Migraine

I am interested in Tyramine as a possible trigger. Could someone link me to some information. I understand that it's not a listed ingredient but included when a high protein food break downs.

I often eat leftovers for lunch but realize now that Sat nights chicken on my salad monday for lunch might be a trigger.

any help would be appreciated.

lisa

I had to avoid tyramines when I was on Nardil in the late '90s. I'll try to list some of them. I googled "nardil and tyramines" and got some good information.

Alcohol, including red wine sauces and non-alcoholic beer

Cured meats -- cold cuts, ham, smoked meats

Chargrilled meats

Organ meats -- liver, kidneys

Fava beans -- "broad" beans. I never knew what that meant

Anything soy, including edamame and soy sauce. Or soy extract.

Yeast extract, fresh out-of-the-oven bread.

Sourdough bread

Meat extract, autolyzed yeast extract, MSG

I found one prepared frozen entree that was safe. I think it was a vegetable spaghetti, prima vera or something like that.

Cheese. I was a real pain in the rear when we went out to an Italian restaurant, but I was able to negotiate something safe to eat.

That's not a complete list. Your doctor may have a better one, and you might find more if you surf the net. The no-tyramine diet is a real challenge, but it's do-able. I took Nardil for 2 1/2 years and never had a tyramine reaction.

Good luck!

Gretchen in Mississippi

Gretchen,

I apologize - this is a bit off topic but has to do with Nardil. I started it up about two months ago. I'm now up to four a day, and it's going pretty well (given the side effect profile of this drug, which I'm sure you're quite familiar with).

Did you have trouble with insomnia? And if so, did it get better eventually?

I take my last dose of the day at noon (per dr's orders), and I get incredibly sleepy from about 3-5 (have to keep getting up and moving in order not to actually fall asleep).

Then I have a restless night beginning at about 2 a.m. (sometimes have to get out of bed) and wake up way earlier than I used to.

I'm putting up with it right now because I'm committed to this new plan, which will eventually involve one more increase, and then some slow decreases on some of my old meds, and I really want to see this out because the plan makes sense --- but I've never had insomnia in my life before and it is driving me nuts sometimes.

I even got up at 2:00 a.m. the other night and did yoga until I felt sleepy again (one hour later). I thought, "Geez, if someone looks through my blinds they are going to think I'm crazy", but I felt restless and moving was the only cure.

Sorry to go on and on, but you're one of the only folks I've heard talk about Nardil, and I'm just trying to get a sense of other people's experiences.

Lynne

Lisa,

(Sorry I got off-topic with Gretchen).

I'm following the low-tyramine diet for Nardil. Gretchen's right - it takes some discipline and reading but it is quite do-able.

It turns out that a lot of the tyramine issues have to do with how meat ages. You can read about this or talk with your doctor to check it out, but this is what I learned in diet class.

Basically, if you buy fresh meat, cook it right away, and then eat or freeze it right away, there is very little tyramine content. That's what I am working on right now in my kitchen. No more saving grilled chicken breasts for three days, then making them into pasta sauce! Mostly there's a 48 hour rule, but I prefer to just eat then freeze so I don't have to worry about it.

Meat that other people have cooked (like deli meat) is the big problem. You don't know how long it's been sitting there and aging. I was told I could have a certain amount per meal and be safe with Nardil, but if you're trying to avoid it as a trigger, best talk with your doctor about how to handle deli meat and cheese. But don't worry about the fresh stuff.

The good thing is that non-aged cheese is fine, and that includes mozzarella! If you can be sure there's nothing else mixed in. Cottage cheese, cream cheese, yogurt - it's all fresh and has basically no tyramine as long as you check the expiration date.

I didn't get warned about grilled meats and I've been eating them quite safely, so I don't know what the deal is with that. You can check it out.

So far, buffets, potlucks, and restaurants are the hardest places, but like Gretchen said, as long as you make yourself kind of a pain in the neck at the restaurant and insist on knowing everything about your dish, you can find something to eat. I've never gone hungry yet. I bring my own food to potlucks, though.

The nice thing is that the low-tyramine diet sort of points you toward veggies and fruit and good stuff like that, and fresh meat and low-fat dairy, so even if your intent is not necessarily to eat better, you end up doing it anyway!

Investigate! I am suspicious of your chicken salad also.

Lynne

When you go into a restaurant, remember that regardless of what you choose to eat, you are a paying customer. The restaurant has an interest in having you as a satisfied customer who will return, and will recommend their establishment to others. So don't hesitate to ask for something "special," as long as you do it in a courteous and respectful tone.

thank you for the help and I will keep asking and keep searching.

What do you think about hard boiled eggs? probably 48 hrs with them too?

lisa

Lisa, there's a mention of tyramine as a trigger, as well as a list of foods it can be found in, in Elaine Magee's Tell Me What to Eat If I Have Headaches and Migraines. I wouldn't necessarily buy this book just for this list, but if you can find it in a local library it's worth checking out. Amazon.com link is HERE.

I will also caution you that some of the information she provides in there is a little outdated, but her lists of problem foods may be very helpful for you.

Lynne --

I went off the Nardil in 2000. It did a good job for 2 years. At some point, I added Ambien to my mix, so I guess I was having insomnia problems. I'm still taking the Ambien.

How is the Nardil doing for you? We added Zyprexa after a year or so. On that combination, I gained a LOT of weight. I'm slowly losing it. I'm shopping in the Misses department again!

Gretchen in Mississippi

Hi Lisa,

Here is a link to the National Headache Foundation's topic sheet on Low Tyramine Diet. It has a list of foods.

According to this link,

quote:

Tyramine is produced in foods from the natural breakdown of the amino acid tyrosine. Tyramine is not added to foods. Tyramine levels increase in foods when they are aged, fermented, stored for long periods of time, or are not fresh.

Here is another topic sheet from the National Headache Foundation on Tyramine.

Hope this helps!

Kelly

Hi


Tyramine is one trigger for some folks. Have you seen our Migraine Triggers page? You can find great information on trigger identification, management and a Migraine diary HER.

Let us know how you are making out ok?

Gretchen,

Re: the Nardil. You know, I think it's starting to help. It's still early days - I had a dosage increase three weeks ago and since then it seems like my daily head pain and nausea is coming down.

The weight thing is sort of weird. When I went into the hospital I was my pregnancy weight, presumably because of the Neurontin but who knows. After fooling around with all those meds, I came back home and promply lost about 15 lbs. It just melted off - and I was eating the exact same as I had been before.

Now I've gained 10 lbs back since the last Nardil increase. I have to assume all this is med-related, and hopefully when we go lower on the Neurontin some of the weight will drop off again, but it's very strange to see the poundage change so fast even when my eating is the same.

I'm still having insomnia with the Nardil, but at least I'm not getting out of bed in the middle of the night anymore. I've got to start getting myself to bed earlier, even if I don't feel sleepy. I think that might help. I hate to add a sleep aid on top of all this other stuff!

Lynne

thank you for the tyramine info and links. still keeping track and trying to find if there is a connection. two migraines this week without any of my left over dinner meats. keep on keepin on...