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.

That’s all for now.

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

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Other Articles You Might Like

Tyramine Intolerance vs. Histamine Intolerance

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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.

12 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.

  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.

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