Ask Dr. Gourmet

What foods are high in tyramine?

I am an RN and have a new home care client. She is on Zyvox, which states she should have no more than 100mg of tyramine at any one meal. I guess that this would be similiar to MAO inhibitor antidepressant medications, that can cause a spike in blood pressure.

Do you have information on the number of milligrams of tyramine in foods which should be limited in her diet?

Dr. Gourmet Says...

Certainly some antidepressants interact with foods that contain tyramine. There is some evidence that foods that are high in tyramine can also contribute to migraine headaches.

Think of foods that are aged or fermented and they will likely have high levels of tyramine. Some legumes such as lentils and lima beans are also to be avoided.

Here's a guide of foods to avoid:

High Tyramine Foods

Do NOT eat the following foods if you take MAO inhibitor medicine.

Beverages:
Ales and beers
Burgundy wine
Chianti wine
Sherry
Vermouth

Breads & Starches:
Breads made with aged cheeses and meats, or yeast extracts
Homemade or high yeast breads

Dairy Products:
Aged & processed cheeses, like cheddar, blue, and cheese spreads
(You can eat the following cheeses: cream cheese, farmer's cheese, cottage cheese, & ricotta cheese)

Fruits & Vegetables:
Banana peels
Fava bean pods
Italian or broad green beans
Kim chee (fermented cabbage)
Lentils
Lima beans
Sauerkraut
Spoiled or overly ripe fruits

Meat & Protein Foods:
Aged, dried, cured meats
Dried or pickled fish
Meat jerky
Leftovers that may be partly fermented
Liver
Meat extracts
Salami or dry sausage
Salted, smoked, or pickled meat or fish

Other:
Brewer's yeast
Bouillon or broth with yeast
Commercial gravies
Crackers made with cheese
Homemade yeast breads
Marmite and other yeast spreads
Miso (fermented soybean paste) and soy sauce
Yeast extracts

Moderate Tyramine Foods

Eat or drink only 1/4 to 1/2 cup total of the items on the following list each day if you take MAO inhibitor medicine.

Beverages:
Bouillon
Distilled liquor
Red, white, and port wines

Breads & Starches:
Commercial breads without, or low in yeast

Dairy Products:
Cultured products such as buttermilk, sour cream, yogurt
Unpasteurized milk products

Fruits & Vegetables:
Avocados
Chinese pea pods
Raspberries
Red plums
Spinach

Meats & Protein Foods:
Fish roe and caviar
Meat pates
Peanuts

Other:
Coffee, tea, colas: only 2 cups total of these per day
Chocolate products: only 1 small serving per day
Monosodium glutamate (MSG)
Teriyaki sauce: only 2-4 Tbsp per day

Thanks for writing,

Timothy S. Harlan, MD, FACP, CCMS
Dr. Gourmet