Tyramine is a chemical that is found in many of our foods and which acts to contract blood-vessels.

It is formed when particular bacteria break down proteins, and about 10% of all migraineurs get a migraine attack if they eat more than a very small amount of tyramine, according to Dr. Birthe Krogh Rasmussen in the Danish newspaper Jyllandsposten. As a rule of thumb, you can reckon that 6 mg tyramine triggers migraine (Walker et al. 1996)

Bacteria form tyramine

In general there is a lot of tyramine in matured foods. Cheese, salami and smoked meats are classic and well-known triggers of tyramine-migraine, but many other things contain just as much tyramine. Bacteria, especially, make tyramine, so ordinary yeast bread doesn’t contain much tyramine, but sourdough bread can contain a lot.

Bacteria are deliberately added to a whole range of food products to 'get the right taste', for example lactobacilli, while other products mature 'naturally' when the bacteria in the product get to work. It is especially those bacteria that decompose meat that create large amounts of tyramine. Salami, bacon and any form of preserved fish can therefore contain very large amounts of tyramine.

There are reports that cloves and cinnamon reduce the production of tyramine in meat products (Shakila et al. 1996), so possibly tyramine migraineurs could eat salami flavoured with cinnamon and/or cloves. Frying oil is also suggested as a possible means of reducing the amount of tyramine in food (Nout et al. 1993).

The quantities reported here are taken from various chemical studies. Larger (and smaller) amounts of tyramine may easily be present in the foods we buy.

The maturing of e.g. cheese and the brewing of beer are biological processes and even though dairies and breweries do all they can to make a product that’s the same each time, there can be differences in the amount of tyramine in the same type of cheese or beer bought at different times or from different suppliers. In the same way, there can be large variations in the amount of tyramine in smoked fish and bananas, because they’ve been stored under different conditions.

Tyramine migraineurs have a difficult time in finding a pattern in their migraine attacks. One day they have no problems eating bananas, the next it’s not such a good idea. Diary notes cause confusion and the conclusion can be that it must be 'something else' that triggers their migraine.

It’s so easy to find 'reasons' for migraine attacks. Stress or a change in the weather can always get the blame if there’s nothing else that is apparently 'guilty' of triggering a migraine attack.

Tyramine content of various ordinary foods.

Most of the information comes from the Danish Food Agency, 1994.

Food item	Tyramine content mg/100 g	Food item	Tyramine content mg/100 g
Brie and camembert	0-200	Smoked ham	0-62
Hard cheese	0-250	Fresh pork	0.5-4.1
Fresh cheese and cottage cheese	0-1.3	Fresh beef	2
Roquefort	0.7-110	Poultry	2
Flour	0.03-0.25	Chicken liver	10
Potatoes, tomatoes, spinach	0-0.4	Frosen fish	0
Most fruits	0	Canned fish	0-60
Bananas	0.2-9.5	Chocolate	0-1
Rasberries	1.28-9.25	Beer (different types)	0-167
Avocado	2.3	Wine (champagne type)	0.3-2.4
Oranges	0-2.5	Vermouth	0-6.7
Liver (pork)	27	White wine (different types)	0-2
Salami	0-125	Red wine (different types)	0-1.5
Soy sauce	13-88

Studies have shown that many migraineurs excrete tyramine more slowly than control people (Merikangas et al. 1995). Chemical analysis of a urine sample taken during a migraine attack can therefore determine whether you have tyramine migraine.

If you want to read more:

H. M. L. J. Joosten, P. Gaya and M. Nunez, 1995. Isolation of tyrosine decarboxylaseless mutants of a bacteriocin-producing Enterococcus faecalis strain and their application in cheese. Journal-of-food-protection (USA) 58, 1222-1226.

Levnedsmiddelstyrelsen (Danish food agency), 1994. Indholdet af tyramine i levnedsmidler. Erling Saxholt, 26. August 1994. (In Danish)

K. R. Merikangas, D. E. Stevens, J. R. Merikangas, C. B. S. Katz, V. Glover, T. Cooper and M. Sandler, 1995.Tyraminee conjugation deficit in migraine, tension-type headache, and depression. Biological Psychiatry 38, 730-736.

M. J. R. Nout, M. M. W. Ruikes, H. M. Bouwmeester and P. R. Beljaars, 1993. Effect of processing conditions on the formation of biogenic amines and ethyl carbamate in soybean tempe. Journal of food safety (USA) 13, 293-303.

R. J. Shakila, T. S. Vasundhara amd D. V. Rao, 1996. Inhibitory effect of spices on in vitro histamine production and histidine decarboxylase activity of Morganella morganii and on the biogenic amine formation in mackerel stored at 30 degrees C.Zeitschrift fuer Lebensmittel-Untersuchung und -Forschung 203, 71-76.

S. E. Walker, K.I. Shulman, S. A. N. Tailor and D. Gardner, 1996. Tyraminee content of previously restricted foods in monoamine oxidase inhibitor diets. Journal of Clinical Psychopharmacology 16, 383-388.