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The NHF’s “Low Tyramine Headache Diet”

The NHF’s “Low Tyramine Headache Diet”

Tyramine rich foods

The National Headache Foundation’s (“NHF”) low tyramine diet helps migraine sufferers identify and avoid diets containing large amounts of the biogenic amine tyramine.  This list is a good starting point to identify certain foods with high tyramine content. Our approach should be to avoid only those trigger foods that cause migraines, while consuming the ones that do not. Now, this is easier said than done.

The low-tyramine diet

Tyramine occurs as a result of the food’s aging process. Migraine sufferers, in general, can have problems dealing with biogenic amines.  The result is that, as migraine sufferers, we have to simply limit or avoid those foods that are high in tyramine. This is often not an easy task. Therefore, the work that the NHF has done is both beneficial and vital for those suffering from migraines. Since we as individuals have vastly different tolerance levels, many items on this list that say “allowed” might not be tolerated at all. Likewise, some food items listed under “use with caution” might be perfectly fine to consume. That is why the list only serves to begin the discovery process for your individual triggers.

Low-tyramine diet highlights

Some of the highlights are included below, with a link to the document.


ALLOWED

  • Milk
  • American Cheese
  • Coffee Cakes
  • Onions Cooked in Foods
  • White Vinegar

USE WITH CAUTION

  • Sausage
  • Corned Beef
  • Bologna
  • Any Meats with Nitrates or Nitrites
  • Sour Cream
  • Parmesan
  • Raw Onion
  • Avocados
  • Banana
  • Papaya
  • All Soups with Hydrolyzed Yeast, Meat Extracts, or MSG
  • Coffee & Tea
  • Scotch
  • All Chocolate Based Products
  • Apple and Other Fermented Vinegars

Odds and ends

Dairy can be difficult to consume for many suffering from migraines. Therefore, it may make sense to avoid most dairy at least initially. Items that have generally been sitting out at the store are likewise not recommended. Coffee and tea have a mixed track record. For some, caffeine can actually help with migraines. As a general rule, the longer the fruit takes to ripen, the likelier that it can act as a migraine trigger. Therefore, it is not surprising to find bananas and papaya on the list. But, I would also add watermelon and mangos to the list of fruits to avoid.

Try a diet with lower tyramine in order to lessen migraines.

References:
1. www.headaches.org/pdf/Diet.pdf – “Low Tyramine Headache Diet*”

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  • This diet has been invaluable to my son. I don’t know if it stops headache triggers, but it radically decreases the ‘fog’ he had all the time around his migraines. After a year, I can tell if he’s cheated just by how he acts. It combines well with a low tyramine diet.

  • For so many years i tried to figure out my triggers, food journal,,but i’m not able to pin point, when i have good days, i will have have the same food, headache will come back, i,cannot find a pattern,,it’s like so many things triggers, can you give me a detailed list of what your triggers are, i eat very healthy, but i know there are some healthy food that are triggers
    Thanks again

    • Hi Annie,

      It can be very frustrating to find your particular triggers but don’t give up.

      Just because you eat healthy does not necessarily mean that you are avoiding your triggers. Avocado and onion are very healthy foods, but in my case I cannot eat them. Cayenne pepper is supposed to help with migraines and is otherwise very good for you, but again, in my case it is a trigger.

      As I have written in “The Cause of Migraines”, thresholds really do matter. If your migraine threshold is low, you are likely to experience heavier episodes until the threshold returns. It will take time for it to return to normal and during this time, you will experience more frequent migraines.

      In order to get a better sense for your particular situation, can you answer the following questions.

      – How are you compiling your food journal? How much detail? (including oils, spices, sugars, etc.)
      – What is the general duration between episodes (24hrs, 48hrs, or more)
      – How many times per week do you experience migraine episodes?
      – How long does an episode last?
      – What is your exercise regimen like?
      – Do you use any medications for your episodes?
      – Do you get tired a few hours before an episode sets in?

      Thanks,

      LWM

      • Thanks
        I write everything, but now i try to be really precise, like spices and oil, i’m very active, i have horses
        It’s been 12 years that i suffer from chronic headaches, that means everyday, sometimes the pain on a scale is 3 /4 which i consider a good day, sometimes it’s a 10 which happens less, i take advil liquid gel, usually it helps , but when it’s a 10 , nothing works,

        I know when you talk about the theshold, that’s why,it’s so hard to figure out my triggers,me too i think onion and avocado are a trigger,spinach also, it seems all my triggers are healthy, fresh cilantro i,think, when i have good days, i look at everything i ate, try to find a pattern, but with no luck

        • Do you drink coffee or tea regularly? If you do, I would suggest eliminating either of these from your diet.
          If you consume dairy products, I would suggest eliminating all dairy immediately.

          Avocado is very high in tyramine which is why you cannot consume those without getting migraines.

          Have you found any safe foods at all?

          The following are my safe foods. However, just because they are in my case does not mean that they will be for you:

          – Vegetables: celery, tomato, cucumber, parsley, romaine lettuce, spinach, potato (really a starch), corn, string beans, zucchini, broccoli, carrots, asparagus

          – Meat/fowl: beef (not ground), pork (not ground), chicken, duck, turkey (not ground),eggs (I tend to get migraines from lamb because the meat is too greasy too much grease acts as a trigger)
          * I never buy ground meat, pork, or turkey because they act as severe triggers due to additives. If you want ground products, have it ground from fresh products in front of you.
          * If you barbeque any of these, you cannot add olive oil, any type of off the shelf dry rub, or off the shelf barbeque sauce. In almost all cases these contain a variety of ingredients that you must stay away from.

          – Seafood: salmon, swordfish, white fish, fresh tuna, sole (Avoid: craw fish, mussels, oysters). All seafood should preferably be cooked/steamed/grilled/pan seared, again without olive oil.

          – Fruits (fresh!): grapes, strawberries, blueberries, raspberries, apples, peaches, nectarines, pears. Avoid: grapefruit, oranges, tangerines, water melon, cantaloupe, figs, bananas, pineapple.

          Desserts are tricky and in my case they consist of fresh fruit. You should stay away from refined sugars and if you must, use only brown sugar and use it sparingly. Avoid all chocolates and products that contain cocoa or dairy if at all possible.

          In rare cases, I still get the migraines. What helps me immensely is a 30-45 minute exercise routine daily.

          Hope this helps.

          • Thankfully coffee is not a trigger, however tea is, dairy, i can drink milk, cheese that depends, i know cottage and other are triggers, chocolate seems to be ok, i,think sometimes it depends on the kind, a lot of time it depends of my threshold, or it is spices, something i eat often and not aware, or a combination of many things, i tried dairy, gluten free, not better, You talked about olive oil, is it the only one, ah and noticed also, pickles, olive, everything in brine? Ground meat, is it the same if it’s organic
            Thanks so much for all your help

          • If tea is a trigger, then it is likely the caffeine. Therefore, you should try eliminating coffee from your diet to see how your body reacts. I would eliminate both caffeine and dairy from my diet for at least one month. Anything pickled can be problematic and I avoid both olives and pickles. Anything in brine should be avoided. For me it does not matter whether something is organic or not if it is a food I should avoid.

            What I would really recommend is to start with a clean slate. Just consume rice with cucumber and light salt for a few days and try to establish a baseline. Then try to include other foods slowly over time and see if you have an episode. For instance, add boiled chicken. If you do not experience migraines, cook the chicken together with just olive oil in a pan to see how you react.

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