MAO Inhibitor Foods

Monoamine oxidase inhibitors (MAOIs) are drugs that allow the enzyme tyramine to accumulate in your body, sometimes with unpleasant and even life-threatening results. Tyramine occurs widely in plants and animals and enters the body through what you eat and drink, so if you are taking an MAOI, you should adjust your diet to minimize its intake. These are basic guidelines; for a detailed list of dietary restrictions, consult a health care professional such as a physician or registered dietitian.

Foods to Avoid

• If you're avoiding tyramine, say no to aged cheeses.

  Many foods that are part of our normal menu are troublesome for those on MAOIs. Tyramine increases in foods as they age, so in general, avoid anything that is aged, fermented, dried, pickled or overripe (including leftovers that have been in the refrigerator for several days).

  High on many lists of foods to avoid are some American favorites. Among them are alcohol (including hard liquor and beer; even nonalcoholic beer is still fermented), sausages (including bologna, pepperoni and hot dogs), aged and blue cheeses (including Roquefort, Gorgonzola and brie), pickled herring, tofu (and anything else made from soybeans, including soy and teriyaki sauces), sauerkraut, raisins, caviar and even avocados.

  Some foods that are staples in other cuisines but relatively uncommon in the average American diet also fall into this category, including Korean kimchi, Japanese miso, Indonesian shrimp paste and meat or yeast extracts (Marmite and Bovril in the U.K. and Vegemite in Australia).

Foods in Moderation

• Drink wine in moderation if you're taking MAOIs.

  On a low-tyramine diet you can enjoy limited amounts of such treats as: any food or beverage containing caffeine, chocolate, sour cream, American cheese (up to 3 oz. per week), one to two 4-oz. glasses of red or white wine per day (except Chianti) and no more than two 12-oz. bottles of beer per day.

Foods to Enjoy

• What About Pizza?

  A tyramine-free diet consists mainly of fresh fruits and vegetables (omit avocados and papaya), fresh meat, poultry and fish (no liver), fresh cheeses (such as cream cheese, cottage cheese and ricotta), dairy products (milk and ice cream), starches (pasta, rice and cereals), dried peas and beans and peanut butter. When dining out, watch for ingredients in foods that are otherwise acceptable. These could be breads, crackers or casseroles made with aged cheese. That cheeseburger sounds innocent enough, but be sure to ask what kind of cheese is on it.

  Regarding one of America's favorite foods, The National Center for Biotechnology Information reports, via PubMed, that "pizzas from large chain commercial outlets are safe for consumption with MAOIs. However, caution must be exercised if ordering pizzas from smaller outlets or gourmet pizzas known to contain aged cheeses." The key to reducing tyramine in your diet seems to be to buy fresh, cook fresh and eat fresh.