As I embark on my latest strategy to eliminate my headaches, the one thing I see repeated over and over is that liver is to be avoided, because it contains high levels of tyramine. Tyramine is a known trigger for migraines. After searching for several hours on this one point, I believe the recommendation to avoid all liver is based on a bad assumption.
I don’t have access to the full study, but I did find this statement in an abstract for Dietary tyramine and other pressor amines in MAOI regimens: a review. J Am Diet Assoc. 1986 Aug;86(8):1059-64.
Any food rich in aromatic amino acids can become high in tyramine if aging, contamination, prolonged storage, or spoilage occurs.
Stephen R. Saklad wrote up some summary points from that study in the article Foods to Avoid with MAOIs.
- no detectable levels identified in fresh chicken livers
- high tyramine content found in spoiled or unfresh livers (McCabe, 1986).
The abstract for the study Tyramine content of previously restricted foods in monoamine oxidase inhibitor diets. Walker SE. 1996 Oct;16(5):383-8. states:
Foods that were found to have dangerously high concentrations of tyramine (> or = 6 mg/serving) included chicken liver aged 9 days (63.84 mg/30 g), air-dried sausage (7.56 g/30 g), soy sauce (0.941 mg/ml), and sauerkraut (7.75 mg/250 g).
Should this be a realistic concern? From the 2007 study Effects of a Tyramine-Enriched Meal on Blood Pressure Response in Healthy Male Volunteers Treated with Selegiline Transdermal System 6 mg/24 Hour:
Spoiled or improperly stored meats may contain higher amounts of tyramine (eg, unrefrigerated chicken liver); however, it is unlikely that numerous servings of spoiled meat will be consumed.(40) Realistically, ingestion of any of these foodstuffs in such large quantities is highly improbable.
What is the difference in tyramine content between fresh and “aged” liver? Here is another clue. From Monoamine Oxidase: Basic and Clinical Perspectives by D.P. Holschneider, M.D. and J.C. Shih, Ph.D.:
It is estimated that the tyramine content of beef liver may vary as much as 50-fold, depending on the method and period of storage…
A 50-fold difference! It appears from my amateur sleuthing that liver has gotten a bad name because a worst-case scenario number has been used as a baseline for recommendations. I get my beef liver frozen from the farmers’ market. I set it down in the refrigerator to thaw and then cook it the next day. I’m thinking I should be fine.
I’ll be keeping track of my tyramine intake in my headache journal. If tyramine is indeed the guilty party, which may or may not be true, then I’ll be able to measure outcomes with and without fresh liver.
Please add to the comments if I got something wrong in this post. I’m just interested in the truth. I’d hate to discard the most healthy food on the planet because we are using a spoiled meat metric.