Tyramine Intolerance – underlying cause of migraine headaches?

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Introduction

A migraine is more than just a severe headache; it is a debilitating condition often accompanied by nausea, vomiting, sensitivity to light and sound, and sometimes a preceding aura. For many, these episodes are linked to a reduced ability to clear the amino acid tyramine, a condition known as tyramine intolerance. In individuals with insufficient amounts of the enzyme monoamine oxidase (MAO), tyramine levels can build up, leading to migraines, heart palpitations, and gastrointestinal issues.

What is Tyramine Intolerance?

Just as the amino acid histidine breaks down into histamine, tyrosine breaks down into tyramine. Normally, the enzyme MAO breaks down excess tyramine. However, certain medications—such as MAO inhibitors for depression or Parkinson’s disease—inhibit this enzyme, causing tyramine to accumulate. Some individuals naturally have insufficient MAO levels, which results in the same intolerance. When tyramine builds up, the body responds by releasing neurotransmitters like epinephrine and norepinephrine, triggering a “fight or flight” response that increases blood pressure and heart rate.

Symptoms and Risks

The primary symptoms of tyramine intolerance include migraines, heart palpitations, and nausea. In severe cases, particularly for those on specific medications, a rapid and dangerous increase in blood pressure called a hypertensive emergency can occur. This condition is serious and requires immediate clinical attention, as it can potentially lead to hemorrhagic stroke or organ damage. For most people with intolerance, however, the main struggle is managing the recurring, debilitating migraines triggered by dietary intake.

The Tyramine Intolerance Diet

For those affected, a low-tyramine diet is often recommended to see if symptoms improve. Tyramine occurs naturally in protein-containing foods, but its levels increase as foods age, mature, or ripen. Common triggers include aged cheeses, cured or processed meats, fermented foods, and certain alcoholic beverages. Because tyramine levels fluctuate based on food processing and storage, managing the diet is more complex than simply following a static list.

Personalized Support for Migraines

While some foods are universal triggers, tyramine sensitivity varies between individuals. One person may be triggered by a specific aged cheese, while another is not. Rather than restricting every possible source, it is often more effective to systematically identify and eliminate your specific triggers. This targeted approach provides significant relief without unnecessary dietary restriction, allowing for a more sustainable and enjoyable lifestyle.

More Info?

If you have been diagnosed with tyramine intolerance or suspect you may be sensitive to tyramine, I can help. You can learn about me and the Comprehensive Dietary Package that I offer, to which a Migraine add-on can be added.

To your good health!

Joy

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References

  1. Joneja J. Histamine and tyramine sensitivity — how closely are they linked? Food Matters. October 2017. [https://www.histamine-sensitivity.com/histamine-tyramine-similaraties-10-12.html]
  2. Van Eaton J. Tyramine-Free Diets. Healthline. February 1, 2019. [https://www.healthline.com/health/tyramine-free-diets]
  3. Hall-Flavin D. MAOIs and diet: Is it necessary to restrict tyramine? Mayo Clinic. [https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/maois/faq-20058035]
  4. Costa MR, Glória MBA. Migraine and Diet. Encyclopedia of Food Sciences and Nutrition (Second Edition). 2003. [https://www.sciencedirect.com/science/article/pii/B012227055X007835]
  5. Skypala IJ, Williams M, Reeves L, et al. Sensitivity to food additives, vaso-active amines and salicylates: a review of the evidence. Clinical and Translational Allergy. 2015 Oct 13;5:34. [https://doi.org/10.1186/s13601-015-0078-3]
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