Should People Taking MAOIs Follow a Tyramine-Free Diet?

If you’re sensitive to tyramine or you’re taking MAOIs, you may want to limit your intake of tyramine-rich foods and beverages to lower your chances of tyramine buildup.

High tyramine foods

Certain foods have high amounts of tyramine, especially foods that are fermented, cured, aged, or spoiled.

Foods that concentrate more than 6 mg of tyramine per serving are considered high in tyramine. Specific foods with high tyramine content include (8, 9, 10):

  • salt-dried fish such as mackerel, cod, and sardines
  • unpasteurized, strong, or aged cheeses such as cheddar, feta, blue cheese, and Gorgonzola
  • casseroles or pizzas made with aged cheeses
  • cured or smoked meats or fish, such as sausage and salami
  • some overripe fruits
  • certain beans, such as fava and broad beans
  • some sauces and gravies, such as soy sauce, teriyaki sauce, fermented fish sauce, and bouillon-based sauces
  • pickled products such as sauerkraut and kimchi
  • sourdough breads, yeast-leavened breads, or breads made with aged cheese or meat
  • fermented soy products such as miso soup, bean curd, and tempeh, as well as forms of tofu that are fermented, such as “stinky tofu”
  • fish or shrimp paste
  • concentrated yeast products such as spreads (Marmite, Vegemite) and brewer’s yeast
  • protein supplements with yeast products
  • improperly stored or spoiled foods
  • mincemeat pie
  • meat tenderizers or foods prepared with meat tenderizers
  • certain alcoholic beverages, such as tap or home-brewed beer, Korean beer, and vermouth

Moderate tyramine foods

Certain foods concentrate moderate amounts of tyramine. If you want or need to limit tyramine, you should eat these only occasionally — no more than three servings of any foods on this list daily — and pay close attention to how you feel.

Some cheeses and dairy products are less tyramine-rich than others, including (8):

  • American cheese
  • Parmesan
  • farmer’s cheese
  • havarti
  • brie
  • yogurt

Read more  Correlation Between Body Mass Index and Blood Pressure Levels Among Hypertensive Patients: A Gender-Based Comparison

Other foods with moderate levels of tyramine include:

  • avocados
  • anchovies
  • raspberries
  • broccoli
  • eggplant
  • citrus (grapefruit, oranges, pineapple, lemons, limes)
  • chocolate
  • some wines
  • nuts, seeds, and nut butters
  • wine vinegar and apple cider vinegar
  • certain red and white wines

You may be able to have some beer or certain other alcoholic drinks. Most bottled beers should be safe to drink in modest amounts, but avoid draft (tap) beer.

Because wines are fermented, you should limit your intake to no more than 4 ounces per day — and be sure to check with a healthcare professional first.

Low- or no-tyramine foods

Fresh, frozen, and canned meats, including poultry and fish, are acceptable for low tyramine diets. You can also include the following:

  • grains, including pasta, bread, cereal, and rice
  • non-aged packaged or luncheon meats (except for salami and other aged or cured meats)
  • non-fermented or pasteurized dairy, such as milk
  • non-fermented or pasteurized cheeses, such as cream cheese, ricotta cheese, and cottage cheese
  • fresh, canned, and frozen fruits and vegetables
  • eggs
  • raisins
  • cooking fats and oils
  • fresh and canned legumes, such as most beans, lentils, and peas (aside from fava beans and broad beans)
  • ketchup, Worcestershire sauce, and most salad dressings (aside from any that contain aged fish products or other fermented foods)
  • coffee, tea, and soft drinks
  • certain liquors, such as bourbon, rum, vodka, and gin

If you decide to drink lower-tyramine liquors, be sure to do so with food. The food will slow down your body’s absorption of any trace tyramine in the liquor.

If you experience side effects from any food or drink — whether it’s high or low in tyramine — discontinue eating or drinking that food or drink, and be sure to mention the reaction to a healthcare professional.

— Update: 02-02-2023 — found an additional article Lowering Tyramine-Foods to Eat and Avoid from the website for the keyword a hypertensive crisis may occur while eating foods containing tyramine.

Tyramine is formed from the amino acid tyrosine and plays a role in blood pressure regulation. It is found naturally in the body and a variety of foods.

Read more  Hypertension artérielle pulmonaire : définition, symptômes, traitement

People prone to migraines or those who take monoamine oxidase inhibitors (MAOI) may need to limit their intake of foods rich in tyramine.

Learn more about how naturally occurring sources of tyramine affect the body and whether you need to avoid certain foods.

Brothers91 / E+ / Getty Images

Side Effects of High Tyramine

Ingestion of high tyramine-containing foods in people taking MAOIs produces headaches, blurry vision, chest pain, and palpitations (a change in the way the heart beats) associated with hypertension, intracranial hemorrhages, and myocardial injury.

Migraines and Headaches

The enzyme monoamine oxidase breaks down tyramine. For people taking MAOIs, this enzyme is stopped, increasing levels of tyramine in the blood.

Higher levels of tyramine are associated with an increased risk of headaches and migraines; therefore, people who use MAOIs may experience more migraines. These headaches are likely to occur because tyramine causes nerve cells to release norepinephrine, changing chemical levels in the brain, which leads to pain.

Tyramine-related migraines occur in people prone to migraines when there is cerebral vasoconstriction (contraction of the blood vessels in the brain) followed by rebound dilation of the cranial vessels. Diets low in tyramine are often recommended when looking to identify migraine triggers.

High Blood Pressure

MAOIs treat various symptoms, including anxiety disorder, depression, and early stages of Parkinson’s disease. High levels of tyramine can cause a hypertensive crisis, which occurs when a sudden rise in blood pressure is considered a medical emergency. Symptoms include:

  • Heart palpitations
  • Anxiety
  • Bloody nose
  • Nausea
  • Shortness of breath
  • Headache
  • Lightheadedness

If you are experiencing any of these symptoms or your blood pressure is 180/120 millimeters of mercury (mm Hg), you should be immediately seen by a healthcare provider. If they believe you have a hypertensive emergency, you will need to go to the emergency room.

Foods High in Tyramine

Some foods are naturally higher in tyramine. Tyramine levels also increase when food is aged or fermented. Foods higher in tyramine may need to be omitted or limited. Your amount will depend on your symptoms, medical history, and medications. Some foods high in tyramine include:

Read more  Clinical features and outcome in 25 dogs with respiratory‐associated pulmonary hypertension treated with sildenafil

  • Aged cheeses (cheddar, feta, blue, brie, swiss, parmesan, provolone)
  • Alcohol (wine and beer)
  • Cured meat and processed meat (salami, sausage, bacon, cold cuts)
  • Foods that contain nitrates, sulfites, aspartame, Monosodium glutamate (MSG), concentrated yeast (marmite, vegemite)
  • Coffee
  • Chocolate
  • Soy sauce, teriyaki sauce, miso
  • Pickled or salt-dried foods like fish
  • Fermented foods (kimchi, sauerkraut, kefir, tofu)
  • Aged bananas, avocado, grapes, citrus fruits

Foods Low in Tyramine

Other foods contain little to no tyramine. Eating fresh foods and avoiding leftover, spoiled, or overripe foods is recommended.

  • Fruits and vegetables
  • Dairy and non-dairy products (milk, cheese, etc.)
  • Fresh chicken, fish, turkey, pork, meat
  • Starches (bread, rice, pasta, other grains)
  • Nuts and seeds
  • Cooking oils and fat (olive oil, butter)
  • Legumes (except fava beans)
  • Water, club soda, caffeine-free beverages

Do I Need to Restrict My Intake?

You may need to restrict your tyramine intake if you suffer from chronic migraines. This is especially true if you notice that certain foods trigger your migraines. A healthcare provider or registered dietitian (RD) can help you identify triggers and create a meal plan that fits your individual needs.

If you take MAOIs, you will need to limit your intake of tyramine. If you have any questions, discuss them with your medical team.


Tyramine is a natural compound found in many different types of foods. High levels of tyramine are associated with headaches, migraines, and high blood pressure. People who take certain medications and are prone to migraines may need to follow a low tyramine diet and choose foods like fruits and vegetables, dairy, fresh chicken, nuts, and seeds. Foods high in tyramine include aged cheeses, chocolate, cured meats, fermented foods, and more. Discuss your needs with your healthcare provider.

A Word From Verywell

Foods high in tyramine can negatively impact people who suffer from migraines and those who take MAOIs. Following a low tyramine diet may be necessary to manage symptoms and prevent serious side effects such as a hypertensive crisis. Evaluate your diet to assess your tyramine intake and intervene accordingly. Sometimes, reducing certain foods can help. In other instances, total elimination may be necessary.


Recommended For You

About the Author: Tung Chi