Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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4-hydroxy-phenylethylamine; CAS number: 1-67-2; tyramine (engl.)

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Tyramine is a biogenic amine. It forms bitter-tasting, colourless crystals which are slightly soluble in water and easily soluble in boiling ethanol. Tyramine is formed in the human body by decarboxylation from the amino acid tyrosine. Tyramine is formed exogenously by the action of bacteria during the decomposition of proteins.

Tyramine acts as an indirect sympathomimetic. However, in the human organism it is so quickly broken down by monoaminooxidases (MAO, FMO = flavin-containing monooxygenase) that the substance does not have any biological (circulatory) effects when taken orally. Tyramine is also degraded by cytochrome P450 2D6.

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Tyramine is a natural additive in various foods. This applies especially to foods that undergo biological processes such as fermentation. These include many types of cheese, red wine or chocolate. Tyramine is also a natural component of bananas and mistletoe.

Tyramine containing food and foodstuffs

  • Meat: Liver (all types) and meat treated with tenderisers.
  • Sausage: cured and smoked varieties, especially long-life sausages.
  • Fish: stored and canned products, such as smoked fish, dried fish, anchovies, caviar, marinated herring, salted herring. Also shellfish and snails.
  • Dairy products: matured and more fermented cheeses, such as Camembert, Emmental, Gorgonzola, Gruyère, Cheddar and sour milk cheese.
  • Sour cream, buttermilk, creme fraiche, yoghurt, soured milk, kefir, curd, cream cheese are rated differently.
  • Vegetables: mainly sour pickled varieties such as sauerkraut, mushrooms, aubergines, gherkins, mushrooms. Also tomatoes, avocados, lentils, broad beans.
  • Fruits/Nuts: pineapple, bananas, raspberries, papaya, dried fruit, rhubarb. Also all kinds of nuts, especially peanuts, almonds, pistachios.
  • Drinks: Red wine, vermouth, beer, non-alcoholic beer, caffeinated drinks in large quantities (cola, coffee, etc.), lactic acid fermented juices and lemonades.
  • Other: yeast, meat extract, yeast extract, curry powder, chocolate, marzipan, liquorice, tofu.

Tyramine low food:

  • Fresh meat without added tenderisers,
  • Fresh fish (fresh or frozen)
  • Baked goods without yeast addition, e.g. muesli, noodles, sourdough bread without yeast;
  • Fats: butter, margarine, oils
  • Dairy products: milk, cream. Whether the following dairy products are allowed in a low-tyramine diet is a controversial issue: soured milk, buttermilk, curd, layer cheese, cottage cheese, cream cheese, fruit curd (apple, pear, melon), cream and milk ice cream, young Dutch Gouda cheese, spreadable cheese
  • Vegetables: potatoes, many vegetables except the tyramine rich ones (see above)
  • Fruit: apple, pear, melon (see above)
  • Drinks: Mineral water, coffee (max. 2 cups per day), freshly squeezed fruit and vegetable juices (e.g. from apples, pears, carrots), tea, soft drinks without caffeine
  • Other: Eggs (except brine eggs), custard and dessert powder (if free from chocolate and nuts), sugar, jams, honey.

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When taking medication with non-selective MAO-inhibitors at the same time, oral tyramine intake. with simultaneous inhibition of its breakdown can lead to an accumulation of tyramine with a possibly strongly pronounced circulatory effect up to a hypertensive crisis (so-calledtyramine or "cheese effect"). Tyramine sensitivity is also observed in advanced liver cirrhosis (increased tyrosine levels in these patients).

Furthermore, tyramine, like other biogenic amines (including histamine in strawberries, shellfish and crustaceans; serotonin in bananas and nuts) can trigger a "food allergy"(food intolerance). In addition, the consumption of foods rich in tyramine and histamine can trigger migraine attacks in people who are predisposed to them.

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Tips for the storage, preservation and preparation of food

  • Special attention should be paid to the storage of food when purchasing.
  • Buy fresh food from the region (these are usually fresh and have only short transport distances)
  • Avoid preserved food if possible
  • Shop several times a week and consume food quickly.
  • Do not store food at room temperature. Cool storage delays the ripening process of plants. The rapid spoilage of meat is avoided.
  • Do not store food in the refrigerator for more than a few days.
  • Pay attention to the expiration date when buying.
  • In the case of potentially risky foods, try only small portions at first. Pay attention to physical reactions (measure blood pressure if necessary)
  • Keeping a food log: clearly document what is and is not tolerated.

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  1. Blackwell B et al,(1969) Monoamine oxidase inhibition and intolerance to foodstuffs. Bibl Nutr Dieta 11:96-110.
  2. Fulenwider JT et al. (1978) Deranged tyrosine metabolism in cirrhosis. Yale J Biol Med 51:625-633.
  3. Jansen SC et al (2003) Intolerance to dietary biogenic amines: a review. Ann Allergy Asthma Immunol 91:233-240.
  4. Latorre-Moratalla ML et al.(2017) Tyramine and histamine risk assessment related to consumption of dry fermented sausages by the Spanish population. Food Chem Toxicol 99:78-85.
  5. Niwa T et al(2011)Human liver enzymes responsible for metabolic elimination of tyramine; a vasopressor agent from daily food. Drug Metab Lett 5:216-219.
  6. Prester L (2011) Biogenic amines in fish, fish products and shellfish: a review. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 28:1547-1160.
  7. Weidenhiller M et al (2012) Histamine intolerance syndrome (HIS): plethora of physiological, pathophysiological and toxic mechanisms and their differentiation. Z Gastroenterol 50:1302-1309.


Last updated on: 29.10.2020