Low-Tyramine Diet

MAOI Diet

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

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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%5Fmaoi.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.

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