When you eat something high in tyramine, a naturally occurring compound formed when proteins break down in aged, fermented, or spoiled foods. Also known as tyramine compound, it normally gets broken down by enzymes in your gut and liver. But if those enzymes are blocked—like when you're on certain antidepressants—it can build up fast and cause a sudden, dangerous spike in blood pressure.
This isn’t just about cheese or wine. monoamine oxidase inhibitors, a class of antidepressants that stop the enzyme that breaks down tyramine. Also known as MAOIs, they include drugs like phenelzine and tranylcypromine. If you’re taking one, even small amounts of tyramine can trigger a hypertensive crisis, a medical emergency where blood pressure rises so high it can cause stroke, heart attack, or organ damage. You don’t need to avoid all aged foods—but you do need to know which ones are risky.
Older cheeses like cheddar, parmesan, and blue cheese are top offenders. So are cured meats—salami, pepperoni, and pastrami. Fermented soy products like miso, tempeh, and soy sauce can pack a punch too. Even pickled herring, draft beer, and overripe bananas have been linked to reactions. And it’s not just what you eat—it’s how long it’s been sitting. Leftovers older than a day, especially meats and cheeses, can develop dangerous levels of tyramine. Store-bought processed foods are usually safe, but homemade or artisanal versions? Not always.
People on MAOIs aren’t the only ones at risk. Some migraine meds, decongestants, and even certain supplements can interfere with tyramine breakdown. If you’re on any prescription for depression, anxiety, or chronic pain, check with your doctor before adding new foods or supplements. A single bite of aged cheese might not hurt you—but if you’re on the wrong combo of meds, it could.
You don’t need to live on plain rice and boiled chicken. Many people on MAOIs manage fine by avoiding the top 5-10 high-risk items and sticking to fresh, unaged foods. Keep a food log if you’re unsure. Talk to your pharmacist about your meds. And if you ever feel a sudden headache, pounding heart, or blurred vision after eating—get help right away. Tyramine reactions are rare, but they’re serious. The good news? Once you know the triggers, you can enjoy most meals without fear.
Below, you’ll find real-world guides on how to avoid dangerous drug interactions, what to do if you’re on thyroid meds or blood thinners, and how to spot hidden risks in everyday supplements. These aren’t theoretical warnings—they’re lessons from people who’ve been there, and they can keep you safe.
