Tyramine Intolerance: A Hidden Cause of Migraines and Blood Pressure Fluctuations

While harmless to most, tyramine can trigger disruptive symptoms in sensitive people. Learn how to detect and manage tyramine sensitivity.

At 45, Zoe thought she knew her body—until she was blindsided by sudden episodes of a racing heart and overwhelming anxiety, which she initially blamed on work stress. She'd only eaten a slice of pepperoni pizza and a ripe banana earlier that day. However, when a pounding headache struck just hours after her usual comforting dinner of cheesy pasta and a glass of red wine, she began to suspect a food connection—especially as the symptoms returned after repeating the same meal the next night.

Zoe went searching for answers in the nutrition world. She discovered she was reacting to high levels of tyramine, a natural compound found in aged cheeses like parmesan, cured meats, and red wine. The compound had built up in her system and triggered these unsettling reactions.

Tyramine sensitivity occurs when the body cannot properly break down tyramine due to low levels of the enzyme monoamine oxidase-A (MAO-A). This enzyme deficiency can trigger symptoms like blood pressure spikes, heart palpitations, nausea, migraines, and anxiety. Low levels of MAO-A can be caused by genetics or medications. Chronic migraines are also common. Symptoms typically appear 1 to 12 hours after eating high-tyramine foods, but can also occur delayed, 1 -3 days later.

The Tyramine frequency is in the Allergens panel of the imaet software and may be picked up potentially at the top of a BioScan result or instantly in the 'Test Single Item' function as a numerical value. Values above 60 can be interpreted as a tolerance issue. 99 or 100 TSI value would be a severe intolerance or an actual allergy.

Your Body’s Tyramine

Defense System

The enzyme MAO-A breaks down neurotransmitters or brain chemicals like serotonin, dopamine, and norepinephrine, along with food compounds called amines such as tyramine. All neurotransmitters require balance, with accumulation leading to neurological disease.

The MAO-A gene governs the speed of activity of the enzyme MAO-A. Gene variations affect tyramine breakdown, which correlates with higher tyramine sensitivity along with poorer antidepressant responses in some people.

Chronic stress worsens this problem by increasing norepinephrine levels, which can overwhelm already reduced MAO-A activity and intensify symptoms like hypertension and mood swings.

The Biofield panel features the MAO-A gene frequency for epigenetic assessment of it's function and bioenergetic feedback applications to improve function.

Tyramine sensitivity can result in the following conditions.

1. Migraines

Tyramine-induced surges in norepinephrine constrict blood vessels, activating pain pathways. This effect is delayed, often striking hours after eating, which complicates diagnosis.

2. Anxiety and Mood Swings

Excess norepinephrine disrupts emotional regulation. In one study, gene variants were linked to baseline anxiety severity in psychiatric patients, highlighting MAO-A’s role in mental health.

3. Hypertensive Crises

For those on MAO inhibitors—a form of anti-depressant medication that prevents the breakdown of certain neurotransmitters—tyramine-rich foods can cause dangerous blood pressure spikes. This phenomenon was first noted as the “cheese reaction” in the 1960s. Even small amounts of cheese (6 to 10 milligrams) may trigger symptoms in sensitive people. Of note, cheddar cheese has about 42 milligrams per 1-ounce serving.

Part of this post was adapted from a Sheridan Genrich, NP post at Epoch Health