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Low-Tyramine Diet
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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 CategoryFoods RecommendedFoods to Avoid

Grains

  • All commercial breads (except sourdough)
  • Hot and cold cereals
  • Pasta, rice, grits
  • Fresh or homemade yeast breads, sourdough breads
  • Crackers

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)
  • Bananas, overripe fruit, avocados

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

  • Margarine, butter, mayonnaise
  • Salt, pepper, spices, and herbs
  • Sugar
  • Potato chips, popcorn
  • Sherbet, ice cream, and jello
  • Hard candy
  • Cookies, cakes, and other baked products (made without yeast)
  • Limit chocolate desserts, candies, and syrups
  • Teriyaki and soy sauce (limit to ¼ cup per day)
  • Instant soup mixes and bouillon cubes (check ingredients for yeast), miso soup
  • Cheese-filled dessert and cheesecake
  • Imported chocolate
  • Brewer's yeast
  • MSG
  • All aged and fermented products

Additional Suggestions

  • Limit caffeine intake. While there is no tyramine in caffeine, consuming too much caffeine can result in high blood pressure.
  • Check ingredient lists for the presence of tyramine-containing ingredients, such as marmite and yeast-extracts.
  • 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

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_maoi.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.



Last reviewed May 2008 by Maria Adams, MS, MPH, RD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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