With Turkey Day coming, it seems like a good time to talk about tyramine headaches. Before you become befuddled with your excellent feast, you might want to consult your headache diary to see if you are one of those who are sensitive to tyramine, a chemical produced in foods from the natural breakdown of the amino acid tyrosine.

Why now? Because among other foods, you can find tyramine in turkey. Not to worry, though. If you do suffer from tyramine headaches, you can do something to reduce tyramine in your diet.

What Is Tyramine and What Link Does It Have to Headaches?

As mentioned above, tyramine is the result of the breakdown of the amino acid tyrosine. It’s in anything that has this amino acid, but the amount differs according to the age, fermentation, or storage time of the food. 

Humans have an enzyme that breaks down monoamines called Monoamine Oxidase (MAO). MAO helps process tyrosine. If you don’t have enough MAO in your system, you could get headaches or migraines from consuming foods high in tyrosine.

Scientists figured out the connection in the 1950s when MAOI antidepressants went on the market. MAOIs inhibit monoamine oxidase production (which is why you see warnings about them for various medications.)

People taking MAO inhibitors presented with headaches and high blood pressure from eating high-tyrosine foods. Why it happens is still a mystery.

Researchers speculate that tyramine may trigger migraines by causing nerve cells in the brain to release excess norepinephrine. Another possibility is that higher levels of tyramine plus an unusual level of brain chemicals can cause changes in the brain that lead to headaches.

What Foods Have Tyramine?

Almost any food that has been aged, fermented, or stored for a long time can have tyramine in it. The most common foods on American tables containing tyramine tend to be the following:

• Aged dairy products like cheese, such as bleu, brick, and cheddar
• Smoked, aged, dried, fermented, or pickled meats, poultry, or fish
• Cured meats containing nitrates and nitrites like smoked turkey
• Some types of beer
• Broad beans, like fava beans and snow peas
• Heavily yeasted bread, like sourdough
• Fermented cabbage, aka sauerkraut
• Fermented soy products like miso, bean curds, soy sauce, teriyaki sauce, and bouillon
• Nuts 
• Wine, vinegar, and wine vinegar
• High protein foods stored long-term or not kept cold enough
• Improperly stored or spoiled food

If you find yourself with a migraine after eating these types of foods, you may be sensitive to tyramine. Also, tyramine tends to be additive. You may be able to tolerate a small amount of certain foods without problems, but if you eat a little aged cheese, a little wine, and a little bit of cured meat, the tyramine can add up and cause a headache. 

Creating a Low Tyramine Diet

As we said earlier, you can do a few things to reduce tyramine in the foods you eat or avoid certain foods in your diet. 

First, consume only freshly purchased and prepared meat, fish, or eggs. Otherwise, stick to canned or frozen (as long as the canning or freezing was done when the food was very fresh). Cook and eat the food the day it is bought or freeze it immediately.

Eat fresh produce within two days of purchasing it. Don't eat leftovers kept in the refrigerator for more than two days and throw out spoiled, moldy, or overripe foods.

Avoid eating smoked, cured, aged, pickled, or fermented food.

Avoid anything with nitrates or nitrites, which includes many lunch meats. Read the labels carefully before consuming.

Avoid aged cheeses. Instead, go for fresh cheeses which include:

• American cheese
• Cottage cheese
• Farmer’s cheese
• Ricotta and mozzarella
• Cream cheese

Consume bread, pasta, and cereals low in yeast and reduce tyramine by using only allowable ingredients when making bread products. 

You can have unlimited vegetables and fruits except for citrus fruits and some beans. Oranges, lemons, pineapples, tangerines, grapefruit, lemons, and limes contain higher levels of tyramine than other fruits. Limit yourself to half a cup a day.

Also, avoid raw onions. Cooked onions are less problematic.

Finally, just on general migraine reducing principles, limit your caffeine intake or stick to decaffeinated drinks.

Tyramine levels rise when food is stored at room temperature. The amino acid tyrosine continues to break down, generating tyramine as the food sits out. Refrigerator and freezer storage can reduce tyramine in food. When you thaw frozen food, be sure to do it in the refrigerator or microwave to reduce tyramine generation.

Is Tyramine Causing Your Migraines?

You can determine if tyramine is one of your migraine triggers by keeping a headache diary for several months. 

• Write down the time and date each headache starts.
• Describe how the headache or migraine feels. Use exact descriptions.
• State where the migraine falls in your menstrual cycle if applicable.
• Write down everything you eat and when.
• Note whether you have been exposed to other common headache triggers like strong smells, bright lights, loud noises, or other triggers such as stress or lack of sleep.

Tyramine headaches don’t necessarily start right after eating the offending food. The head pain may not start for 24 hours or more after you eat certain trigger foods. When studying your headache diary for triggers, be sure to note foods eaten a day or two before the migraine occurs. 

Final Note

Not everyone who suffers migraines or is sensitive to tyramine is affected equally. Some individuals are more amine resistant than others and have a difficult time breaking down any amine, including tyrosine. 

To have a Happy Thanksgiving (and comfortable Black Friday shopping), whip up a low-tyramine Thanksgiving dinner with fresh turkey, fresh cheeses, and fresh fruits and vegetables if possible. Take it easy with citrus fruits and drinks, and avoid smoked, fermented, and pickled things. 

Enjoy migraine-free holidays by reducing stress as well. Get plenty of rest. And if you suffer a migraine anyway, you can use it as an excuse to get everyone else out of the house!

As always, the staff at the Migraine Relief Center wishes you Happy Holidays and stands ready to assist you in diagnosing and treating your migraines.