Tyramine

Tyramine (4-hydroxy-phenethylamine) is a monoamine compound derived from the amino acid tyrosine. It is a member of the phenethylamine family. It occurs widely in plants and animals and is metabolized by monoamine oxidase. If this process is compromised by the use of monoamine oxidase inhibitors (MAOIs) and foods high in tyramine are ingested, a hypertensive crisis can result. The first signs of this were discovered by a neurologist who noticed his wife, who at the time was on MAOI medication, had severe headaches when eating cheese. For this reason, the crisis is still called the "cheese syndrome", even though other foods, such as red winem nuts and salami can cause the same problem.

Tyramine is also a known trigger for migraine attacks, causing many sufferers of the disease to keep a diet low in the compound.

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Tyramine (figure 1) is a trace biogenic amine synthesized by the decarboxylation of the amino acid tyrosine during the fermentation or decay of food products. Foods containing considerable amounts of tyramine include fish, chocolate, alcoholic drinks, and fermented foods such as cheese, soy products, sauerkraut, and processed meat.2

A large dietary intake of tyramine can cause the tyramine pressor response which is defined as an increase in systolic blood pressure of 30 mmHg or more. The displacement of noradrenaline from neuronal storage vesicles by tyramine is thought to cause the vasoconstriction, and increased heart rate and blood pressure of the pressor response. The possibility that tyramine acts directly as a neurotransmitter comes from the discovery of a G protein-coupled receptor with high affinity for tyramine called TA1. The TA1 receptor is found in the brain as well as peripheral tissues including the kidney. A receptor with high affinity for tyramine supports the hypothesis that tyramine may also act directly to affect blood pressure regulation