Tyramine

[Steviemarram]

Hi, quite new to this forum and this is my first post.

Recently diagnosed with Afib, 58 year old man, otherwise healthy. I have different types of episodes. Some seem to be just ectopics - sporadic skipped beats; some I guess Afib since lasting longer with a "bird in the chest/stomach " sensation and irregular pulse; and on a few occasions extremely fast but regular pulse.

Not taking any meds pending seeing an arrhythmia specialist cardiologist next month.

My question to the forum is on two episodes which were super fast but seemingly regular pulse. Both these episodes followed shortly after meals that likely contained Tyramine. My heart rate slowed after about two hours, and was normal soon after. On the second occasion I was on holiday and able to quickly get support from paramedics which most likely calmed my anxiety, so I think there was a psychological element too.

My question is: does anyone have any knowledge or experience of Tyramine triggering a super- fast heart rate or other episode?

Many thanks in advance for any responses

Steve

[JayDJ]

Not Afib but headaches.

Reading up on it and symptoms of "Tyramine" sensitivity covers; "Increased blood pressure, increased heart rate, severe headaches/migraine headaches" + a lot of other stuff. It seems to affect some and those that it does affect it can affect them in different ways.

[Steviemarram in reply to JayDJ]

Many thanks JayDJ

[UK_5010]

Before an ablation, I suspected tyramine was able to trigger AF in me. Mature cheese and steaks would usually trigger an episode so, much as I enjoyed them, had to be avoided. Anything with a lot of MSG was also a no-no. Certain bottled beers and some red wines could also bring on AF. Any leftovers which had been left out for a day seemed to be guilty as I believe tyramine builds up in them. After the ablation I'm carefully experimenting but don't want to tempt fate too much! Good luck.

[Steviemarram in reply to UK_5010]

Many thanks - that's made a few connections and helps with my list of no go foods. I'm pretty much avoiding red meat now as well as any meat or poultry that's not freshly cooked. Useful too that some bottled beer and some wine - ie not all, though I've hugely reduced my alcohol intake. Thanks again

[UK_5010 in reply to Steviemarram]

The beer was a strange one - Thornbridge bottled beers seemed to be a trigger and bottle conditioned ales were also fatal! Some others seemed ok including real ale from a hand pump although not all. Did switch to decaffeinated drinks but not 100% convinced they were a problem...so long as you don't overdo it. Covid, and possibly some reaction to counter measures, seemed to make the AF occur more frequently but, fortunately, since the ablation it has been absent - just a few ectopics now and again. Hope you get to the bottom of it all.

[Steviemarram in reply to UK_5010]

Thanks - some weeks ago I had an episode after drinking a moderate amount of beer in a real ale micro pub. as it wasn't much I was a bit surprised so you've thrown some light on it.

[Espeegee in reply to Steviemarram]

I'm sure red wine was one of my triggers, my AF, not all but just random. There is something called Vagal AF triggered by eating. All my AF episodes have occurred at the end of my evening meal and wine seems to be a trigger. Not white, just red. I'm really careful and mostly drink water. I've not heard of tyramine so found yours and the other posts interesting I had supraventricular ectopics for a very long time too I invested in a Kardia which helps to tell you what is happening with your heart rhythm when you can feel it's gone awry The Kardia is inexpensive and I found it reassuring on the many occasions my heart started dancing about

[Steviemarram in reply to Espeegee]

Thanks. I came across Tyramine on a US med site, Cleveland Clinic, which I've found very clear and useful. Link here: my.clevelandclinic.org/heal....

My heart reactions to certain foods seemed crazy until this which offers a very plausible explanation. The latest episode was from a seemingly innocent chicken sandwich but one of my friends said spontaneously that the chicken looked like it was out of a can, which would likely mean it had a high level of tyramine. Hence my original post and all the very helpful responses.

(Btw, if I'd thought it was going to be canned chicken, I wouldn't have bought it)

I think the vagal nerve is playing a part for me, thanks for mentioning it, as food seems to be a common theme for my ectopics and/or AF. So I'm trying to figure out the problem foods and it seems pretty much anything processed causes some adverse reaction.

Like you I've cut back dramatically on alcohol which actually isn't such a bad thing in any case.

Thanks again for your comments.

[AustinElliot]

Hi Stevie,

I put a ton of Parmesan on my spaghetti (or as the joke goes I have Spaghetti with my Parmesan) I am pretty definitive that I have had 3 episodes of AF after a meal of Parmesan.

I am not sure if its the salt or the Tyramine in the Parmesan. It has 3x the salt of other cheeses. Anyway I am experimenting with no Parmesan, vs some other aged cheeses like Cheddar, and then may add a splash of Parmesan (like most muggles) to see if anything raises my HR.

No other food sensitivity that I know of.

Good fortune figuring this out. Regards

[Belle11]

I had eaten sausages about 15 hours before I went into sudden rapid AF in Spring 2019 (though I also suspected steroid knee injections the previous day as a possible trigger). I then had a cardioversion in Jan 2020, which put me back into normal rhythm . I soon noticed though, that each time I ate bacon, ham - even Parma ham with no nitrites added, or sausages - I got ectopics, so I cut these foods out. I did wonder if tyramine might be to blame. There's a medical case history of someone whose AF was triggered by tyramine containing foods in the BMJ, and this US cardiologist lists it as a possible trigger drafib.com/blog/foods-to-av...

Having cut these foods out, I stayed in AF for over 3 1/2 years - don't know if that was one of the things that helped to keep me in rhythm for so log .....

[Steviemarram in reply to Belle11]

Hi Belle, many thanks. Your experience seems similar and has made more sense of my situation. It seems heavily processed meats are a real problem and I now remember some other occasions when poor quality restaurant meat may have led to ectopics and AF. Very helpful, thanks

[Belle11 in reply to Steviemarram]

Glad if it helps. Sometimes sharing our experiences here comes up with perspectives that not many medics seem to have on their radar.

[Steviemarram in reply to Belle11]

Absolutely!

[Cabot]

Hi Steve,

Well, the good news is that if you do have a tyramine trigger eventually you may be able to lessen its effect over time.

Partly that means looking for what you might be ingesting that might block your ability to make the enzyme that breaks down tyramine -- MAO inhibitors like tumeric, coffee, chocolate, blueberries, etc. Apparently iron helps the gut to manufacture the enzyme needed.

I had tyramine triggers and cut out most foods that were medium or high in tyramine because I didn't want my heart to learn to go into afib. Then I used the iron fish as a source of iron. And a year later I am pretty much back to normal in terms of diet, although I avoid super high sources like the sausages and ham and cheese some of the other forum writers mentioned.

Haven't had afib in 6 months, although of course that could change. I did do other heart-supportive things like all kinds of vagus nerve soothers, grounding, etc. But for me tyramine was a big deal.

I hope you figure out your unique afib situation and I wish you the best!

[Steviemarram]

Hi Cabot, thanks for this and for the positive outlook. I hadn't considered inhibitors at all, nor a possible iron deficiency so this offers a broader strategy to my diet going forward. I'm also working on other stuff around the vagus nerve and just generally trying to eliminate stressors. Thanks again.