Tyramine: What is it and why is it dangerous?

What is tyramine?

Tyramine is a biogenic amine that results from the breakdown of the amino acid tyrosine, a process that occurs mainly during fermentation or spoilage of foods. It occurs naturally in fermented products, aged cheeses, cold cuts, red wine and other foods. Normally, tyramine plays a role in the body as an indirect sympathomimetic; it is rapidly broken down by the enzyme monoamine oxidase (MAO). However, when this breakdown process is impeded - for example, by the use of MAO inhibitors - excessive tyramine intake can lead to a dangerous rise in blood pressure, known as "cheese syndrome".

MAO inhibitors and their impact

MAOIs are used in medicine to treat depression and other mental disorders. These drugs block the action of monoamine oxidase, preventing neurotransmitters and substances such as tyramine from breaking down rapidly. As a result, even relatively small amounts of tyramine can cause a strong physiological response. It is important to follow a tyramine-restricted diet when taking MAOIs to avoid hypertensive crises.

Ayahuasca and tyramine

Ayahuasca is a traditional plant medicine that has been used for centuries in shamanic ceremonies in South America. This drink contains natural MAOIs, usually in the form of harmala alkaloids, which cause psychoactive components such as DMT to act more effectively. Since the MAOI also interferes with the breakdown of tyramine, following a strict tyramine-restricted diet is highly recommended while preparing for an ayahuasca ceremony.

Psilohuasca and tyramine

In recent years, there has been interest in combining psilocybin-containing mushrooms with natural MAOIs, a combination sometimes referred to as psilohuasca. Although this approach is still in the experimental phase, again, the interaction between the MAOIs and tyramine can lead to potentially dangerous increases in blood pressure. It is therefore important, as with ayahuasca, to drastically limit tyramine intake during the preparation period.

Psiloflora and tyramine

The term psiloflora refers to the combination of psychedelic mushrooms with passion flower. Although the focus here is less on a deliberate combination with MAOIs, the natural variation in composition of plants and mushrooms in combination with other substances can still affect sensitivity to tyramine. For anyone considering participating in a psiloflora ceremony, we still recommend the diet low in tyramine to avoid unwanted side effects.

The tyramine-restricted diet

A low tyramine diet involves eschewing certain fermented and ripened foods for a while. This diet is recommended for people taking MAOIs and for participants in psychedelic sessions with substances like ayahuasca or psilohuasca. Choosing fresh, unprocessed food and avoiding highly fermented products reduces the risk of a blood pressure spike. Observing diet for several days before the session has a positive impact on the safety and quality of the experience.