Drinks and tyramine: 49 foods rated

Tap and unpasteurised beer is the drink Gardner's 1996 review singles out - live yeast keeps producing tyramine in the barrel, which is why draught can be well above bottled. Shulman's assay of over 100 foods, seven years earlier, had found alcoholic beverages safe as a class, so this is a restriction the later review ADDED rather than one it kept. Pasteurised bottled beer is the lower form, and 'craft' or 'unfiltered' on a label points the other way.

• Gardner et al., J Clin Psychiatry 1996, the review that narrowed the MAOI diet
• Shulman KI et al., J Clin Psychopharmacol 9 (1989)

Kombucha is a live culture still working in the bottle, on the shelf and in your fridge - which makes it the one drink here whose tyramine keeps rising after you buy it. A bottle opened and left for a week is not the drink you bought.

• EFSA Journal 2011 (tyramine and histamine in fermented foods)
• McCabe-Sellers et al., J Food Compos Anal 2006

Alcohol as a category is on MAOI lists for what it comes in rather than for the ethanol: tap beer is the one the modern review still restricts, and the fortified and aged wines - sherry, vermouth - are the older list's entries; wine and bottled beer it treats as safe in moderation, and distilled spirits leave the amines behind in the still. Shulman's assay of over 100 foods, seven years before that review, put it plainly: alcoholic beverages, Chianti included when taken in moderation, appeared to be safe.

• Gardner et al., J Clin Psychiatry 1996, the review that narrowed the MAOI diet
• Shulman KI et al., J Clin Psychopharmacol 9 (1989)

Alcohol-free beer is brewed and fermented exactly like beer and then has the alcohol removed - the yeast did its work before that step. Removing the alcohol removes no tyramine. What the guidance separates is the container rather than the alcohol: Gardner et al. restrict tap beer and treat bottled or canned beer as safe in moderation, and alcohol-free beer is bottled.

• Gardner et al., J Clin Psychiatry 1996, the review that narrowed the MAOI diet
• Shulman KI et al., J Clin Psychopharmacol 9 (1989)

Coffee is a legacy entry too. Its measured tyramine is negligible, and what people notice from coffee is caffeine - a stimulant that raises blood pressure by its own route, which can look like the reaction this axis is about without being it.

• Gardner et al., J Clin Psychiatry 1996, the review that narrowed the MAOI diet
• Shulman KI et al., J Clin Psychopharmacol 9 (1989)

Kvass is bread fermented into a drink, and how much tyramine survives depends on the method - surveys of beers made by different processes find wide variation. Unpasteurised kvass keeps fermenting in the bottle.

Almond milk is unfermented and mostly water. Plant milks have been surveyed for biogenic amines and the unfermented ones come back low; it is the cultured versions - the yogurts and the aged nut cheeses - that move.

• Sen N.P., Journal of Food Science 34 (1969) 22-26, per-food tyramine content

Black tea carries measurable amines in the leaf, but an infusion transfers only part of what a plant holds into the water and the leaf is discarded. Note the contrast with the histamine axis, where tea is listed for inhibiting the DAO enzyme - tyramine is cleared by MAO instead, which tea does not touch.

Champagne is low, and that is a correction to older advice. The assay that measured tyramine in more than a hundred foods to guide MAOI patients found alcoholic drinks in moderation to be safe - including the Chianti that older lists singled out. The alcohol itself remains a separate issue.

Coconut milk is unfermented and mostly water. Plant milks have been surveyed for biogenic amines and the unfermented ones come back low; it is the cultured versions - the yogurts and the aged nut cheeses - that move.

• Sen N.P., Journal of Food Science 34 (1969) 22-26, per-food tyramine content

Cola is carbonated water with sugar or sweetener, caramel colour, acid and caffeine. None of those is a protein, and tyramine needs protein, bacteria and time. It is on the scale because caffeinated drinks are reviewed alongside tyramine on some protocols, not because it carries any.

• Sen N.P., Journal of Food Science 34 (1969) 22-26, per-food tyramine content

Sugar-free cola is carbonated water with sugar or sweetener, caramel colour, acid and caffeine. None of those is a protein, and tyramine needs protein, bacteria and time. It is on the scale because caffeinated drinks are reviewed alongside tyramine on some protocols, not because it carries any.

• Sen N.P., Journal of Food Science 34 (1969) 22-26, per-food tyramine content

A standard fresh eggnog has little to no tyramine, but aged versions or those made with aged spirits may contain some.

Green tea carries measurable amines in the leaf, but an infusion transfers only part of what a plant holds into the water and the leaf is discarded. Note the contrast with the histamine axis, where tea is listed for inhibiting the DAO enzyme - tyramine is cleared by MAO instead, which tea does not touch.

Malt beer is low, and that is a correction to older advice. The assay that measured tyramine in more than a hundred foods to guide MAOI patients found alcoholic drinks in moderation to be safe - including the Chianti that older lists singled out. The alcohol itself remains a separate issue.

Sweet rosé wine is low, and that is a correction to older advice. The assay that measured tyramine in more than a hundred foods to guide MAOI patients found alcoholic drinks in moderation to be safe - including the Chianti that older lists singled out. The alcohol itself remains a separate issue.

Tea carries measurable amines in the leaf, but an infusion transfers only part of what a plant holds into the water and the leaf is discarded. Note the contrast with the histamine axis, where tea is listed for inhibiting the DAO enzyme - tyramine is cleared by MAO instead, which tea does not touch.

Vermouth is low, and that is a correction to older advice. The assay that measured tyramine in more than a hundred foods to guide MAOI patients found alcoholic drinks in moderation to be safe - including the Chianti that older lists singled out. The alcohol itself remains a separate issue.

Wine is low, and that is a correction to older advice. The assay that measured tyramine in more than a hundred foods to guide MAOI patients found alcoholic drinks in moderation to be safe - including the Chianti that older lists singled out. The alcohol itself remains a separate issue.