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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 Category Foods Recommended Foods to Avoid
    Grains
    • All commercial breads (except sourdough)
    • All baked goods
    • Hot and cold cereals
    • Pasta, rice, grits
    • None
    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)
    • Banana peel
    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
    • Monosodium glutamate (MSG)
    • Brewer’s yeast
    • Bouillon and bouillon-based soup
    • Chocolate
    • Lasagna, casserole, pizza, or other food made with meat or cheese on the "avoid" list
    • Marmite spread
    • Vegemite spread

    Additional Suggestions

    • Limit caffeine intake. While there is no tyramine in caffeine, consuming too much caffeine can result in high blood pressure .
    • 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

    California diet manual. State of California website. Available at: http://www.dds.ca.gov/Publications/docs/DDSDietManual.pdf . Accessed January 4, 2010.

    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%5Fmaoi.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.

    Nutrition care manual. American Dietetic Association website. Available at: http://nutritioncaremanual.org/auth.cfm?p=%2Findex.cfm%3F . Accessed January 3, 2009.

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