30 years, but I’m only now beginning to notice the profound & sad impact it has had on my life. If I consume tyramines, I will become deathly ill, with a suicide type headache & usually 6 hours of vomiting & dry heaving, sweating and chills (you don’t always know your consuming them). I’ll usually lie on the floor on my stomach and “moan like a wounded animal” (my husband’s description). During this time, I cannot be moved, touched, can’t talk well, and usually lose control of my bladder & bowels. I just started a Facebook page for this & shared one of your articles; hope you don’t mind.. It’s a public page until I get my first group member. I’m so interested & surprised that there is so much information out now. I’ve just learned that what I’m having is a hypertensive crises. Question: Wouldn’t it be worse for a person who takes SSRI & SNRI reuptake inhibitors? Would love to have your opinion.

    1. Christie Hartman PhD

      Those episodes sound like a nightmare, Jennifer! So glad you know what causes the episodes and hope you’re better now. As far as the meds go, I haven’t heard of any issue with those. Obviously, MAOIs are a problem. But I can’t help but wonder about SNRIs because of the effect they have on norepinephrine, which is the main culprit in these episodes.

      READERS: anyone out there notice issues when taking SNRIs?

    2. Hi Jennifer

      I to have hypertensive crisis when I have to much unknown tyramine in my system. I’m so sick of going to the ER, I feel for you and know how bad it makes you feel. Why do we get such a spike. I usually get flushed as well.

      Are you taking anything for it when these attacks happen? or are you just dealing with it until it goes away.

      I have also read honey and quercetin which is a flavonoid can inhibit MAO enzyme production.

  7. Hi Christie
    Thank god for you and your book, four trips to the ER, numerous hypertensive crisis episodes, countless blood tests and scans with nothing found apart from your really healthy. Then the salami and cheese god moment with a dental injection (epinephrine) = a severe hypertensive crisis. As usual no one could find anything until I googled salami and cheese hypertensive crisis and ended up on your page, my mind was instantly blown.

    All my symptoms were very similar to yours plus massive unexplainable blood pressure spikes, tingly hands and back of neck with a hot flushed face, I thought I was going crazy, loosing it. After reading your book and doing some food tests it looks like Tyramine attacks and potentially histamine as well, great double whammy!

    Do you know if epinephrine is associated with tyrosine and tyramine? if so, did I inject myself with kryptonite.

    Have you done any research into natural MAO inhibitors? I read an article that some test tube research papers found flavonoids like quercertain and natural foods like honey and citrus have an effect on inhibiting MOA-A reaction in the body. Was this the perfect storm in relation to my health issues.

    Thanks so much for your dedicated and relentless research on tyramine.
    Al from Oz

    1. Christie Hartman PhD

      Alastair: I am so glad you found the culprit and that I could help! You made my day with your comment. Those hypertensive crises are scary as hell. Those of us with TI tend to fall into 2 groups, the migraine folks and the blood pressure/hypertensive crisis folks; I’m a migraine person so I can’t imagine what hypertensive crisis feels like.

      Yes, I’ve looked into natural MAO inhibitors (and stuff that increases MAO), but haven’t found anything too definitive yet. Those with TI want to increase MAO, though, so avoiding anything that inhibits MAO is wise. As far as epi goes, it’s so similar to norepi that I’m not surprised you reacted badly to it.

      1. Hi Christie

        Thanks for that, do you know how long it takes for the body to get rid of tyramine.

        If you ever need research subjects I would be more than happy to help, I believe a lot of people go through this without even knowing and like you and me have years from hell.

    2. Hi Alastair!!

      We are experiencing the same exact symptoms to tyramine. May of 2021, my PCP prescribed three medications (muscle relaxer, naproxen and diuretic) for sciatica and I was already taking a blood pressure medication. I had never checked my BP at home. After charting my BP, I realized it went 30+ points after drinking my one cup of coffee I drink. Of course, every time I had my doctors appointment was in the am after my cup of coffee. On May 23, 2021 I was in the ER for a hypertension crisis. I was told all of my test were excellent and that I was suffering from anxiety. I went to the ER 10 times from May 23 – July 30, 2021….there were times I should have gone but thought I can’t go to the ER every day. After the third time going to the ER, I had my PCP find me a cardiologist. Before my appointment with him, I found an article on Tyramine Intolerance. In the article

  8. The FAILSAFE diet has recognized the role that amines play in mood/behavior. They remix the letters in amines and call it “meanies” to help people remember the characteristic effect. Lots of parents find that when they limit amines in a ‘difficult’ child’s diet, their behaviors improve.

    I find that I am quite sensitive to amines, and tyramine particularly so (migraines). My children seem similarly sensitive, I notice it in their mood/behavior.

    https://www.fedup.com.au/factsheets/additive-and-natural-chemical-factsheets/amines

    1. Christie Hartman PhD

      Yes, I am a fan of the Food Intolerance Network. They helped me when I was first figuring stuff out, and I recommend it often, especially to people dealing the food sensitivity in children.

  9. I am unlucky one who have tyramine and other biogenic amine sensitivities to the extent it almost feels like anaphylactic attack and also I not only get migraines, I also get vasodilation or vascular effects. I go into a paralyze kind of state where I shouldn’t be bothered by any kind of stimulus like touch, noise. Acute attacks are horrible and every evening I am in a miserable state, reason being my list of intolerance is way too long. If I eat just rice and potatoes, I can navigate easily through the day. Coming to banana, surprisingly I started tolerating it when I added B2 five years ago, but b2 dint help with many other stuff. With some foods I get palpitations all over my body like every cell is beating to get rid of culprit, with some foods I get migraines but no beating. So looks like I am stuck between vaso dilation or vaso constructions imbalances. But then I also get twitches, jerks all over so sounds like neuro musculur effect of low MAO. I am a biochemist and planning to dig deep into pathways. However I also feel depletion of specific gut bacteria might have triggered it at first place. I have MAO +|- snp, so not that bad. Hopefully one day we will have answers for this.

    1. Christie Hartman PhD

      Sounds very challenging. Yes, I think the gut bacteria play a very strong role with amine intolerance. My next article will elaborate on that. Feel better!

  10. Four years ago, after taking 2 different antibiotics, I came down with a mysterious cluster headache that was preceded by ringing in my ears, itchy ears, nasal congestion, and low blood pressure. I ended up going to the ER and they gave me prednisone which killed the pain. But for weeks after that I got pain in my left ear and ringing after eating. When I looked at what I was eating when the ringing started it would always have “natural flavors” listed as an ingredient. I also had it from grapes. The symptoms eventually went away but I had another similar cluster headache on the other side 1 1/2 years later. Even though I was diagnosed with an “atypical migraine”, I had no migraine symptoms like fatigue, nausea, light or sound sensitivity. In fact, I was incredibly energetic and agitated, especially during the 1st headache.

    After that I had episodes of tinnitus on and off for a couple years that I would associate with the “migraine” coming on and take prednisone on and off. I had a UTI at one point and had to take antibiotics and the symptoms flared briefly. Then in 2021 I got it along with some terrible digestive problem accompanied by diarrhea. The whole deal was a huge mess (too much to relate here) but the accompanying nighttime tinnitus was extreme and I started waking up every morning between 2 and 4AM with my ears ringing, nose running, and sweating. The symptoms declined after a few months and eventually I just had a an annoying hiss in my left ear at night.

    Then in March 2022 I had to take 2 different antibiotics for a sinus infection (I reacted to the first one). Since then the symptoms have been raging and after a very detailed food and symptom log I have traced it to a list of foods -all high in tyramine. The most dramatic reactions are to fermented foods: once (thinking I should eat pickled foods to expand my gut bacteria) I woke up with a sound like Niagra Falls going on in both ears, pain in my left ear, and a pain in my left temple. During the episode my blood pressure changed swung between 90 and 165. Not that long ago, I accidentally tried eating sourdough bread (didn’t realize it was fermented) and within a week was in the urgent care with severe pulsatile tinnitus, diarrhea, and flushing. I still have ear ringing at night and when I have a flare I wake up with the ringing and my left ear is bright red. Sometimes I break out into rosacea.

    Last week I had my 3rd Primary Care physician tell me it was “psychological”. It was pretty devastating. I’ve had to push for tests for celiac disease and carcinoid syndrome. Carcinoid syndrome is rare, but the symptoms do match exactly and I advise anyone with them to still get the CgA test for it since it is often missed. It is extremely hard to get the symptoms across to doctors anyway, because they give me only 15 minutes to relate the history and symptoms and often interrupt me. This makes me talk fast, which reinforces their idea that it’s anxiety.

    Other symptoms I have are heart palpitations, muscle, twitches, sudden blood pressure drops, and anxiety. I’ve been on a 7 day heart monitor and my heart is fine. Two different allergists say I am not allergic to anything and made me feel ashamed for even going to them. (The only reason I went to the them is because doctors insist that’s where I go when I describe the symptoms.) Despite the fact that my left ear only itches when I am having an attack, and there is often pain in the ear, I am offered mineral oil for the “dryness”. One ENT just told me “tinnitus is incurable and to make it my friend”. He had no interest in the other symptoms.

    I am glad to have come across this site. I am wondering if one of the reasons it has gotten so bad and persistent this time around (I seemed to recover in a few months before) is that I discovered the food connection and then stopped eating the foods instead of eating through it. I have had to because the reactions are intense. But I am wondering if what I need to do is try to re-introduce the foods slowly to train my system to tolerate them. Right now I cannot eat in any restaurants or social situations and travel is difficult. I worry about what would happen should I need to be in the hospital and eat the food since medical personnel just smile condescendingly like they are humoring me when I tell them I cannot eat foods with tyramine.

    1. Christie Hartman PhD

      Beverly: have you looked into histamine intolerance? The blood pressure drops, rosacea, and the grape reaction made me think histamine.

      1. Actually, that was the first thing that I thought it was. Initially, I would have immediate allergic-type reactions. But after months of logging it was clear that the worst reactions involved tyramine. Those were the ones that caused increased blood pressure and flushing. It may be that I am intolerant to both. It’s hard to find a food with histamine that does not also have tyramine. At this point, I am exhausted with logging and analyzing. I can currently eat only about 10 things. My plan was to increase slowly and carefully (something like spinach) and tolerate the reactions if they are not too bad and see if they die down. Then increase again. Repeat…

        1. This is the current list of foods that I have reactions too:
          fermented foods
          alcohol
          restaurant food
          cured meats
          aged protein
          over-ripe fruit
          aged cheese
          spinach
          avocado
          tomato
          bananas
          processed foods
          peanuts
          grapes

  11. Thank you! That is very useful. BTW, I love that chapter in your Tyramine Intolerance Handbook on “Talking to Your Doctor about Tyramine Intolerance”. It helped me not be so frustrated and angry about it, which does not help the symptoms either :-). I did try going to a naturopath which went totally against my grain (I am a scientist). I tried to be open-minded but in the end opted not to take the supplements they suggested, some of which sounded a bit dangerous. I already had diarrhea; who knows what that would have done! They really had no measurements or criteria to support their plan. In the end, a strategy of doing nothing if you don’t know is better and safer.

    1. Christie Hartman PhD

      Yeah, naturopaths can range from fairly science-based to complete quacks. Supplements are tricky for me too.

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