Low Tyramine Diet for Migraine Tyramine is produced in foods from the natural breakdown of the amino acid tyrosine. Tyramine is not added to foods. Tyramine levels increases in foods when they are aged, fermented, stored for long periods of time, or are not fresh. Food Group Allowed Use With Caution Avoid If on MAOI Meat, Fish, Freshly purchased and Any with nitrates or nitrites added i Fermel1ted'sausages: pepperoni, Poultry, Eggs prepared' meats, fish, salami, mortCldella, summer or Meat and poultry EggsAny sausage, etc. Non-fresh or Substitutes allowed items that are improperly stored meat, fish, oanned or frozen poultry or pickled herring Limit processed meats to 4 ounces per meal ** Limit tofu or tempen to 10 ounces per day Dairy Milk: whole, 2% or Aged cheeses Cheddar cheese Limit other aged skim Fresh cheese: cheeses to 4 ounces per meal e.g, American, cottage, Blue, Brick, Brie, Cheddar, Swiss, farmer, rlcotta, cream Roquefort, Stilton, Parmesan, cheese, mozzarella, Provolone, Emmentaler, Velveeta or other etc **Limit any combination of processed cheese, aged cheese and processed meats etc Soy milk, soy cheese to TOTALof 4 ounces per meal. Breads, All breads, biscuits, Cereals, Pasta pancakes, coffee cakes, etc All cooked and dry cereals All pasta: spaghetti, rotini, ravioli, (with allowed ingredients), macaroni, , and egg noodles ~ Vegetables All except on caution Raw onion Fava or broad beans, sauerkraut section(including all Limit fermented soy products like dried beans except fava mlso, soy sauce, and teriyaki or broad beans) sauce to 1ounce per day Fruits All except on cautlon limit intake to 1/2 cup per dayfrom section citrus types: orange, grapefruit, tangerine, pineapple,lemon and lime Soups Soups made from allowed ingredients, homemade broths Beverages Decaffeinated coffee or Limited caffeinated beverages to no Alcoholic beverages: No more than ! tea, club soda, caffelne- more than 2 servings per day (less 2 domestic bottled or canned free carbonated than200mg total) *Consult with your beers or nonalcoholic beer 01' 4 " beverages physician & pharmacist regarding ounce wine per day. No tap beers alcoholic beverages Desserts & Any made with allowed Chocolate based products: ice cream S~ets foods and ingredients: (1.cup), pudding (1.cup), cookies (1. sugar, jelly, jam, honey, average size), cakes (3" cube), and hard candies, cakes, chocolate candies (i/20Z). (All count as cookies one serving of caffeinated beverage) Ingredients Any not listed in the Monosoclium"Glutamate (MSG) listed on Food caution section Nitrates/nitrites$ulfitesAspartame labels Fats, Oils, and All cooking oils and Concentrated yeast extract i.e. Miscellaneous fats Commercial salad Marmite or Vegernlte dressings with allowed ingredients, vinegars All fresh nuts and seeds All spices and extracts not listed in restricted ingredients Caffeine Content of Selected Beverages Carbonated beverages "I' Coffee 6oz=103mg Decaffeinated tea or I Tea 6oz=31-36mg(lnstant and 3-minute brew) 12oz=30-50mg coffee 6oz=2mg (Regular and sugar-free) I General Guidelines • Each day eat three meals with a snack at night or six • The foods listed in the "CAUTION" column have smaller small meals spread throughout the day" amounts of Tyramine or other vasoactive compounds. • Avoid eating high sugar foods on an empty stomach, Other foods in the "CAUTION" column do not contain when excessively hungry, or in place of a meal. Tyramine but are potential headache "triggers". • All food, especially high protein foods, should be prepared Each person may have different sensitivities to certain and eaten fresh. Be cautious of leftovers held for more level of Tyramine or other vasoactive compounds in foods. than one or two days at refrigerator temperature. Freeze • If you are not on an MAOI medication, you should test the leftovers that you want to store for more than 2 or 3 days. use of foods in the "avoid" column in limited amounts. In Cigarette and cigar smoke contain a multitude of you are taking an MAOI medication; do not consume chemicals that will trigger or aggravate your headache. If foods in the "Avoid" column. Consult with your prescribing you smoke, make quitting a high priority. Enter a smoking physician for additional precautions. cessation program. • Adapted from the Saint Joseph Hospital & Diamond Headache Clinic Headache Diet..