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Dr. Bob is Robert Hsiung, MD,
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Posted by katie tkm on September 22, 2002, at 17:01:21
In reply to Re: bacon and eating out, posted by jsarirose on September 22, 2002, at 16:46:30
thanks so much for info
best wishes
katie
Posted by cybercafe on September 22, 2002, at 17:45:19
In reply to bacon and eating out » Bobbiedobbs, posted by katie tkm on September 22, 2002, at 16:28:52
i think the schulman report mentions a report by wing and chey or something with more specific information on chinese food -- i would love to get my hands on that article> aha! finally i've found some brand info on which soy sauce are ok - thanks bobbiedobbs. do you know where i can get any more information on specific brands etc? i've found the shulman write-ups but not a complete report on brands tested.
>
> also, i'm really surprised no diets mention bacon. it's smoked, but so is the sometimes safe sliced ham. can you eat it safely?
>
> does anyone else have the same problems finding foods to eat out that i do and how do you get around it? i love asian food (vietnamese, chinese etc) and this seems like a definite no-no. i also find the idea of never having any sauces, gravies or soups hard to take.
>
> i read in the shulman report that chicken and beef boullion seem to be ok. this is in direct opposition to other diets. does this mean i can actually use stock cubes. anybody else's expereience and knowledge would be great to know.
>
> thanks,
> katie
>
>
Posted by katie tkm on September 22, 2002, at 17:50:28
In reply to Re: bacon and eating out, posted by cybercafe on September 22, 2002, at 17:45:19
hi
thanks for these messages.
more questions for the maoi munching masses - does anyone know about soy cheese?
katie
p.s. i'm in oz
Posted by jsarirose on September 22, 2002, at 21:28:23
In reply to soy cheese » cybercafe, posted by katie tkm on September 22, 2002, at 17:50:28
> hi
> thanks for these messages.
> more questions for the maoi munching masses - does anyone know about soy cheese?
> katie
> p.s. i'm in ozI looked into that before because I was going to try it. As long as it's not aged (and it tends not to be) it should be okay. It's made from soy, which is fine. The things that may make a specific brand bad would be if they used aged soy or I would wary if it was smoked (although it should be okay anyway). You should also read the ingredients just in case they've added some strange no-no like autolyzed yeast (not that they would, but just in case).
Other than that - regular soy cheese is no problem. Just like soy milk is fine too.
-Jessica
Posted by Bobbiedobbs on September 23, 2002, at 0:02:17
In reply to Re: soy cheese, posted by jsarirose on September 22, 2002, at 21:28:23
Katie: I don't know if the report you saw is the one that discusses soy. There were five soy sauces tested _ Wing's, Kimlan, Ozeki Sashemi, Pearl River and Kikomannan. The only one that had a high level of tyramine was Pearl River. However, I would hardly regard these tests as conclusive. Shulman, based on these tests, recommends avoiding all soy sauces and soybean products. However, when I called SmithGlaxo (which makes Parnate) they told me soy products are OK as long as they are not fermented. They said "yes" to Tahini and sesame paste and no to tofu, tempeh and tamari sauce. That may be a bit cautious (they ARE the manufacturer). The key is to avoid any fermented product and be judicious with soy sauce. I have had lots of soy sauce over the years - mostly the watered down, Americanized versions like La Choy - without any problems.
I don't know of any problem with bacon or ham in conventional form.
You need to be vigilant when eating in Asian restaurants. A big no no is miso soup. I've eaten in Malaysian, Thai and Chinese without problems but again one needs to be careful about special ingredients.
Anyway, good luck to you. I think Nardil can be a great drug. I took it for years and it really helped me alot.
Where is your Oz?
Phil
Posted by jsarirose on September 23, 2002, at 0:23:41
In reply to Re: soy cheese, posted by Bobbiedobbs on September 23, 2002, at 0:02:17
I wholeheartedly agree with Phil. The only thing I would add is that tofu (not aged, not tempeh) is just fine too. I can't imagine why GSK would say it's not if they said soy is fine. It's simply soy in another form. I've eaten a lot of it over the months - no problems at all!
-Jessica
Posted by katie tkm on September 23, 2002, at 6:12:56
In reply to Re: soy cheese, posted by Bobbiedobbs on September 23, 2002, at 0:02:17
hey phil
thanks for your posts - i've found them really helpful. the specific info on brands is perfect - do you know where i can get this full report? i don't mind sending away for it or going to a university library for back issues of the journal. all the shulman and gardner reports i've been able to find on the net haven't listed the kind of detail you mention.
my particular oz is australia. i could be wrong but i figured most of the other users were american or candadian. this doesn't make a huge difference with brands because we have a lot of the same products. i just thought i'd mention it in case it had some relevence.
reading some of the other posts i must admit i feel lucky to be in a country where all medications (even the new ones) are covered by the public system. all prescriptions for low income earners are $3.20. how awful to know there could be something which can you help you but you can't afford to take it.
nardil does seem to be helping me at the moment and i'm cautiously excited about it. i'll just have to wait and see if i continue to improve and whether the exhausting side effects fade with time.
goodluck and best wishes
katieKatie: I don't know if the report you saw is the one that discusses soy. There were five soy sauces tested _ Wing's, Kimlan, Ozeki Sashemi, Pearl River and Kikomannan. The only one that had a high level of tyramine was Pearl River. However, I would hardly regard these tests as conclusive. Shulman, based on these tests, recommends avoiding all soy sauces and soybean products. However, when I called SmithGlaxo (which makes Parnate) they told me soy products are OK as long as they are not fermented. They said "yes" to Tahini and sesame paste and no to tofu, tempeh and tamari sauce. That may be a bit cautious (they ARE the manufacturer). The key is to avoid any fermented product and be judicious with soy sauce. I have had lots of soy sauce over the years - mostly the watered down, Americanized versions like La Choy - without any problems.
> I don't know of any problem with bacon or ham in conventional form.
> You need to be vigilant when eating in Asian restaurants. A big no no is miso soup. I've eaten in Malaysian, Thai and Chinese without problems but again one needs to be careful about special ingredients.
> Anyway, good luck to you. I think Nardil can be a great drug. I took it for years and it really helped me alot.
> Where is your Oz?
> Phil
Posted by Bobbiedobbs on September 24, 2002, at 20:11:46
In reply to Re: soy cheese » Bobbiedobbs, posted by katie tkm on September 23, 2002, at 6:12:56
Katie: Dr. Shulman is very good about sending free copies of the reports, at least based on my experience. I sent him international postage to the USA in a return envelope, and he not only sent me the study but returned unused the postage.
The address is:
Kenneth I. Shulman MD, Dept. of Psychiatry, 2075 Bayview Ave., Toronto, Ontario, Canada M4N 3M5. Email is [email protected]
The specific report with the soy tests is "Refining the MAOI Diet, Tyramine Content of Pizzas and Soy Products." It appeared in the Journal of Clinical Psychiatry in March of 1999 (Vol 60, p. 191-193).
The other article, which summarizes his colleagues' research on MAOIs to date, is "A Reevaluation of Dietary Restrictions for Irreversible MAOIs,", in a publication called Psychiatric Annals, June, 2001. I don't know whether this publication would be available in a library, even an academic one. That report gives tyramine content of various wines among other things. He believes (and I agree) that these medications will actually be a lot safer if people are given (and follow) scientifically-sound dietary restrictions rather than a whole panoply of dated, unduly restrictive prohibitions based an anecdotal evidence.
I should have realized that OZ was Australia. I thought you were being metaphorical. Well compared to our medical system Australia is OZ. I just paid a $50 copay for a month's supply of Parnate and that is WITH a decent health insurance policy. Unfortunately, there is no generic equivalent.
Hopefully the benefits of the Nardil will over a reasonable time outweigh the side effects for you. I'm taking Parnate and it definitely takes a bite out of me above a certain (30 mg) threshhold. Parnate and Nardil appear to act differently even though they are related. When I first began with Nardil it actually made me hypermanic. Anyway, hope that helps. Best wishes, Phil.
Posted by cybercafe on September 24, 2002, at 21:38:51
In reply to Re: soy cheese, posted by jsarirose on September 23, 2002, at 0:23:41
hey jess i am getting really bad acne (strangely small, little bumps, but many, many of them on my forehead) .... have you had any success? ... is it diet, exercise, anti-acne medication, what works best?
Posted by jsarirose on September 25, 2002, at 1:13:44
In reply to acne!, posted by cybercafe on September 24, 2002, at 21:38:51
>
> hey jess i am getting really bad acne (strangely small, little bumps, but many, many of them on my forehead) .... have you had any success? ... is it diet, exercise, anti-acne medication, what works best?
>While I'm not happy that you are sharing this symptom with me, I am glad to get a little companionship. I don't think it's a very common side effect for everyone. It was hard to verify that the Parnate was causing it - but since it became horrible as I went up to 100mg and has since improved as I went back down to 40mg - I'm completely convinced it's the Parnate.
So - what to do. I see a dermatologist. All we do is treat it as a bad case of acne. I really don't know of any information specific to Parnate acne that suggests alternative treatment. I take Erythromycin (and there are other stronger antibiotics to combat it, but this one doesn't make me nauseas), and I use 10% Bactril (sp?) topical in the shower. And I do all the other regular things to treat acne. I also went back on the pill which helped quite a bit for me, however I don't recommend you try it! It does make me wonder if Parnate effects hormones at all (I've never heard that it does). However I have fairly messed up hormones anyway, so the pill takes care of several issues for me. Unfortunately that is all we've come up with so far.
I'm more than happy to trade info if you learn of anything though! I really didn't find much about it on the internet.
-Jessica
Posted by katie tkm on October 2, 2002, at 10:41:57
In reply to Re: soy cheese, posted by Bobbiedobbs on September 24, 2002, at 20:11:46
What would I do without you guys? The shared info and support have been invaluable. It's wonderful to know there are people out there dealing with the same meds and issues. Thanks very much to Jessica and Phil for your time and generosity. The best of luck to both of you.
Would you guys (and anyone else) mind telling me about your side effects on different MAOI's? I know it's a bit personal so I don't mind if you don't want to.
All other classes of antidepressants have been unsuccessful in treating my severe recurrent depression. Nardil seems to be very good for me but I am having some trouble with side effects. I'm going to see if they fade with time (I've been on it for a month, 45mg, and already some side effects have faded). If they don't fade I may change to selegiline or parnate. We have moclobemide in Australia but apparently it's effects are fairly weak.
Like you Jess, my pschiatrist knows much less about MAOI's than I do because they are not often prescribed anymore. Thank goodness the drugs even exist! I find him very good in general but he doesn't have much experience of different side effects, diet etc.
The major problems I'm having are with fatigue (I have to nap a lot and limit my activity), insomnia (difficulty dropping off and waking up during the night) and anorgasmia (can't come - not very important at the moment but I'm sure/hope sex will be in the future!).
x katie
Posted by jsarirose on October 2, 2002, at 16:10:53
In reply to side effects of MAOI's » Bobbiedobbs, posted by katie tkm on October 2, 2002, at 10:41:57
> Would you guys (and anyone else) mind telling me about your side effects on different MAOI's? I know it's a bit personal so I don't mind if you don't want to.
>Parnate isn't known to have a negative sexual side effect, in fact it usually increases sex drive. For me, it has had that effect (not a bad thing unless you have no one to share that increased drive with!).
As for negative side effects, for me, my acne has gotten pretty bad with Parnate. There are of course the dietary restrictions, which I won't go into since you know about them. I am occasionally dizzy and have to pause when standing quickly from a sitting or prone position. I have trouble sleeping, but I take Trazodone for that so it actually doesn't effect me too much.
Those are the main negatives for me. The dizziness isn't a big deal. The worst for me is the acne (and of course diet restrictions). But the benefit I've gained from Parnate greatly out weighs any downsides. Oh, and I've also lost a lot of weight. It helps control my cravings and compulsive eating. It also controls my appetite. I've been able to start eating much healthier and lose weight while on Parnate.
So - I think that's it for me! I've never taken Nardil so I don't know how it compares. I do know my doctor chose Parnate because of the weight issue (it doesn't promote weight gain) and the (non) sexual side effects.
-Jessica
Posted by Bobbiedobbs on October 2, 2002, at 22:26:37
In reply to Re: side effects of MAOI's, posted by jsarirose on October 2, 2002, at 16:10:53
Hi - I can't write anything coherent tonight as I'm too harried and stressed out but will try to send you something that may be helpful tomorrow - I actually know (in person, no less!) a couple of people who have taken Nardil in the past (besides myself.
BTW, Jess, my doctor tells me trazadone is contraindicative to Parnate. Also, the acne is listed as a "reported" side effect to Parnate in the manufacturer's material. Phil
Posted by katie tkm on October 2, 2002, at 23:23:24
In reply to Re: side effects of MAOI's, posted by jsarirose on October 2, 2002, at 16:10:53
thanks for info jess, hope acne improves.
and phil - hope you feel better soon buddy
x katie
Posted by jsarirose on October 3, 2002, at 1:44:51
In reply to Re: side effects of MAOI's, posted by Bobbiedobbs on October 2, 2002, at 22:26:37
> BTW, Jess, my doctor tells me trazadone is contraindicative to Parnate. Also, the acne is listed as a "reported" side effect to Parnate in the manufacturer's material. Phil
Yeah, there are actually quite a few drugs that are contraindicative to Parnate that doctors are now prescribing. Once again, I think the pharmaceutical companies are extremely conservative to avoid lawsuits. But if you look at actual practice vs. theory, many 'taboo' drugs work just fine with Parnate. Of course I would absolutely only take something with a doctor's guidance. I've heard of others taking Trazodone too. I think if the doctor is monitoring closely, it's okay to try.
-Jessica (my two cents!)
Posted by Bobbiedobbs on October 4, 2002, at 0:30:34
In reply to Re: side effects of MAOI's, posted by jsarirose on October 3, 2002, at 1:44:51
Katie:
Nardil worked like a charm for me in relieving (or at least mitigating) my social inhibition and anxiety. The bummer was the side effects at 60 mg and higher. These included insomnia (this did get better over time),intermittent constipation, "urinary retention" (or to put it crudely, difficulty taking a piss), difficulty maintaining an erection and, at 60 mg, a complete inability to reach orgasm. These symptoms would show up beginning at about 45 mg. and whop me at 60 mg. (They weren't much of a problem at lower doseages).I put up with all this because I felt more comfortable socially, less anxious and inhibited and generally better able to function (well, at least socially.) I would drop the med level down to get relief.
After a few years, the side effects worsened while the benefits diminished. I switched to Parnate, which I've taken for the past two years. P. has been a different beast altogether. Its side effects are less acute but it also has less of a kick. It doesn't appear to cause weight gain, as did Nardil. However, I'm taking naps during the day and, at 40 mg. or higher, have to put up with the aforementioned constipation and anorgasmia.
That said, from what I've heard and read, the two medications seem to act differently on different individuals. Some people get hyper on Parnate, others are fatigued. But some of the things you mentioned I'd say are common complaints, particularly with Nardil.
I should add that some of the initial side effects which I experienced with Nardil dropped off after a few weeks. These included dizziness (particularly upon going from reclining to standing) dry mouth, shakies (leg shaking - quite the turn-on!) and sleeping difficulty.
You might consider giving the Nardil awhile longer, dropping the level down when the side effects became harder to tolerable. There is supposed to be some retained benefit from an initial higher dose followed by a maintenance level. If the problems continue, I'd give Parnate a try, as the MAOs appear efficacious for you.
Hope this helps. At least we can eat certain kinds of cheese and drink bottled beer. Best wishes, Phil.
Posted by jsarirose on October 4, 2002, at 13:38:01
In reply to Re: side effects of MAOI's, posted by Bobbiedobbs on October 4, 2002, at 0:30:34
> Hope this helps. At least we can eat certain kinds of cheese and drink bottled beer. Best wishes, Phil.
Is the dietary restriction for Nardil different from Parnate? I didn't know that. I thought it was the same for all MAOI's.
As Phil said, the side effects seem to vary for different people. I was hoping Cyberspace would jump in here too. I believe he had the same elevated sex drive that I had (have). And I believe insomnia is more common than sleepiness - in general of course. There are a few people that seem to have a great intolerance for the drug. Even 10 or 20mg seems to be extremely difficult on their system. For myself, I was taking up to 100mg with the only increased side effects being more dizziness at times, more insomnia (but I take Trazodone as stated before), increased acne, and increased sex drive, which is a negative if you're single. : )
It sounds like YMMV (Your Mileage May Vary) is very true on Parnate.
-Jessica
ps - It just occurred to me, but I wonder if anyone has ever done any studies about differences in side effects for males vs females. I wonder if there are any differences based on sex.
Posted by ayrity on October 5, 2002, at 0:41:35
In reply to Re: side effects of MAOI's, posted by jsarirose on October 4, 2002, at 13:38:01
Well, I'm on 70 mg of Parnate now for several weeks. Still having occassional bad blood pressure spikes after a dose, not related to food, and unpredictable (some days, BP fine; other days, BP through the roof after a dose). I can't seem to tolerate more than 20 mg at a time, but as we go up on the dose I can't keep spreading the doses out all day or I'll be popping pills like crazy! If things aren't better soon, we might try Marplan.
As far as other side effects on the Parnate, I've had a really bad taste in my mouth for a while now. Anyone else have that problem?
Also, sleepy during the day; insomnia at night (but I had that beforehand as well).
A bit of an effect on orgasm now at 70 mg- not delayed or anorgasmic, just much less intense.
A bit of dizziness at times on standing suddenly, but that hasn't been too bad.
My mood's a bit better, and I feel a bit more "chatty" with strangers, but this has not been dramatic enough to justify the side effects so far. Ah well.... Drug resistent depression sucks.
Posted by Bobbiedobbs on October 5, 2002, at 1:17:26
In reply to Re: side effects of MAOI's, posted by ayrity on October 5, 2002, at 0:41:35
Jessica - To answer your question, I don't think there is any inherent difference in food restrictions between the Nardil and Parnate except to the extent that they may act differently on different individuals.
My remark on the beer and cheese was meant to apply to MAOs generally.
I share the same characteristic of the last poster vis a vis Parnate (and Nardil) - sleepy during the day and up at night. Both of these medications - Nardil in particular - reved up my sex drive (and pursuit of partners) The problem was at high doses I was restricted in my range of fulfillment options. It did make for greater creativity. Some of you folks may have a greater tolerance for higher doses generally. I haven't pushed Parnate beyond 50 mg. Phil
Posted by jsarirose on October 5, 2002, at 1:50:19
In reply to Re: side effects of MAOI's, posted by Bobbiedobbs on October 5, 2002, at 1:17:26
> Jessica - To answer your question, I don't think there is any inherent difference in food restrictions between the Nardil and Parnate except to the extent that they may act differently on different individuals.
> My remark on the beer and cheese was meant to apply to MAOs generally.
> I share the same characteristic of the last poster vis a vis Parnate (and Nardil) - sleepy during the day and up at night. Both of these medications - Nardil in particular - reved up my sex drive (and pursuit of partners) The problem was at high doses I was restricted in my range of fulfillment options. It did make for greater creativity. Some of you folks may have a greater tolerance for higher doses generally. I haven't pushed Parnate beyond 50 mg. Phil
>Thanks for the clarification. I definitely know the some people seem to be med sensitive and others are med resistant. I almost always have to take the highest dose of meds. My sister takes less than a "medicinal" dosage of her med and does fine.
For those of you with "Treatment Resistant Depression", here's a great site. It outlines the suggested med route for TRD. My doctor has followed the suggestions (on her own) which gave me renewed faith in her.
http://www.acnp.org/g4/GN401000105/Default.htm
-Jessica
Posted by katie tkm on October 5, 2002, at 3:57:21
In reply to Re: side effects of MAOI's, posted by jsarirose on October 5, 2002, at 1:50:19
god, it's interesting how these side effects are different for all of us. there are some similarities and i must say knowing what others have experienced is reassuring.
i'm doing my best not to get excited (because i have recurrent depression which has gone into spontaneous remission several times) but Nardil is the first drug which has ever worked for me. i could actually feel it lifting the depression/anxiety.
reading this bulletin board was great because it helped me stick out the horror side effects which have mostly faded now. the pros vs cons are definitely worth it for me at the moment and i cannot describe the relief of discovering my "self" and my capabilities again. it's something i dearly wish for everyone who's experienced severe depression - no one who's not been through it can know what it's like.
i wouldn't say i'm completely magically recovered but the difference in the last few weeks is pretty amazing. i'm taking life slow and gently and not expecting too much at this stage. only time will tell how the medication and remaining side effects pan out. i'm hoping i may be well enough to return to study next year.
i've said thanks a million times but i am so grateful for the people and the info on this board. it's made a difference. the maoi diets drs/drug companies/pharmacies still hand out (and most of the diets on the web) are terribly restrictive. i was willing to take it because the depression was so bad but the info on this site has shown me i don't really have to change my lifestyle that much. i can still drink and eat out!
**jess, did you notice on that virtual hospital article you pointed me to there are direct contradictions on diet? the info was excellent but on page 4 it says you can't have yeast extracts (or pickled herring) and in table 7 on page 11 it says you can have both. i'm particularly interested in yeast extracts because i love sauce so much. anyway, i thought i'd better try to find the original articles they reference to get the lowdown. if anyone knows more please let me know.
i just wanted to say "why the fuck don't doctors prescribe MAOI's anymore!!?" i know they're scared but i really had to convince my pdoc and MAOI'S seem to be the answer for me. the MAOI bad rep needs to change. reading the postings makes me realise that others have waited much more than 3 yrs, 4 pdocs and 8 medications looking for a drug that works (and some are still looking). but i wish this had been tried ages ago!!!
best wishes
katie
Posted by Dr. Bob on October 5, 2002, at 13:18:29
In reply to Re: side effects of MAOI's yeast extract » jsarirose, posted by katie tkm on October 5, 2002, at 3:57:21
> i just wanted to say "why the f*** don't doctors prescribe MAOI's anymore!!?"
I understand it's frustrating, but please don't use language that could offend others:
http://www.dr-bob.org/babble/faq.html#civil
Thanks,
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.
Posted by polarbear206 on October 5, 2002, at 16:09:54
In reply to Dr. Bob : as Dr. your MAOI vs SSRI?, posted by chad_3 on October 5, 2002, at 14:09:51
> I return only for this post ...
>
> Was curious Dr. Bob how often your prescribe MAOI's. As you know, expert psychiatrists consider these considerably underutilized. And latest consenses is that MAOI's have less sexual side effects than SSRI's in general.
>
> I personally feel the post was not offensive - I felt she spoke honestly and sounded compassionate and caring...
>
> My input,
>
> Chad
> http://www.socialfear.com/
>
>
>
> > > i just wanted to say "why the f*** don't doctors prescribe MAOI's anymore!!?"
> >
> > I understand it's frustrating, but please don't use language that could offend others:
> >
> > http://www.dr-bob.org/babble/faq.html#civil
> >
> > Thanks,
> >
> > Bob
> >
> > PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.
>
>
In my own opinion and from my experience, the older drugs (MAOI'S and Tricyclics) are far more
superior to the newer generation of antidepressants. Esp. for those with atypical/vegitated and more severe forms of endogenous dperessions. They are refered by many p-doc's as "OLD FAITHFULS".Laura.
Posted by Dr. Bob on October 6, 2002, at 11:55:29
In reply to Re: please be civil » katie tkm, posted by Dr. Bob on October 5, 2002, at 13:18:29
> PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.
Here's a link:
http://www.dr-bob.org/babble/admin/20020918/msgs/7669.html
Sorry, but some discussion about medication got moved along with that about posting policies...
Bob
Posted by jsarirose on October 6, 2002, at 17:20:31
In reply to Re: Follow-ups regarding posting policies, posted by Dr. Bob on October 6, 2002, at 11:55:29
(I'll skip the posting issue.)
Katie - I kind of understand why MAOI's are a later, not first choice, but I totally agree that they shouldn't wait so long to try them. I've been through so many years of depression and failed drug attempts (legal) and Parnate is the first thing in ages to help me. I felt/feel like you! I'm so excited to actually have some relief and perhaps start thinking about a future again. It's a little scary to trust it, but I, too, am just going slowly and trying to enjoy.
Regarding the MAOI diet lists on the site I mentioned (http://www.vh.org/Providers/Conferences/CPS/19.html), they actually aren't completely inconsistent. For the yeast extract it lists specifically Marmite as having a very high tyramine count, and later it mentions that yeast extract is okay except for Marmite. The herring it first states has a level of 2.45 per serving which is within aceptable levels unless a great amount is eaten. Then later it lists it as an acceptable food. I agree that it is a bit contradictory about whether it is unlimited or not. My take is that based on the tyramine level listed, it's okay in limited amounts. Completely my opinion though!
Let me know if you are still confused! (It's not easy...) And I also agree that this site is great. I've learned so much from everyone here.
-Jessica
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