People with Familial Dysautonomia have decreased MAO levels similar to those taking MAOI’s (Monoamine Oxidase Inhibitors). Thus, if someone with FD eats tyramine-containing food, their insufficient MAO will not be able to remove the tyramine causing their tyramine levels to rise. This rise causes a “hypertensive crisis” due to constriction of blood vessels and an acute elevation of blood pressure. Symptoms include palpitations, nausea and vomiting.

What is Tyramine?

  • A component of protein that is produced in foods from the natural breakdown of the amino acid tyrosine.
  • Cannot be added to foods, but can be produced in almost any food that contains protein.
  • A vasoactive amine that can be found in fermented, pickled, smoked or processed foods and foods that have been stored in the refrigerator for several days.
  • Levels are naturally high in certain foods such as aged cheese, avocados, eggplant and many others and should never be eaten by an individual with FD.
  • Cooking does not destroy it.
  • MAO (Monoamine Oxidase), found in the GI tract and liver, removes it from the body. Those with normal levels of MAO will metabolize it with no ill effects.

Tyramine-Safe Food List

This list was compiled from approximately 20 tyramine lists found on the internet. While similar, no two lists were identical. In fact, most lists conflicted. For example, mozzarella cheese appears in the safe column on most lists, but also appears in the caution column on some lists. This variation is caused by the same food having different amounts of tyramine in it when tested by the list-maker.

When items appeared in two columns, the item was placed in the more restrictive column. For example, canned shellfish appears in the caution column in most lists, but appears in the avoid column in a few lists. For safety, canned shellfish appears in the avoid column on this list.

Because the same food may have different amounts of tyramine in it from batch to batch, lot to lot, preparation to preparation, there will not be a fool-proof list. In classifying a few items, such as beets and spinach, they typically appeared in the safe column however they were placed in the avoid column due to preliminary scientific results from the Laboratory for Familial Dysautonomia Research at Fordham University.

View/Print 4-page Food List (PDF)

Familial Dysautonomia NOW Tyramine-Safe Sample Recipes


Peach Matzo Kugel Mashed Acorn & Butternut Squash Chicken Pot Pie Salmon Risotto "Momlette" Shepherd's Pie

Looking for new, tasty and safe easy-to-make tyramine-safe recipes designed to please every member of your family? Each featured FD NOW recipe has been made from scratch, and has been sampled in our kitchens by at least one person with FD with no adverse side effects.

Click on any image above to view and print a PDF of the recipe.