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San Clemente Journal

Tyramine – The Headache Tyrant

Apr 29, 2007 10:03PM ● By Don Kindred
by Maggie Zeibak

Headaches can throb. Headaches can pound and pulsate. Headaches can gnaw away behind your eyelashes and extend their tentacles down to your stomach and stir up gut wrenching, dizzying nausea. For those of us who constantly battle this unwelcome companion, we try different approaches – perhaps a new pill, aromatherapy, acupuncture, or biofeedback techniques. We question whether it is a tension headache, a migraine, a cluster, a sinus or a yet-to-be-labeled headache.

And then, there is the morning headache. The one that constantly awakens you at 4am, disrupting any more thoughts of sleeping until the alarm clock rings. Hoping that changing your position from horizontal to vertical will help, you creep downstairs to drink your first cup of coffee. Ha! Is that something that triggers a headache? Check out the amount of caffeine you consume – it can be helpful or a hindrance.

But let’s say you have this feeling that most of your headaches are related to the foods you eat. The first thing a medical professional is going to ask you to do is keep a dietary record to compare with the frequency of headaches. Once you know that a steady consumption of wine and aged cheeses, among other foods, can trigger the silvery zigzag of a migraine aura, it may be easier to eliminate or reduce them from your normal intake. Adding to this chore of record keeping, you may be asked to follow a restricted diet, but this is usually for a short, manageable period of time. Secondly, you need to identify where it hurts – at the base of the skull, top of the scalp, one side of the head or behind the forehead.

Unraveling the mysteries of food related headaches might take an inordinate amount of time, as much of the process is trial and error. We need to seek the cause of the headache, not treat the symptom. During the time that I was on a quest for answers, my frustration level rose until I found the National Headache Foundation ( and found the answer staring me in the face. Who would have thought that some of the healthiest foods I was eating could have such a detrimental effect on my well-being?

The culprit was Tyramine; produced in foods from the natural breakdown of the amino acid tyrosine. No, it isn’t added to foods, but the levels of Tyramine in foods increase when they are aged, fermented or stored for long periods. Not everyone is sensitive to raised amounts, but for those of us who are, remedial noshing is in order. This does not mean that one day you can eat say, spinach, with no ill effects, because you rarely know how fresh these foods are and how long they’ve been hanging around in transportation. Now, isn’t that depressing?

If this isn’t a good reminder to eat “fresh” then I don’t know what is. Buzzing around nowadays is the phrase “from field to fork” and it is something to remember, and a good reason to visit our Sunday Market on Avenida Del Mar for fresh vegetables. Leftovers take on a whole new identity and become an elephant in the refrigerator rather than a quick, reheated meal on the run. Learning to freeze leftovers within a day, to eat at a later date, can avoid an episode of fuzzy, foggy thinking that often accompanies the headache. The piece of filet mignon that you couldn’t quite finish last night and now languishes in that nasty Styrofoam container, needs to be bagged and stored in the freezer if you’re not going to eat it today. Tyramine is forming and it is your enemy (but don’t get paranoid, you can work around it).

The T-word now enters your vocabulary. Foods containing this substance in large quantities can trigger a headache and palpitations in some people, but not necessarily, in others. Being aware of what you put into your mouth, and in what combinations, can help you avoid discomfort later on. For example, at breakfast I savored smoked salmon as a treat, then at lunchtime I piously tucked into a Soybean patty topped with melted Swiss cheese. Later in the day, a handful of nuts preceded Hubby’s famous Chicken Livers Tarragon cooked in Vermouth, for dinner. Oh, and did I mention the Dove Chocolates that assaulted me mid-afternoon? Let me share with you, that by next morning I really didn’t care to hear the dawn chorus of ratty little birds outside my window – I was hurting.

Realizing that these are not everybody’s favorite choices, once you start examining your food selections you may see a pattern emerging. Is it the tofu shake you have every day or the cold cuts? Streamlining and adapting your everyday eating habits may seem like an insurmountable task, but it really isn’t. Once you decide to work around certain foods and limit the High-T foods in large quantities, perhaps you’ll start to feel like a new person. Do your research. Google-up “Low Tyramine Diet” and compare website information. You don’t have to deprive yourself completely, you can have a little portion but it has to be by itself and not in combination with other “off-limits” foods. As always, follow your doctor’s advice before starting a new diet.

Meats - Aged, dried, fermented, smoked or pickled products. Pepperoni, salami, and anything with nitrates or nitrites added – like hot dogs. Non-fresh meat or liver.
Dairy - Aged cheeses: Blue, Brie, Cheddar, Swiss, Roquefort, Stilton, Mozzarella, and Provolone.
Vegetables - Snow peas, Fava Beans, Sauerkraut, Pickles, Olives, Spinach. Restrict raw onion. Fermented Soy products like Miso, Soy and Teriyaki Sauces.
Nuts - All nuts including Peanut Butter
Beverages - Chianti, Sherry, Burgundy, Vermouth, Ale, Beer and Non-alcoholic fermented beverages.

Although there are smaller amounts of Tyramine in other foods, such as Yogurt, Sour Cream, Sourdough Bread, Citrus fruits, Avocados, Bananas, Raisins and Plums, they can be consumed in moderation. In fact, the key here is a wide selection of foods and small helpings of the T-foods may be eaten. It works for me, but I’m not saying that I don’t fall off the wagon periodically and make injudicious choices. Balancing out your particular diet can take a while, but once you’ve got that overload of Tyramine in a stranglehold, life’s going to be worth living again. b