Could Leftovers for Lunch or a Slice of Sourdough Lead to Migraine Episodes? 

If pickled and fermented foods, or even leftovers, sometimes trigger migraine attacks for you, tyramine could be to blame. Read on to find out what tyramine is, and how to avoid it.

Tyramine is an organic compound that’s naturally present in plants, animals, and humans. Tyramine is also in certain foods, and levels typically increase in aged foods.

Ongoing research indicates that tyramine may be connected to migraine, meaning eating foods high in tyramine could trigger attacks.

Let’s take a look at what tyramine is, what produces tyramine, and why tyramine triggers migraine attacks. Plus, we’ll cover which foods high in tyramine you may want to avoid, alongside alternatives to replace these foods in your diet.

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What is tyramine?

Tyramine is a type of organic compound called a biogenic amine.

Tyramine is produced when enzymes break down tyrosine (an amino acid, another type of organic compound).

This process happens in:

• foods containing tyramine or tyrosine, as they ripen and age
• your body, as you digest these foods

The amount of tyramine in a given type of food partly depends on the amino acids, biogenic amines, and enzymes that are also in that food (since all work together to produce tyramine), plus how old that food is.

The amount of tyramine present in your body partly depends on what you eat, as well as how your body’s enzymes break down amino acids and biogenic amines.

What’s the connection between tyramine and migraine?

As the medical community continues to explore what causes migraine, one area of study centers around the foods we eat, and the amino acids and biogenic amines they contain.

This includes tyramine. Foods high in tyramine are known to trigger migraine attacks.

Research into why this happens is ongoing, and theories exist related to enzymes and the sympathetic nervous system.

Tyramine, enzymes, and migraine

Some research indicates that people with migraine may have low levels of the enzymes responsible for metabolizing certain amino acids and biogenic amines during digestion. Including the enzymes that metabolize tyrosine and tyramine.

When you eat foods high in tyramine, and your body has trouble breaking down the compound, levels become high. The resulting tyramine buildup may trigger migraine attacks.

The authors of this 2023 study suggest that tyramine is a contributing factor for migraine headaches and pain sensitivity.

Tyramine, the SNS, and migraine

Why do elevated tyramine levels in the body trigger migraine attacks? The reason may be connected to the sympathetic nervous system (SNS), the part of the nervous system that regulates body processes related to “fight-or-flight” mode.

Abnormal activity in the SNS is thought to be linked to migraine, and tyramine has effects on the SNS.

Tyramine may indirectly activate certain SNS responses that may trigger migraine, like an increase in heart rate or blood pressure. For example, excess amounts of tyramine can raise blood pressure, and elevated blood pressure may be related to migraine attacks.

Foods high in tyramine

It appears likely that eating foods high in tyramine can trigger migraine attacks for some, although research into the “why” is ongoing.

Avoiding these foods may help you lower the risk of an attack.

Remember to consult with your doctor, migraine specialist, or nutrition expert if you decide to go tyramine-free. That way, you can ensure that your migraine-supportive diet still gives you the nutrients you need to fuel your body.

Here are some foods that are high in tyramine, plus alternatives to replace them in your diet.

Aged cheeses

Aged, fermented cheeses tend to have high levels of tyramine. Generally speaking, the more pungent the smell, the more fermented the cheese — and the higher the tyramine.

Cheeses you may want to avoid include:

• feta
• cheddar
• Parmesan
• Roquefort
• Gruyere

Not all cheeses are equal in tyramine. Unripened and unaged cheeses are less mature, so they often contain lower levels of tyramine.

If you want to keep some cheese in your life, try seeing how your body reacts to fresh cheeses like:

• ricotta
• cottage cheese
• cream cheese
• mozzarella
• farmer cheese

Fermented dairy

Fermented dairy products also tend to be high in tyramine.

You may be better off skipping products like:

• buttermilk
• sour cream
• yogurt
• frozen yogurt
• kefir

For alternatives, try coconut milk-based products, like coconut milk yogurt.

Not all dairy contains tyramine, though. Milk, for example, has low levels, meaning it’s OK to consume (although some people find that dairy triggers migraine).

Aged, processed, or ground meats

Tyramine levels tend to increase as meat is aged, whether dried, smoked, or salted. Processed or ground meats may also contain more tyramine.

High-tyramine meat products to avoid include:

• pepperoni
• salami
• liver
• sausages
• hot dogs
• prosciutto

Meat that’s fresh, however, often has lower levels of tyramine. Try freshly bought and prepared:

• pork
• beef
• chicken
• duck

Cured fish

Whether pickled, salted, or smoked, it’s best to avoid fish prepared with any kind of curing process.

Tyramine levels are generally higher in:

• pickled herring
• sardines
• pickled cod

Fresh fish is usually a better option tyramine-wise, such as fresh:

• tuna
• salmon

Yeast-leavened breads

Breads made using yeast can contain high levels of tyramine, including:

• sourdough bread
• rye bread
• barley bread

To avoid yeast in bread, try:

• Irish soda bread
• flatbread

Fermented soy products

Fermented soy products may contain high levels of tyramine, including:

• soybean paste
• soy sauce
• miso
• fermented tofu, like “stinky tofu”
• tempeh

To replace the depth of flavor that fermented soy provides, you can try using freshly cooked mushrooms.

Pickled vegetables

Vegetables that have been pickled or fermented have elevated tyramine levels.

You may want to stick with fresh vegetables, and skip options like:

• pickles
• pickled onions
• kimchi
• sauerkraut

For a similar kick of pickle-like flavor, you can try adding acid in moderation, like small amounts of white vinegar.

Dried or overripe fruits

Dried fruits often contain high levels of tyramine, partly due to the drying and aging process. Ditto for fruits eaten when very ripe or overripe, since these accumulate tyramine as they ripen.

Try to avoid dried versions of any fruit, like dates or raisins.

Plus, skip overripe fruits, like:

• bananas
• avocados
• papayas
• figs

Opt instead for fresh or frozen fruit, including:

• apples
• peaches
• cherries
• kiwis

Caffeine

Caffeinated beverages may have elevated tyramine levels, and are best avoided or consumed in moderation.

This includes:

• coffee
• caffeinated teas
• energy drinks
• most sodas

For alternatives, try:

• decaf coffee
• herbal teas
• club soda
• fruit juices
• caffeine-free sodas, like ginger ale

You may also want to avoid alcohol, in particular fermented beverages like wine and beer, which may be higher in tyramine.

Leftovers

Tyramine forms naturally as food sits around. That means that eating food that’s been in the fridge for too long may trigger migraine attacks — even when, for other people, those leftovers are still safe to eat.

You may be better off eating food as soon as possible or within 1 to 2 days of cooking.

But that doesn’t mean that leftovers and batch cooking aren’t possible for you at all. To make dishes last longer, try freezing leftovers instead of putting them in the fridge. Freezing slows the production of biogenic amines, meaning frozen leftovers have low tyramine.

How to manage your tyramine intake

To help manage your tyramine intake, aim to:

• Avoid fermented, pickled, and aged foods of any kind, since tyramine increases with time.
• Cook with fresh ingredients, prepared soon after purchasing.
• Freeze meat, fish, or poultry that you don’t eat quickly (then thaw in the fridge, not at room temperature).
• Store prepared food carefully in airtight containers in the fridge, and eat it within a few days.
• Use caution when eating out, since you don’t know how food has been stored.

Monitoring your tyramine intake is particularly important if you take an MAOI (monoamine oxidase inhibitor), like certain antidepressants. MAOIs block the enzymes that break down tyrosine and tyramine. This can lead to high tyramine levels in the body, and can make migraine attacks more likely.

Takeaway

Tyramine is an organic compound naturally present in the body and in certain foods.

High tyramine levels appear to cause migraine attacks. This could be related to differences in the enzymes that metabolize tyramine and to tyramine-triggered responses in the sympathetic nervous system.

Avoiding foods high in tyramine may help keep tyramine levels in your body low, which may reduce the risk of migraine attacks. Steer clear of any pickled, fermented, or aged foods, in particular.

Talk with your doctor if you’re interested in eliminating tyramine from your diet so you can ensure you’re still getting a good balance of nutrients.