What is the cheese effect with tyramine?
An acute attack of hypertension that can occur in a person taking a monoamine oxidase inhibitor (MAOI) drug who eats cheese, caused by an interaction of the MAOI with tyramine, formed in ripe cheese when bacteria provide an enzyme that reacts with the amino acid tyrosine in the cheese.
Does Mao metabolize tyramine?
Tyramine is physiologically metabolized by monoamine oxidases (primarily MAO-A), FMO3, PNMT, DBH, and CYP2D6. Human monoamine oxidase enzymes metabolize tyramine into 4-hydroxyphenylacetaldehyde.
What causes tyramine sensitivity?
Why You Should Avoid Tyramine The body relies on an enzyme known as monoamine oxidase to break tyramine down. Some people don’t have enough monoamine oxidase to process tyramine, resulting in high tyramine levels. Some medications also interfere with monoamine oxidase production, making tyramine consumption dangerous.
Why does tyramine cause hypertensive crisis?
In humans, if monoamine oxidase inhibitors (MAOI’s) and foods high in tyramine are ingested, tyramine is not degraded and a hypertensive crisis can result from tyramine displacing stored monoamines such as dopamine, norepinephrine, and epinephrine from synaptic vesicles.
What happens with MAOI and tyramine?
If you take an MAOI and you eat high-tyramine foods, tyramine can quickly reach dangerous levels. This can cause a serious spike in blood pressure and require emergency treatment. Avoid consuming foods that are high in tyramine if you take an MAOI.
How does MAOI cause hypertensive crisis?
Since MAOIs inhibit monoamine oxidase, they decrease the breakdown of tyramine from ingested food, thus increasing the level of tyramine in the body. Excessive tyramine can elevate blood pressure and cause a hypertensive crisis.
How does tyramine cause norepinephrine release?
Tyramine displaces norepinephrine from storage vesicles, possibly by alkalinizing them.
Why do you avoid tyramine with MAOI?
How do you reduce tyramine?
Ways to Lower Tyramine
- Choose fresh meats, poultry, or fish.
- Tyramine levels go up when foods are at room temperature.
- Eat fresh produce within 2 days.
- Don’t eat leftovers you’ve kept in the refrigerator for more than a day or two.
- Toss spoiled, moldy, or overripe foods.
What amino acid should be avoided while taking MAOIs?
MAOIs can cause dangerous interactions with certain foods and beverages. You’ll need to avoid foods containing high levels of tyramine ― an amino acid that regulates blood pressure ― such as aged cheeses, sauerkraut, cured meats, draft beer and fermented soy products (for example, soy sauce, miso and tofu).
How does tyramine affect norepinephrine?
Tyramine produces vasoconstriction via release of endogenous norepinephrine, the main neurotransmitter of the sympathetic nervous system mediating cardiovascular responses to stressors.
What can you not take with MAOI?
You’ll need to avoid foods containing high levels of tyramine ― an amino acid that regulates blood pressure ― such as aged cheeses, sauerkraut, cured meats, draft beer and fermented soy products (for example, soy sauce, miso and tofu). The interaction of tyramine with MAOIs can cause dangerously high blood pressure.
What happens if you eat high tyramine while taking MAOI?
If you take an MAOI and you eat high-tyramine foods, tyramine can quickly reach dangerous levels. This can cause a serious spike in blood pressure and require emergency treatment.
Which cheeses are high in tyramine?
Examples of foods high in tyramine include: Strong or aged cheeses, such as aged cheddar, Swiss and parmesan; blue cheeses such as Stilton and Gorgonzola; and Camembert. Cheeses made from pasteurized milk — such as American cheese, cottage cheese, ricotta, farmer cheese and cream cheese — are less likely to contain high levels of tyramine.
Do inhibitors of monoamine oxidase-A interact with dietary tyramine?
Monoamine oxidase inhibitors and the cheese effect The behavior of inhibitors of monoamine oxidase-A (MAO-A) is considered in terms of the possibility of having an effective antidepressant that does not give rise to hypertensive interactions with dietary tyramine.
What is the connection between tyramine and headaches?
The tyramine connection was discovered by a British pharmacist whose wife was taking an monoamine oxidase inhibitors (MAOI). He noticed that every time they had a meal with cheese, she would get a severe headache. Cheese, especially aged cheese, contains substantial amount of tyramine.