Tyramine: What Is It and Why Is It Dangerous?

What is tyramine?

Tyramine is a biogenic amine formed from the breakdown of the amino acid tyrosine, a process that primarily occurs during fermentation or spoilage of foods. It occurs naturally in fermented products, aged cheeses, cured meats, red wine, and other foods. Normally, tyramine acts as an indirect sympathomimetic in the body; it is rapidly broken down by the enzyme monoamine oxidase (MAO). However, when this breakdown process is hampered—for example, by the use of MAOIs—excessive tyramine intake can lead to a dangerous increase in blood pressure, known as "cheese syndrome.".

MAO inhibitors and their influence

MAOIs are used in medicine to treat depression and other mental disorders. These drugs block the action of monoamine oxidase, preventing the rapid breakdown of neurotransmitters and substances like tyramine. As a result, even relatively small amounts of tyramine can trigger a strong physiological reaction. It is important to follow a tyramine-restricted diet when using MAOIs to prevent hypertensive crises.

Ayahuasca and tyramine

Ayahuasca Ayahuasca is a traditional plant medicine used for centuries in shamanic ceremonies in South America. This drink contains natural MAO inhibitors, usually in the form of harmala alkaloids, which ensure that the psychoactive components such as DMT are more effective. Because the MAO inhibitory effect also hinders the breakdown of tyramine, following a strict tyramine-restricted diet is strongly recommended when preparing for an ayahuasca ceremony.

Psilohuasca and tyramine

In recent years, there has been a growing interest in combining psilocybin-containing mushrooms with natural MAO inhibitors, a combination sometimes referred to as psilohuasca. Although this approach is still experimental, the interaction between MAOIs and tyramine can also lead to potentially dangerous increases in blood pressure. Therefore, as with ayahuasca, it is important 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. While the focus here is less on an intentional combination with MAOIs, the natural variation in the composition of plants and mushrooms, when combined with other substances, can still affect sensitivity to tyramine. For anyone considering participating in a psiloflora ceremony, we still recommend a low-tyramine diet to avoid unwanted side effects.

The tyramine-restricted diet

A low-tyramine diet involves temporarily avoiding certain fermented and aged foods. This diet is recommended for people taking MAOIs and for participants in psychedelic sessions involving substances like ayahuasca or psilohuasca. Choosing fresh, unprocessed foods and avoiding highly fermented products reduces the risk of a blood pressure spike. Adhering to this diet for a few days before the session positively impacts the safety and quality of the experience.