Migraines are a debilitating medical condition characterized by severe, recurring headaches that can incapacitate patients for hours or even days. Traditionally, migraines were associated with fatigue or illness, but certain foods and beverages can also trigger these painful episodes.
One such trigger is tyramine, a naturally occurring compound found in aged and fermented foods, such as aged cheeses, smoked fish, cooked meats and some types of beer. Tyramine can also be present in foods that are improperly stored or not refrigerated. It is known to cause blood vessel constriction, which can lead to migraines, particularly in individuals with low levels of the enzyme monoamine oxidase (MAO), which breaks down tyramine.
Migraine symptoms often include an aura—temporary visual or sensory disturbances that precede other symptoms like intense head pain, nausea and sensitivity to light and sound. The connection between tyramine and migraines was first identified in the 1950s when patients taking MAO inhibitors experienced headaches and high blood pressure after consuming tyramine-rich foods.
Aged cheeses, such as cheddar, blue cheese, camembert, Swiss, feta and parmesan, are high in tyramine. In contrast, lower levels of tyramine are found in fresh dairy products like cottage cheese, yogurt, fresh milk, cream cheese and sour cream.
Wine is another common migraine trigger due to its fermentation process involving sodium bisulfite and amines, including histamine and tyramine. Histamine dilates cerebral blood vessels, while tyramine causes their constriction. Both actions can trigger headaches in sensitive individuals. For those with sulfite sensitivity, organic wines, which are sulfite-free, may be a better option.
Dr. Daniel Oved Photo: Shmulik ShalishRecognizing the link between diet and migraines is crucial. If headaches follow the consumption of cheese or wine, sensitivity to tyramine is likely. Wine generally contains higher concentrations of amines than cheese, making it a more potent trigger.
Effective treatments are available for those who experience frequent migraines, defined as at least one episode per week. These treatments aim to prevent attacks and reduce the overuse of painkillers. One such treatment involves a monthly or quarterly injection, offering a manageable and consistent solution.
- Dr. Daniel Oved is the director of the Headache and Facial Pain Clinic at Tel Aviv Sourasky Medical Center - Ichilov Hospital