|
As reported in the
article,
New Discovery, some autonomic crises may be
preventable by avoiding certain dietary triggers, including a
compound called tyramine. FD patients may wish to access
the accumulated wisdom of other patient populations, most
notably, those who suffer from migraines, and those who take a
class of antidepressant drugs known as MAO inhibitors, or MAOIs.
People on MAOIs are always warned by their doctors to avoid
tyramine because it can cause hypertensive crises, which have
symptoms that are very familiar to the autonomic crises
experienced by those with FD: elevated blood pressure and heart
rate, excessive sweating, and vomiting. Similarly, some migraine
sufferers experience autonomic crises very similar to FD crises
(in addition to head pain and visual auras) when they eat
certain foods.
Internet-based
research using the search term “tyramine” can be very useful for
compiling a tyramine-free or low-tyramine diet. For the
convenience of our readers, we are publishing some dietary
guidelines here as well. Generally speaking, any food made of
protein contains the tyramine precursor, the amino acid
tyrosine. As tyrosine breaks down, tyramine levels increase, so
the longer a food is stored, the greater the possible quantity
of tyramine. Therefore, protein based foods should always be as
fresh as possible, and leftovers from those foods should not be
eaten.
The following foods
are known to contain high levels of tyramine and should be
avoided: ales and beers (including non-alcoholic), burgundy and
chianti wine (including non-alcoholic), sherry, and vermouth;
breads made with cheeses and meats or yeast extracts, high-yeast
breads; aged cheeses (the cheese closest to the rind has the
most tyramine); eggplant, red plums, banana peels and overripe
bananas, fava bean pods, Italian or broad green beans, kim chee
(fermented cabbage), lentils, lima beans, sauerkraut, overripe
fruit; aged, dried, or cured meats, dried or pickled fish, meat
jerky, leftover meats, liver, meat extracts, salami or dry
sausage, salted, smoked, pickled, or canned meat or fish, shrimp
paste; meat tenderizers; brewer’s yeast, broth with yeast,
commercial gravies, unpasteurized milk products, crackers made
with cheese, homemade yeast breads, marmite, vegemite, and other
yeast spreads, miso (fermented soybean paste), soy and teriyaki
sauces, yeast extracts, and tofu if more than a few days old.
Monosodium glutamate (MSG) can cause a tyramine-like reaction so
should also be avoided. Many prepared foods, such as canned
soups, contain yeast products or MSG, so labels should be read
carefully.
The following foods
should be eaten with caution and moderation; negative reactions
should be carefully watched for: bouillon; distilled liquor,
some wines; commercial breads without or low in yeast and
sourdough bread, yogurt, avocados (not overly ripe), Chinese pea
pods, raspberries, papaya, passion fruit, spinach, tomatoes,
dried fruits, citrus and pineapple; peanuts and other nuts and
seeds; and chocolate products.
Tyramine content can
vary depending on processing method, age, and amount of
fermentation, ripeness, or contamination. For example, game
meats are often aged before they are cooked, making them unsafe.
Foods that typically have small amounts of tyramine can become
foods with high levels as they are stored over time.
Protein-based foods that are stored should be viewed with
suspicion, including luncheon or deli meats, protein extracts
used in dietary supplements, gelatin, and some condiments and
seasonings. |
