Question
I just started taking a monoamine oxidase inhibitor (MAOI) for depression. Is it really necessary to follow a low-tyramine diet while on this drug?
Answer
Yes. People taking monoamine oxidase inhibitors (MAOIs) must follow a low-tyramine diet to prevent a serious side effect of the medication. Tyramine is an amino acid normally found in your body that helps regulate blood pressure. It is also found in certain foods, such as many cheeses and wines and certain meats.
MAOIs impair the function of the enzyme monoamine oxidase, which is responsible for the breakdown of tyramine in your body. Elevated levels of tyramine can cause a dangerous increase in blood pressure and lead to stroke. So, it is important to avoid or limit foods that are high in tyramine while taking an MAOI.
It is difficult to quantify the exact amount of tyramine in foods. Although tyramine occurs naturally in some foods, it can also result from the bacterial breakdown of protein in foods as they age. Also, tyramine can vary among different brands of certain foods due to different processing, storage and preparation methods. The most practical advice is to eat food at its very freshest.
To reduce tyramine in your diet:
- Purchase meat, poultry, fish, eggs, milk and milk products that are properly packaged, refrigerated, frozen or canned.
- Don't eat food beyond its freshness date. Check the label.
- Avoid eating leftovers.
- Choose restaurants that prepare food when you order it — not make it up ahead of time and keep it warm. Ask your waiter or waitress if you're not sure.
Ask your doctor or dietitian for a complete list of dietary restrictions if you take an MAOI.
| Low-tyramine diet: Foods to avoid or limit |
| Food type | Restrictions |
| Alcoholic beverages (Talk to your doctor before drinking any alcoholic beverage.) | Avoid: - Sherry
- Vermouth
- Red wines, including Chianti
Limit: - Beer to no more than 12 to 24 ounces a day
- White wine to no more than 4 to 8 ounces a day
|
| Meat, poultry and fish | Avoid: - Caviar
- Pickled and dried herring
- Liver
- Smoked and cured sausages
- Luncheon meats
|
| Vegetables | Avoid: - Fava beans
- Italian green beans
- Sauerkraut
- Snow peas
|
| Soups | Avoid: - Miso soups
- Soups packaged with yeast products
|
| Milk products | Avoid: - Cheeses, both aged and processed
|
| Other | Avoid: - Concentrated yeast extract
- Brewer's yeast
- Yeast supplements
- Yeast paste (marmite)
- Miso
- Large amounts of soy sauce
Exception: - Leavened products made with baker's yeast are allowed.
|
Source: Mayo Clinic Diet Manual, 1994
Last Updated: 09/06/2006
