Tyramine

What is it?: a natural chemical produced when foods are aged or ripened

Where is it?: fermented, aged, cured, and overripe foods

Is it a common trigger?: probably not!

The Basics

Tyramine is a natural food chemical widely thought of as a common migraine trigger. It's a result of the breakdown of tyrosine, an amino acid naturally found in animals, plants, and foods. Amino acids are the building blocks of protein.

Tyramine is known as a vasoconstrictor, meaning it causes your blood vessels to narrow. This, in turn, increases your blood pressure. 

When the average person eats very high amounts of tyramine (which could happen if you ate, say, an entire wheel of brie) they might experience nausea and headaches as a result. This is commonly referred to as the Tyramine Effect

Does this mean, though, that foods high in tyramine are automatically a migraine trigger? Let's look at the science to find out.

The Science

Food triggers are notoriously hard to study (you can read more about that HERE). Because of this, we will look at how tyramine behaves in your body, rather than relying on studies that evaluate whether tyramine triggers a migraine episode or not.

Tyramine is known as a biogenic amine and shares this title with other food chemicals like histamine and phenylethylamine. Biogenic amines are interesting for migraineurs because they can play a role in the gut brain connection and interact with neurotransmitters (chemicals that allow your nerves to communicate with the rest of your body).

When you eat tyramine, it causes neurotransmitters like dopamine and epinephrine to jump into action. These neurotransmitters are part of your "fight or flight" reaction and are what lead to the (temporary) increase in blood pressure that tyramine can cause. 

This is true for anyone, migraineur or not. So perhaps people with migraine react differently to tyramine than the average person?

Migraineurs don't seem to have a decreased ability to process tyramine (except maybe during and episode); they don't seem to have any issues peeing tyramine out (which is a way your body gets rid of extras); and they don't seem to absorb more tyramine than the average person. 

So no, migraineurs don't appear to have any issues with tyramine itself versus the general population.

The reason why we continue to explore tyramine as a migraine trigger despite this is because people taking certain medications that cause tyramine to build up in your body (called MAOI's) experience headaches when they eat tyramine-rich foods. It's also because migraineurs seem to be more sensitive to those neurotransmitters tyramine provokes than the average person.

Then maybe looking at people's actual experience with tyramine and migraine would be helpful to determine if this food chemical is truly a common trigger?

According to one of the largest ongoing studies on migraine and triggers using data from the Migraine Trust and NHF has found that very few migraineurs report tyramine as a trigger - less than 10%. Does that mean it can't be a trigger? Not necessarily. But it's one more piece of the puzzle that leads me to think that, for most people, tyramine is probably not something to be overly concerned about.  

Food Sources

***It's important to note that we don't know the exact amount of tyramine in any of these foods above, and that amounts can vary depending on how aged or ripened the food is. If you're concerned about tyramine, sticking to fruits that are less ripe (like greener bananas) and fresher foods in general is the way to go.

To Avoid or Not to Avoid?

Despite trying to find a clear link between migraine and tyramine for decades, science has been unable to support tyramine as a common migraine food trigger

Anecdotal evidence mirrors this - 7% of migraineurs say tyramine is a trigger, while 10% say tyramine actually prevents episodes for them. 

With the evidence we have right now, it seems that most people likely do NOT need to avoid tyramine. This may come as a bit of a surprise considering most migraine diets recommend avoiding tyramine-containing foods.

If you want to find out if tyramine is a trigger for you personally, it's best to use a food journal and/or an elimination/reintroduction diet to figure it out. You can go HERE for more information about how to do this.

Bottom Line

Tyramine is likely not a trigger for you - but if you notice an increase in symptoms after having guacamole, hot dogs, or kombucha, tyramine may be the culprit.

References

Intolerance to dietary biogenic amines: a review

UW Health Low Tyramine Diet

NHF Low Tyramine Headache Diet

Food as trigger and aggravating factor of migraine

Diet and Headache: Part 1

N1-Headache™ Population Trigger Map® & Protector Map®

Biogenic Amines: Signals Between Commensal Microbiota and Gut Physiology

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Evaluating Food Trigger Science