Low-Tyramine Diet for Migraine

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Tyramine is produced in foods from the natural breakdown of the amino acid tyrosine. Tyramine is not added to foods. Tyramine levels increase in foods when they are aged, fermented, stored for long periods of time, or are not fresh.

Meat, Fish, Poultry, Eggs or Meat Substitutes

Allowed

  • Freshly purchased and prepared meats, fish, and poultry
  • Eggs
  • Any allowed items that are canned or frozen

Use with caution

  • Any with nitrates or nitrites added

Avoid if on MAOI

  • Fermented sausages: pepperoni, salami, mortadella, summer sausage, etc.
  • Non-fresh or improperly stored meat, fish, poultry or pickled herring
  • Limit processed meats to 4 oz. per meal
  • Limit tofu or tempeh to 10 oz. per day

Dairy

Allowed

  • Milk: whole, 2 percent, or skim
  • Fresh cheese: American, cottage, farmer, ricotta, cream cheese, mozzarella, Velveeta, or other processed cheese, etc.
  • Soy milk
  • Soy cheese

Use with caution

  • Aged cheeses

Avoid if on MAOI

  • Cheddar cheese
  • Limit other aged cheeses to 4 oz. per meal, e.g. blue, brick, brie, cheddar, Swiss, roquefort, stilton, parmesan, provolone, emmentaler, etc.
  • Limit any combination of aged cheese and processed meats to total of 4 oz. per meal

Breads, Cereals, and Pasta

Allowed

  • All breads, biscuits, pancakes, coffee cakes, etc.
  • All cooked and dry cereals
  • All pasta: spaghetti, rotini, ravioli, macaroni, and egg noodles (with allowed ingredients)

Vegetables

Allowed

  • All except on caution section (including dried beans, except fava or broad beans)

Use with caution

  • Raw onion

Avoid if on MAOI

  • Fava or broad beans, sauerkraut
  • Limit fermented soy products like miso, soy sauce, and teriyaki sauce to 1 oz. per day

Fruits

Allowed

  • All except on caution section

Use with caution

  • Limit intake to 1/2 cup per day from citrus types: orange, grapefruit, tangerine, pineapple, lemon, and lime

Soups

Allowed

  • Soups made from allowed ingredients, homemade broths

Beverages

Allowed

  • Decaffeinated coffee or tea, club soda, caffeine-free carbonated beverages

Use with caution

  • Limited caffeinated beverages to no more than two servings per day (less than 200 mg total)
  • Consult with your physician and pharmacist regarding alcoholic beverages

Avoid if on MAOI

  • No more than two domestic bottled or canned beers or nonalcoholic beers
  • No more than 4 oz. wine per day
  • No tap beers

Desserts and Sweets

Allowed

  • Any made with allowed foods and ingredients: sugar, jelly, jam, honey, hard candies, cakes, and cookies

Use with caution

  • Chocolate-based products: ice cream (one cup), pudding (one cup), cookies (one averaged size cookie), cakes (3 in. cube), and chocolate candies (1/2 oz.)
  • *All count as one serving of caffeinated beverage

Ingredients Listed on Food Labels

Allowed

  • Any not listed in the caution section

Use with caution

  • Monosodium Glutamate (MSG)
  • Nitrates
  • Nitrites
  • Sulfites
  • Aspartame

Fats, Oils, and Misc.

Allowed

  • All cooking oils and fats
  • Commercial salad dressing with allowed ingredients, vinegars
  • All fresh nuts and seeds
  • All spices and extracts not listed in restricted ingredients

Avoid if on MAOI

  • Concentrated yeast extract, i.e. Marmite or Vegemite

General guidelines

  • Eat three meals each day with a snack at night or six small meals spread throughout the day
  • Avoid eating high sugar foods on an empty stomach, when excessively hungry, or in place of a meal
  • All food, especially high protein foods, should be prepared and eaten fresh. Be cautious of leftovers held for more than one or two days at refrigerator temperature. Freeze leftovers that you want to store for more than two or three days
  • Cigarette and cigar smoke contain a multitude of chemicals that will trigger or aggravate your headache. If you smoke, make quitting a high priority
  • The foods listed in the “Caution” column have smaller amounts of Tyramine or other vasoactive compounds. Other foods in the “Caution” column do not contain Tyramine but are potential headache triggers
  • Each person may have different sensitivities to a certain level of Tyramine or other vasoactive compunds in foods
  • If you are not on an MAOI medication, you should test the use of foods in the “Avoid” column in limited amounts
  • If you are taking an MAOI medication, do not consume foods in the “Avoid” column. Consult with your prescribing physician for additional precautions

Adapted from the Saint Joseph Hospital and Diamond Headache Clinic Headache Diet

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