Tyramine, MAO A and MAO B has any one tried a tyramine reduced diet?

[LAJ12345]

I was reading up on MAO inhibitors as the question was asked which is best, an MAO inhibitor or C/L. My husband has had a genetic test and his results say he has lower expression of MAO A and B so I imagine inhibiting it further is probably not a good thing. But reading this it looks like reducing tyramine in the diet might be a good idea if your MAO expression is low, in fact if you are taking an MAO inhibitor you are required to be on a low tyramine diet.

What are people’s thought on this? Are you on a low tyramine diet?

hindawi.com/journals/omcl/2...

“In the central and peripheral nervous systems, intraneuronal MAO-A and B protect neurons from exogenous amines, prevent the actions of endogenous neurotransmitters, and regulate the intracellular amine content. In peripheral tissues, MAO is involved in the oxidative catabolism of amines and prevent the penetration of dietary amines (such as tyramine from cheese and fermented drinks) into the circulation [21].

The vast majority of research in the field focused on the role of MAO in the nervous system. In line with their role in the inactivation of neurotransmitters, abnormal expression of MAO is considered to be responsible for a couple of psychiatric and neurological disorders and the treatment with MAO inhibitors has been available for more than 50 years in neuropsychiatric disorders [21–23]. Thus, selective inhibitors of MAO-B (selegiline, rasagiline, and safinamide) are indicated in the treatment of Parkinson disease, whereas selective MAO-A inhibitors (moclobemide) act as antidepressants. Lately, the reversible (selective) inhibitors are increasingly used since they are devoid of the side effects of the irreversible MAO inhibitors [24].”

[Zardoz]

I am on an MAO inhibitor and carbidopa /levedopa. I just avoid the worst sources of tyramine; cured meats and aged cheeses.

[MarionP]

There is little need to worry about tyramine in your diet unless you are taking one of the original mao-b inhibitors (phenelzine, parmate, marplan, nardil). Concerns are based on largely outdated information or misinformation, even among psychiatrists. Even the originals are less risky than previously thought, except for those who may overdose.

[LAJ12345 in reply to MarionP]

So where a genetics test says your mao a and b are slow is that like you have an inbuilt MAOI ? Would that mean you shouldn’t go on a MAOI?

[MarionP in reply to LAJ12345]

If you're that extremely unique (if your "test" is actually scientifically valid and can be translated in some sort of real, actual influences snd effects, both rather large "IFs" I should add), then you need to be talking to Mayo clinic. You are tslking about several different specific mechanisms and complex receptor relationships. You aren't going to get much from anyone who isn't one of a very few specialists. Period.

[LAJ12345 in reply to MarionP]

We’re in New Zealand and there only seems to be one person I can find who does these analyses and she is in Auckland . She gets opus analysis run so isn’t a gene expert. Not sure if Mayo clinic is available to us?

Another report from her from opus says he has high dopamine beta hydroxylase activity which apparently is bad. This is based on a list of SNPs that are double mutations and single mutations. So I wonder if this is why he is reacting badly to C/L drugs? But is that offset by the mao a and b that are slow to break the dopamine down?

[MarionP in reply to LAJ12345]

In such a specific case it's not possible to speculate. I guess I would call Mayo Clinic asked for their psychiatry department, and see what referrals or assistance they can make. Of course, if you have the bucks, it's only a short 27 hour flight one way plus expenses + medical fees + lodging. I do know they have virtual online options as well, of some sort. I think I would call 507-405-2554 (you will need the usa country code, i don't know it) and have a chat...that's the psychiatry department. They also have a neurology clinic and that includes some very good neuropsychologists. They may want to collaborate, they very very often do as a matter of routine,.. nothing , and I do mean nothing, matters to them except absolute patient welfare, and that means they team up happily and willingly and often. I'm actually quite more than passingly familiar with both.

[LAJ12345 in reply to MarionP]

Thanks! Can’t get out of nz at the moment even if we have the bucks unfortunately but worth a call for sure!

[bassofspades]

I was on Selegiline for a couple of months and did the low tyramine diet. Never had i ever been so miserable in my life! No cheese, chocolate, deli meats, wine, coffee....never again!

[LAJ12345 in reply to bassofspades]

Yup, sounds like hell

[MarionP in reply to bassofspades]

Precaution overkill from someone insufficiently experienced and/or out of date, consciously trying to make up for it with excess caution at your expense, instead of referring you on to someone with current competence...unless you are in an area where getting someone sufficient is not available.

[bassofspades in reply to MarionP]

One sniff of Swiss cheese gave me a 2 week migraine, worst i ever had . I was literally contemplating suicide.

[LAJ12345 in reply to bassofspades]

Oh gosh that sounds horrendous

[MarionP in reply to bassofspades]

yeah I'd say you're hypersensitive and I don't know why you need to speak to your doctor's about exactly what the mechanism is and how it relates to the your Maoi, specifically which Maoi, there's a fair number of them today, and they don't all do the exact same thing anymore. Takes serious expertise in such a complications case as yours. And it is possible you could have some sort of neurotoxic syndrome that is dangerous with an MAOI, or all them. there are always a few cases of unusual or adverse events that are unique to the individual. Some of them can be quite dangerous.

[bassofspades in reply to MarionP]

I flushed those pills down the toilet! It didn't really help me with my pd either. Horrible.

[MarionP in reply to bassofspades]

Indeed. One wonders what role phenylalanine processing plays (pku, mao). In any case, too many good foods, and including umami neurostimulant otherwise known as MSG (kelp protein, seaweed protein, hydrolized vegetable protein, and glutamate) to give up without an exceedingly good reason...it was one reason for more research into "nicer" MAOIs.

[AmyLindy in reply to bassofspades]

My clinical advisors ended up telling me all those restrictions are largely outdated. Whew. What a relief.