![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 368 to 392 of 488. Go back in thread:
Posted by katiep on July 8, 2003, at 0:06:51
In reply to Re: So, what is left on the danger list? , posted by Seamus2 on January 18, 2002, at 22:01:59
hey all,
thanks for all the great info and support.. I was wondering if anyone had any experience (good or bad) with sake/rice-wine and MAOIs (i'm on nardil)..
thanks much!
kp
Posted by Craig Getty on July 9, 2003, at 1:11:59
In reply to Re: [Sake] So, what is left on the danger list? , posted by katiep on July 8, 2003, at 0:06:51
I have been on Nardil for about 5 weeks (60mg for last 4 weeks). Last week I drank a couple of sake shots (while eating sushi with soy sauce) and was fine. I also had a beer and a couple of other drinks before the night was over (long night at a party). All was fine. Interstingly, though, Nardil seems to have caused me to lose my affection for alcohol. The sake was only mildly enjoyable. Beer has become anathema to me (and I was quite a beer drinker). The only drink I still "enjoyed" was foo foo vodka and cranberry. And even then, I did not want any more after the 2 I had (and at a party like this I'd normally have many). It wasn't the dietary restrictions that kept me from drinking - it was a real lack of taste for it, and alcohol kind of made me nauseous. I don't know if this is typical.
Also, I hear Nardil normally causes weight gain, but I've lost 5 pounds in the last month on it - probably due to a combination of diarrea on the negative side as well as the positives of quitting cheese and beer and starting to exercise.
One more thing - Someone on this message chain talked about dizziness from Nardil. I have been experiencing that a lot, and I hope it goes away. I've been tired too and I believe the Nardil is overpowering the Provigil that I take for ADD type symptoms/daytime sleepiness. Talking to my doc about going from 200 to 400mg of Provigil or maybe switching to something stronger.
> hey all,
> thanks for all the great info and support.. I was wondering if anyone had any experience (good or bad) with sake/rice-wine and MAOIs (i'm on nardil)..
> thanks much!
> kp
Posted by Mairwen on July 16, 2003, at 11:53:31
In reply to Re: [Sake] So, what is left on the danger list? , posted by Craig Getty on July 9, 2003, at 1:11:59
Hi
It was good at last to hear about someone suffering diarrea and not constipation on Nardil. My doctor refused to believe me and I lost 10 lbs in 4 weeks before I decided for myself that the situation was out of control and I would stop taking it. I now take Parnate and have none of the bad symptoms supposedly associated with it.
Does any one else suffer diarrea on Nardil?
Mairwen>I have been on Nardil for about 5 weeks (60mg for last 4 weeks). Last week I drank a couple of sake shots (while eating sushi with soy sauce) and was fine. I also had a beer and a couple of other drinks before the night was over (long night at a party). All was fine. Interstingly, though, Nardil seems to have caused me to lose my affection for alcohol. The sake was only mildly enjoyable. Beer has become anathema to me (and I was quite a beer drinker). The only drink I still "enjoyed" was foo foo vodka and cranberry. And even then, I did not want any more after the 2 I had (and at a party like this I'd normally have many). It wasn't the dietary restrictions that kept me from drinking - it was a real lack of taste for it, and alcohol kind of made me nauseous. I don't know if this is typical.
>
> Also, I hear Nardil normally causes weight gain, but I've lost 5 pounds in the last month on it - probably due to a combination of diarrea on the negative side as well as the positives of quitting cheese and beer and starting to exercise.
>
> One more thing - Someone on this message chain talked about dizziness from Nardil. I have been experiencing that a lot, and I hope it goes away. I've been tired too and I believe the Nardil is overpowering the Provigil that I take for ADD type symptoms/daytime sleepiness. Talking to my doc about going from 200 to 400mg of Provigil or maybe switching to something stronger.
>
>
>
>
>
>
> > hey all,
> > thanks for all the great info and support.. I was wondering if anyone had any experience (good or bad) with sake/rice-wine and MAOIs (i'm on nardil)..
> > thanks much!
> > kp
>
>
Posted by fritz on October 21, 2003, at 22:31:50
In reply to Re: hypertensive experiences? , posted by Bobbiedobbs on July 16, 2002, at 23:00:35
trying to reach bobbiedobbs---do you have any medical sources that support your good luck with the 4,000 frozen dinners and their taboo ingredient "autolyzed yeast extract"?
Posted by bobbiedobbs on November 2, 2003, at 20:01:20
In reply to Re: hypertensive experiences? , posted by fritz on October 21, 2003, at 22:31:50
> trying to reach bobbiedobbs---do you have any medical sources that support your good luck with the 4,000 frozen dinners and their taboo ingredient "autolyzed yeast extract"?
Best source for good information on appropriate diet for maoi users is from Journal of Clinical Psychiatry 57:3 March 1996, "The Making of a User Friendly MAOI Diet" and 60:3, March 1999 "Tyramine Content of Pizzas and Soy Products." The later found no tyramine level of significance in any pizza from any of several large chain commercial outlets (including double cheeze/double pepperoni pizzas.)
Request reprints of these and other related studies from: Kenneth Shulman, MD, Dept. of Psychiatry, Sunnybrook Health Center, 2705 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada.
Another good, related reference is "A Reevaluation of Dietary Restrictions for Irreversible MAOIs" from Psychiatric Annals, 31:6 June 2001. It synopsizes the above research as well as other recent studies. Good luck. Read before eating, please!
BTW, those 4000 TV dinners only had these cheeses: romano, ricotta, mozarella, and parmesan in small quantities, plus pepperoni and sausage. I never even looked at yeast extract as an ingredient until someone raised the issue (2,000 tv dinners later)
Posted by Ted Abel on November 3, 2003, at 11:08:40
In reply to Re: hypertensive experiences? » fritz, posted by bobbiedobbs on November 2, 2003, at 20:01:20
I was wondering if the tryamine content of tap beer was known. I have had luck with a million buds, but maybe the next time I won't be so lucky.
I have had bad luck with yeast, blue cheese and smoked turkey. On the latter, my bp was 400\200, which is a tad too high. By the way, I'm on 60 mg of nardil.Ted
PS Are there any contraindications from taking olmifon, or any benefits?
Posted by jsarirose on November 4, 2003, at 1:59:14
In reply to Re: hypertensive experiences?, posted by Ted Abel on November 3, 2003, at 11:08:40
> I was wondering if the tryamine content of tap beer was known. I have had luck with a million buds, but maybe the next time I won't be so lucky.
> I have had bad luck with yeast, blue cheese and smoked turkey. On the latter, my bp was 400\200, which is a tad too high. By the way, I'm on 60 mg of nardil.
>
> Ted
>
> PS Are there any contraindications from taking olmifon, or any benefits?It's not actually the beer itself that necessarily has a high tyramine content. It's the molds and such that can build up in the hoses and taps that cause the higher levels of tyramine. In theory if you had a brand new system and a keg of beer, the "tap" beer would be perfectly safe (as long as the brewery was safe). That's why they recommend bottled/canned beer from reputable sources. I drink all sorts of microbrews, but I won't drink home made bottled beer from friends. It won't make them sick, but it could make me sick.
By they way, in my opinion it's not worth messing with tap beer. I had my worst hypertensive crisis ever from a moment of weakness and only about 1/3 third of pint of microbrew on tap. It dumb of me, but I got cocky.
-Jessica
Posted by bobbiedobbs on November 4, 2003, at 21:07:18
In reply to Re: hypertensive experiences?, posted by jsarirose on November 4, 2003, at 1:59:14
Researchers at the Univ. of Toronto measured the tyramine concentration of tap and bottled beers. Of 98 beers - half tap and half bottled, all of the bottled/canned (including dealcoholized) "beer" had safe concentrations, while 4 of the 98 beer samples that were on tap had dangerous levels. All four were produced by bottom fermentation (lagers) and brewed by a secondary fermentation process. Thus the researchers recommended against all tap beers, just to be safe. You can get the whole study from the same source as my earlier post. I never heard of the other item you asked about.
Posted by jsarirose on November 4, 2003, at 21:21:50
In reply to Re: hypertensive experiences?, posted by bobbiedobbs on November 4, 2003, at 21:07:18
> Researchers at the Univ. of Toronto measured the tyramine concentration of tap and bottled beers. Of 98 beers - half tap and half bottled, all of the bottled/canned (including dealcoholized) "beer" had safe concentrations, while 4 of the 98 beer samples that were on tap had dangerous levels. All four were produced by bottom fermentation (lagers) and brewed by a secondary fermentation process. Thus the researchers recommended against all tap beers, just to be safe. You can get the whole study from the same source as my earlier post. I never heard of the other item you asked about.
Oooh, fascinating. I'm dying for a good microbrew on tap. I'm trying to remember what kind of beer I had when I had that horrible attack, but I'm not sure. I typically drink ales and porters.
They aren't bottom fermented, are they?
-Jessica
Posted by Bigdave on December 17, 2003, at 19:44:42
In reply to Re: MAOI diet short list, posted by cybercafe on July 22, 2002, at 13:29:19
I'm due to begin a trial course of Nardil in a few days and I've been researching as
much as possible about the MAOI diet restrictions. Unfortunately I'm having to self-
medicate myself as my doctor flatly refused to prescribe Nardil and told me it's unlikely
any dr will prescribe it me for treatment of social anxiety. Very unfortunate for me
since now I have to pay for the medication myself at a cost of £50 a month.My dr described it as a "dirty drug" and said it was no longer used! I wrote to my dr last
week to give him the 'good' news about me taking Nardil myself privately and he wrote back
to me saying "I strongly advise you not to take Nardil without supervision" and recommended
that he refers me to a specialist, a road which I've been down several times already.I've decided that Nardil is something I want to try and I'm sure if I'm sensible
and careful with the diet I'll be fine. That's really the reason for my post to get some
answers and hopefully put to together an overall diet guide. From the posts I've read here
I must say it seems very daunting and confusing with lots of conflicting and non-specific
information.One thing which particularly worries me is people saying that certain things which are
recommend to avoid, are ok, such as beers and wine and some food items. Surely
it's better to be safe than sorry and avoid these items, period? Afterall everyone is
different and what's fine for one person may produce a terrible reaction in another
person. Another reason for sticking to the list rigidly is that it's impossible to say
with any kind of accuracy what levels of tyramine may or may not be found in certain
types of food on the things to avoid list. How can you possibly know how much tyramine
is in a serving with so many different variations and other factors? I think if I start
gambling with this and experimenting I would become very anxious and worried that I'd
have a hypertensive reaction and that might bring one on anyway!If you stick to the guidelines then you're not taking chances is how it seems
to me. It doesnt seem majorly difficult to me to maintain a strict diet, certainly for
vegetarians anyway. The only real sacrifice for me will be cheese and beer which I enjoy
often.It's puzzling to me how since the diet restriction is such an important issue for people
taking MAOI medication, why there isnt a single authorative published list somewhere
on the web with very specific and detailed information which is updated regularly. Perhaps
maintained by the drug manufacturer?One point which is seldom discussed as well is that it's better to take your MAOI
medication sometime AFTER a meal which is likely to contain tyramine. I've read that
this can minimise the chance of a hypertensive reaction or make it considerably less.
This sounds like good sound advice to me and makes sense. Does anyone agree with this
and use this approach with taking MAOI meds?Bigdave
Posted by Bigdave on December 17, 2003, at 20:23:14
In reply to Re: MAOI diet short list, posted by cybercafe on July 22, 2002, at 13:29:19
On the subject of diet restriction and which foods to avoid that might contain tyramine, I'd like to know if anyone has any comments on the following types of foods which I like regularly
but seem to be in a grey area:Bisto Gravy Granules
(contains hyrolysed vegetable protein)Balsamic Wine Vinegar
Brown Sauce (english table sauce)
(contains molasses, date paste, tomato
paste, soy sauce)Quorn products (Vegetarian meat alternatives)
(these contain mycoprotein, rehydrated egg
white, milk protein, gelling agent: pectin)Tesco Vegetarian Bacon Style Rashers
(made from wheat and soya protein)Realeat Vege Mince - this looks like a big no no?
(Rehydrated Wheat Protein (20%), Rehydrated Textured Soya Protein (20%), Vegetable Oil, Soya Flour, Soya Protein Isolate, Yeast Extract, Vegetable Bouillin, Malt Extract)Quorn Mince
(Myco-protein* (88%), Rehydrated Egg White (free-range), Roasted Barley Malt Extract, *Mushroom in origin and not a GMO)Pot Noodle Chicken & Mushroom Flavour -- another no no?
(contains textured soya pieces, Yeast, Yeast Extract, Hydrolysed Vegetable protein)Tamari sauce
Pickled Onions
(contain Lactic Acid, Acetic Acid, Malt Extract)Tinned Soups that contain Yeast Extract or Vegetable Bouillon Concentrate
Tinned Soups that contain Haricot Beans
Curry sauces that contain Yogurt, lacitic acid, Coconut Cream Paste, Mango Chutney)
Frozen stored pasturised milk
(milk thats been stored in the freezer
then defrosted and kept in fridge past its
use by date)Canned/bottled beers:
(I know beers are recommended to be avoided
but wondered if anyone drinks any of these without
adverse affects)
Stella Artois
Holsten Pills
Carlsberg
Heineken
BudweiserWhite Wine:
Regular White Wine
Fizzy White WineSpirits:
Vodka
Irish Whisky Cream Liquor
White RumI know it seems a bit over the top writing down everything in my cupboard, but I dont want to take any chances at all and would like to start as I as mean to go on, with a list of things to avoid and things that are safe, no with no grey areas.
I intend to write to the manufacturers of these products and will post any comments they might care to make in due course.
Bigdave
Posted by brussell on December 17, 2003, at 23:29:51
In reply to MAOI diet restrictions, posted by Bigdave on December 17, 2003, at 20:23:14
You're right about the problems with finding an "authoritative list." Part of the problem is that people do vary in their sensitivity to different kinds of foods. I try to err on the side of caution.
In general, I would avoid anything that has been aged or fermented. Be careful with leftovers--one member of this board reported a HT crises brought on by poultry that had been in her icebox for too long.
Personally, I would avoid most of the things you have listed. They sound so heavily processed that it would be very hard to guess what's really in them. Wine and beer have been prohibited on even the more liberal lists I have seen. The aged sauces you describe sound deadly.
I suspect that realitively pure distilled spirits (like vodka) would probably be okay in reasonable quantities. I'd be cautious about liquors that have much flavor, like rums. My psychiatrist was mainly concerned that the Parnate I take could enhance the intoxicating effect of spirits.
Monitor your blood pressure regularly, and you'll probably gradually get a feel for what works for you.
Good luck. I was surprised by your doctor's hostility towards Nardil. Is he a psychiatrist or a GP? I can understand a GP being reluctant to prescribe this drug. If possible, you should find a specialist who will work with you on dosage, other treatments, etc.
Best Wishes
Posted by Mairwen on December 18, 2003, at 4:20:41
In reply to MAOI diet restrictions, posted by Bigdave on December 17, 2003, at 20:23:14
>
> On the subject of diet restriction and which foods to avoid that might contain tyramine, I'd like to know if anyone has any comments on the following types of foods which I like regularly
> but seem to be in a grey area:
>
> Bisto Gravy Granules
> (contains hyrolysed vegetable protein)
>
> Balsamic Wine Vinegar
>
> Brown Sauce (english table sauce)
> (contains molasses, date paste, tomato
> paste, soy sauce)
>
> Quorn products (Vegetarian meat alternatives)
> (these contain mycoprotein, rehydrated egg
> white, milk protein, gelling agent: pectin)
>
> Tesco Vegetarian Bacon Style Rashers
> (made from wheat and soya protein)
>
> Realeat Vege Mince - this looks like a big no no?
> (Rehydrated Wheat Protein (20%), Rehydrated Textured Soya Protein (20%), Vegetable Oil, Soya Flour, Soya Protein Isolate, Yeast Extract, Vegetable Bouillin, Malt Extract)
>
> Quorn Mince
> (Myco-protein* (88%), Rehydrated Egg White (free-range), Roasted Barley Malt Extract, *Mushroom in origin and not a GMO)
>
> Pot Noodle Chicken & Mushroom Flavour -- another no no?
> (contains textured soya pieces, Yeast, Yeast Extract, Hydrolysed Vegetable protein)
>
> Tamari sauce
>
> Pickled Onions
> (contain Lactic Acid, Acetic Acid, Malt Extract)
>
> Tinned Soups that contain Yeast Extract or Vegetable Bouillon Concentrate
>
> Tinned Soups that contain Haricot Beans
>
> Curry sauces that contain Yogurt, lacitic acid, Coconut Cream Paste, Mango Chutney)
>
> Frozen stored pasturised milk
> (milk thats been stored in the freezer
> then defrosted and kept in fridge past its
> use by date)
>
> Canned/bottled beers:
> (I know beers are recommended to be avoided
> but wondered if anyone drinks any of these without
> adverse affects)
> Stella Artois
> Holsten Pills
> Carlsberg
> Heineken
> Budweiser
>
> White Wine:
> Regular White Wine
> Fizzy White Wine
>
> Spirits:
> Vodka
> Irish Whisky Cream Liquor
> White Rum
>
> I know it seems a bit over the top writing down everything in my cupboard, but I dont want to take any chances at all and would like to start as I as mean to go on, with a list of things to avoid and things that are safe, no with no grey areas.
>
> I intend to write to the manufacturers of these products and will post any comments they might care to make in due course.
>
> Bigdave
>
>
Hi
Just to let you know I can eat some Quorn products, but they do use yeast extract in some. The fillets are ok. One glass of white wine is ok and so is frozen milk.
Mairwen
Posted by bobbiedobbs on December 18, 2003, at 19:22:35
In reply to Re: MAOI diet restrictions » Bigdave, posted by Mairwen on December 18, 2003, at 4:20:41
You will spare yourself alot of unnecessary worry and deprivation if you consult some of the historical posts involving contemporary allowed MAOI diets. Sounds like you are working off of some archaic diet lists! If you do a search under Bobbiedobbs (me) you should find guidance re soy-based products and links to medical studies concerning tyramine and MAOIs.
I used MAOs for over 20 years (up to 60 mg.) and only had reactions to anchovy paste and decongestants. I regularly consumed alcohol (all forms are OK except draft beer, microbrewed beer and non-alcoholic beer) and the soft cheese such as ricotta and mozarella. But please don't take my word for anything (as I'm sure you won't). Do yourself a favor and spend some time and consult some of the historical posts on this site. Best posters were jessica and elizabeth. You should find some links to these folks earlier in this string. Best of luck. Nardil is a great drug if you excercise proper care.
p.s. You might also think about carrying one of of the generally recognized antidotes, such as procardia. Sorry can't give you more details but leaving for a week for vacation. good luck. --Phil
Posted by cornycon on February 18, 2004, at 8:36:03
In reply to Nardil and MAOI diet restrictions, posted by Bigdave on December 17, 2003, at 19:44:42
> I'm due to begin a trial course of Nardil in a few days and I've been researching as
> much as possible about the MAOI diet restrictions. Unfortunately I'm having to self-
> medicate myself as my doctor flatly refused to prescribe Nardil and told me it's unlikely
> any dr will prescribe it me for treatment of social anxiety. Very unfortunate for me
> since now I have to pay for the medication myself at a cost of £50 a month.
>
> My dr described it as a "dirty drug" and said it was no longer used! I wrote to my dr last
> week to give him the 'good' news about me taking Nardil myself privately and he wrote back
> to me saying "I strongly advise you not to take Nardil without supervision" and recommended
> that he refers me to a specialist, a road which I've been down several times already.
>
> I've decided that Nardil is something I want to try and I'm sure if I'm sensible
> and careful with the diet I'll be fine. That's really the reason for my post to get some
> answers and hopefully put to together an overall diet guide. From the posts I've read here
> I must say it seems very daunting and confusing with lots of conflicting and non-specific
> information.
>
> One thing which particularly worries me is people saying that certain things which are
> recommend to avoid, are ok, such as beers and wine and some food items. Surely
> it's better to be safe than sorry and avoid these items, period? Afterall everyone is
> different and what's fine for one person may produce a terrible reaction in another
> person. Another reason for sticking to the list rigidly is that it's impossible to say
> with any kind of accuracy what levels of tyramine may or may not be found in certain
> types of food on the things to avoid list. How can you possibly know how much tyramine
> is in a serving with so many different variations and other factors? I think if I start
> gambling with this and experimenting I would become very anxious and worried that I'd
> have a hypertensive reaction and that might bring one on anyway!
>
> If you stick to the guidelines then you're not taking chances is how it seems
> to me. It doesnt seem majorly difficult to me to maintain a strict diet, certainly for
> vegetarians anyway. The only real sacrifice for me will be cheese and beer which I enjoy
> often.
>
> It's puzzling to me how since the diet restriction is such an important issue for people
> taking MAOI medication, why there isnt a single authorative published list somewhere
> on the web with very specific and detailed information which is updated regularly. Perhaps
> maintained by the drug manufacturer?
>
> One point which is seldom discussed as well is that it's better to take your MAOI
> medication sometime AFTER a meal which is likely to contain tyramine. I've read that
> this can minimise the chance of a hypertensive reaction or make it considerably less.
> This sounds like good sound advice to me and makes sense. Does anyone agree with this
> and use this approach with taking MAOI meds?
>
> BigdaveIn regard to the safety of taking foods in the groups that have tyramine in them.
I have found that the degree of reaction to these foods is more than just the levels of tyramine that they contain. For example the rate of the digestive process, the regularity of Bowel motions, Blood pressure, Medication combinations, Season of the year.
I live in the southeastern part of Australia, My greatest reaction period is in the period between February and June. During this period even very minor levels will result in severe migraine attacks. At other times I am able to eat almost whatever I feel like. As a comparrative example: I like tasty/aged chese, am of Dutch descent and eat Edam and Liverwurst. In my safe period I can eat 250 grams of aged cheese with only a minor fuzzing effect, however in my unsafe period I am restricted to approx. 15 grams. Other foods however are a no-no at all times. Yeast extracts, wine,beer and a number of others.
I am still trying to compile my lists. The process for me is a little more difficult than it would normally be due to mittigating circumstances.
I have the following on my problem list:
Depression: 1 Script
Epilepsy: 3 Scripts
Arthritis: 1 Script
Injury management: 2 Scripts
Resectioned Bowel & Lower Intestines resulting in digestive and elimmination problemsMy level of tolerance is dependant on how much of an impact one or more of the above conditions with their associated medication levels is having on me.
As to the question of taking your meds before or after a meal, my experiance has been that this only results in a shift in the onset time, rather than the severity of the attack.
In a consultation with one Dr. I was prescribed Medical Oxygen to treat what he detirmined as stress pains. (This Diagnosis has turned out to be inaccurate, this detirmination being established by a lifestyle study that found no corroborative evidence. The sensitivity to Tyramine has since been detirmined.) This has had a very positive effect to date. Prior to the Oxygen the severity of the pain was about 9/10 while the attacks would last anywhere from 3 hours to 9 hours. With the Oxygen I have been able to contain the length of the attack to about 15 Minuites, breathing the Oxygen for the whole period. This is generally the end of the attack, however there have been occasions where I have inadvertantly been caught out with the Tyramine content, and this results in an on off pattern. (start of attack; 15 min O2; 2 hour break; attack return; 15 min O2. I had one time that this start stop went for a whole night, bad eating habits. But with checking I found that my BP was only 100/70. Normally my BP is 130/80, so I am assuming that this has some bearing on the case.Blood flow volume v Flush time.
The upshot of all of the preceeding is that from my experience it is better to start with a small amount and gauge its effect on you, then make a decision based on this about it's safety for "YOU"
Because as is shown in test reports done on the content of Tyamine in the same product from different batch's, there is wide variation, the same conclusion should be applied to people and their tollerance levels.Cornycon
Posted by Sad Panda on February 18, 2004, at 9:46:06
In reply to Re: Nardil and MAOI diet restrictions » Bigdave, posted by cornycon on February 18, 2004, at 8:36:03
> > I'm due to begin a trial course of Nardil in a few days and I've been researching as
> > much as possible about the MAOI diet restrictions. Unfortunately I'm having to self-
> > medicate myself as my doctor flatly refused to prescribe Nardil and told me it's unlikely
> > any dr will prescribe it me for treatment of social anxiety. Very unfortunate for me
> > since now I have to pay for the medication myself at a cost of £50 a month.
> >
> > My dr described it as a "dirty drug" and said it was no longer used! I wrote to my dr last
> > week to give him the 'good' news about me taking Nardil myself privately and he wrote back
> > to me saying "I strongly advise you not to take Nardil without supervision" and recommended
> > that he refers me to a specialist, a road which I've been down several times already.
> >
> > I've decided that Nardil is something I want to try and I'm sure if I'm sensible
> > and careful with the diet I'll be fine. That's really the reason for my post to get some
> > answers and hopefully put to together an overall diet guide. From the posts I've read here
> > I must say it seems very daunting and confusing with lots of conflicting and non-specific
> > information.
> >
> > One thing which particularly worries me is people saying that certain things which are
> > recommend to avoid, are ok, such as beers and wine and some food items. Surely
> > it's better to be safe than sorry and avoid these items, period? Afterall everyone is
> > different and what's fine for one person may produce a terrible reaction in another
> > person. Another reason for sticking to the list rigidly is that it's impossible to say
> > with any kind of accuracy what levels of tyramine may or may not be found in certain
> > types of food on the things to avoid list. How can you possibly know how much tyramine
> > is in a serving with so many different variations and other factors? I think if I start
> > gambling with this and experimenting I would become very anxious and worried that I'd
> > have a hypertensive reaction and that might bring one on anyway!
> >
> > If you stick to the guidelines then you're not taking chances is how it seems
> > to me. It doesnt seem majorly difficult to me to maintain a strict diet, certainly for
> > vegetarians anyway. The only real sacrifice for me will be cheese and beer which I enjoy
> > often.
> >
> > It's puzzling to me how since the diet restriction is such an important issue for people
> > taking MAOI medication, why there isnt a single authorative published list somewhere
> > on the web with very specific and detailed information which is updated regularly. Perhaps
> > maintained by the drug manufacturer?
> >
> > One point which is seldom discussed as well is that it's better to take your MAOI
> > medication sometime AFTER a meal which is likely to contain tyramine. I've read that
> > this can minimise the chance of a hypertensive reaction or make it considerably less.
> > This sounds like good sound advice to me and makes sense. Does anyone agree with this
> > and use this approach with taking MAOI meds?
> >
> > Bigdave
>
> In regard to the safety of taking foods in the groups that have tyramine in them.
>
> I have found that the degree of reaction to these foods is more than just the levels of tyramine that they contain. For example the rate of the digestive process, the regularity of Bowel motions, Blood pressure, Medication combinations, Season of the year.
>
> I live in the southeastern part of Australia, My greatest reaction period is in the period between February and June. During this period even very minor levels will result in severe migraine attacks. At other times I am able to eat almost whatever I feel like. As a comparrative example: I like tasty/aged chese, am of Dutch descent and eat Edam and Liverwurst. In my safe period I can eat 250 grams of aged cheese with only a minor fuzzing effect, however in my unsafe period I am restricted to approx. 15 grams. Other foods however are a no-no at all times. Yeast extracts, wine,beer and a number of others.
>
> I am still trying to compile my lists. The process for me is a little more difficult than it would normally be due to mittigating circumstances.
>
> I have the following on my problem list:
>
> Depression: 1 Script
> Epilepsy: 3 Scripts
> Arthritis: 1 Script
> Injury management: 2 Scripts
> Resectioned Bowel & Lower Intestines resulting in digestive and elimmination problems
>
> My level of tolerance is dependant on how much of an impact one or more of the above conditions with their associated medication levels is having on me.
>
> As to the question of taking your meds before or after a meal, my experiance has been that this only results in a shift in the onset time, rather than the severity of the attack.
>
> In a consultation with one Dr. I was prescribed Medical Oxygen to treat what he detirmined as stress pains. (This Diagnosis has turned out to be inaccurate, this detirmination being established by a lifestyle study that found no corroborative evidence. The sensitivity to Tyramine has since been detirmined.) This has had a very positive effect to date. Prior to the Oxygen the severity of the pain was about 9/10 while the attacks would last anywhere from 3 hours to 9 hours. With the Oxygen I have been able to contain the length of the attack to about 15 Minuites, breathing the Oxygen for the whole period. This is generally the end of the attack, however there have been occasions where I have inadvertantly been caught out with the Tyramine content, and this results in an on off pattern. (start of attack; 15 min O2; 2 hour break; attack return; 15 min O2. I had one time that this start stop went for a whole night, bad eating habits. But with checking I found that my BP was only 100/70. Normally my BP is 130/80, so I am assuming that this has some bearing on the case.Blood flow volume v Flush time.
>
> The upshot of all of the preceeding is that from my experience it is better to start with a small amount and gauge its effect on you, then make a decision based on this about it's safety for "YOU"
> Because as is shown in test reports done on the content of Tyamine in the same product from different batch's, there is wide variation, the same conclusion should be applied to people and their tollerance levels.
>
> CornyconHi Cornycon,
I'm in SE Queensland. I'm not on an MAOI(yet), but would love to hear more about what you think about the different tyramine levels of different cheeses. I can live without Beer, Wine, Vegemite, etc. But not sure I can live without some kind of cheese.
Cheers,
Panda.
Posted by cornycon on February 19, 2004, at 1:33:23
In reply to Re: Nardil and MAOI diet restrictions » cornycon, posted by Sad Panda on February 18, 2004, at 9:46:06
Dear Panda
For more info Re. cheese and other foods you can check the following sites.
http://www.migraeniker.dk/engelsk/triggers/tyraminmigraene-englisk.htm
http://www.naturesbounty.com/HealthNotes/Diet/Tyramine_Diet.htmI have generally had no problems with the Cheddar cheese slices. But then again I don't have more than 2-3 slices at a time. However with COON & Mainland Gouda as well as shredded tasty cheese in general I have to exercise caution. I too like like these and can eat a 250gm block in one hit. For this indulgence I sometimes pay very dearly. In the last 2 days I made the mistake of making myself a "Healthy meal" without considering the total content, rather than the individual content of the ingrediants. The onset of the pain was not typical and I compounded the problem by taking a Sudafed tablet because I thought it was a hayfever reaction. I have had almost no sleep and suffered a great deal during this time. So with our love of cheese it is still a case of eater beware. I have at times realised that when I would have expected some sort of consequences, they have not occured. I am thinking that there is a posibility that this situatiuon was a result of the food combinations that I had at the time. I'm still working on this one, as the mittigating factors are many and varied, as you can see from my list. It could also have been the different retention level of one of the other meds that i'm on, a difference in the time that I took my meds, etc, etc. It could have been wheather or not I have had a bowel motion in the last week,(due to ops I have periods of up to 3 weeks between, this has been for my whole life).
Are you considering starting, thinking of seeking help or not started an already prescribed med.
Regards, Best Wishes & good luckCornycon
Posted by Sad Panda on February 19, 2004, at 2:59:04
In reply to Re: Nardil and MAOI diet restrictions, posted by cornycon on February 19, 2004, at 1:33:23
> Dear Panda
> For more info Re. cheese and other foods you can check the following sites.
> http://www.migraeniker.dk/engelsk/triggers/tyraminmigraene-englisk.htm
> http://www.naturesbounty.com/HealthNotes/Diet/Tyramine_Diet.htm
>
> I have generally had no problems with the Cheddar cheese slices. But then again I don't have more than 2-3 slices at a time. However with COON & Mainland Gouda as well as shredded tasty cheese in general I have to exercise caution. I too like like these and can eat a 250gm block in one hit. For this indulgence I sometimes pay very dearly. In the last 2 days I made the mistake of making myself a "Healthy meal" without considering the total content, rather than the individual content of the ingrediants. The onset of the pain was not typical and I compounded the problem by taking a Sudafed tablet because I thought it was a hayfever reaction. I have had almost no sleep and suffered a great deal during this time. So with our love of cheese it is still a case of eater beware. I have at times realised that when I would have expected some sort of consequences, they have not occured. I am thinking that there is a posibility that this situatiuon was a result of the food combinations that I had at the time. I'm still working on this one, as the mittigating factors are many and varied, as you can see from my list. It could also have been the different retention level of one of the other meds that i'm on, a difference in the time that I took my meds, etc, etc. It could have been wheather or not I have had a bowel motion in the last week,(due to ops I have periods of up to 3 weeks between, this has been for my whole life).
> Are you considering starting, thinking of seeking help or not started an already prescribed med.
>
>
> Regards, Best Wishes & good luck
>
> CornyconThanks for the reply Cornycon :) I guessed that the processed slices would be OK for a slice or two, but they don't have any age & therefore tyramine or flavour :( I have seen mention recently that provolone was OK, have you had an experience with it? The second webpage is fairly harsh, I can't believe that you can't have tomatoes!? They don't have much protein so how can they contain tyramine?
I have atypical depression, I am taking Efexor+Avanza & am feeling realtively happy, but I still have zero motivation & drive. Everything I have read so far indicates to me that Parnate is the 'gold standard' for atypical/anergic depression, but if an MAOI diet has to be as harsh as that second webpage suggests then I don't think I could do it.
Cheers,
Panda.
Posted by Chairman_MAO on February 19, 2004, at 7:37:05
In reply to Re: Nardil and MAOI diet restrictions » cornycon, posted by Sad Panda on February 19, 2004, at 2:59:04
I would give up tyramine-rich foods like aged cheeses--which I love dearly--in a heartbeat if I got euthymia and energy in return! There's no contraindication for cannabis, anyway. :) Wellbutrin seems to be doing an OK job, but I am so agitated and paranoid at times that I want to bite down on a block of wood. I've tried Effexor, Celexa, Lexapro, Remeron, desipramine, trazodone, Wellbutrin for depression. When does this madness end?!? Perhaps someday I will get a sympathetic doctor that will trust me with my own freaking life enough to prescribe Parnate.
Posted by cornycon on February 20, 2004, at 5:50:04
In reply to Re: Nardil and MAOI diet restrictions » Sad Panda, posted by Chairman_MAO on February 19, 2004, at 7:37:05
Nardil is a high level side effect generator. If you decide to commence a self tretment program then I would strongly advise you to also put in place some sort of monitoring program.
With regards the warning on Tomatoes: This item is included on the list because there is a certain level generated via Alkaloid biosynthesis. This level is variable and is dependant on the growing environment, contact with insects (they stimmulate response mechanisims as well as depositing protiens onto and into the fruit), stage of development and control sprays used during the growth cycle.
There are a lot of things that I havent tried, so I can't give an answer on your question regarding Provolone. However based on its characteristics I would say that it would have high levels of Tyramine.
I have come across some research that may be of interest. The drug Selegiline ( Eldepryl. Deprenyl) is selective for MOA type B, which is the accepted triggering agent for the Tyramine reaction. It appears that with small doses of this drug the MOAB levels are inhibited to the extent that significant levels of Tyramine can be tolerated before there is any reaction.
The down side to this is that if you take too much with your MAOI you could end up in BIG trouble. For more info consult the following site ( It may not appear like a relavent site but carefully read the info): http:www.parkinsons-information-exchange-network-online.com/drugdb/120.html
RE: Parnate. Have you checked out what this supposed salvation drug can and will do to you???? For more info. check out the following site:
http://www.psyweb.com/Drughtm/tranyl.html
Rather you than me is all I can say.Regards and best of luck to all
Cornycon
Posted by gardenergirl on February 20, 2004, at 6:17:29
In reply to Re: Nardil and MAOI diet restrictions » Chairman_MAO, posted by cornycon on February 20, 2004, at 5:50:04
Provolone, like mozzarella, is not an aged cheese. It is fresh, and thus, unless it is well past an expiration date, it usually contains low to insignificant levels of tyramine.
I'm not sure what you were highlighting with the link. Perhaps the list of side effects? I have to admit, I've seen as long a list on many other drugs. Most of MAOI side effects are tolerable and/or go away in time. Like any drug, there are some SE's that are deal-breakers. This is an individual decision between a patient and doctor. And of course you know that everyone does not respond alike to meds.
I respect your opinion based on your needs, but please do not disrespect the decisions made by others.
gg
Posted by Sad Panda on February 20, 2004, at 7:56:01
In reply to Re: Nardil and MAOI diet restrictions » Sad Panda, posted by Chairman_MAO on February 19, 2004, at 7:37:05
> I would give up tyramine-rich foods like aged cheeses--which I love dearly--in a heartbeat if I got euthymia and energy in return! There's no contraindication for cannabis, anyway. :) Wellbutrin seems to be doing an OK job, but I am so agitated and paranoid at times that I want to bite down on a block of wood. I've tried Effexor, Celexa, Lexapro, Remeron, desipramine, trazodone, Wellbutrin for depression. When does this madness end?!? Perhaps someday I will get a sympathetic doctor that will trust me with my own freaking life enough to prescribe Parnate.
>I haven't asked my doc about Parnate yet, I'm hoping a higher dose of Efexor is going to give me some motivation. If it doesn't work my only other activating med choices here are Reboxetine, Nortriptyline or Parnate.
Cheers,
Panda.
Posted by Sad Panda on February 20, 2004, at 8:19:55
In reply to Re: Nardil and MAOI diet restrictions » Chairman_MAO, posted by cornycon on February 20, 2004, at 5:50:04
> Nardil is a high level side effect generator. If you decide to commence a self tretment program then I would strongly advise you to also put in place some sort of monitoring program.
>
> With regards the warning on Tomatoes: This item is included on the list because there is a certain level generated via Alkaloid biosynthesis. This level is variable and is dependant on the growing environment, contact with insects (they stimmulate response mechanisims as well as depositing protiens onto and into the fruit), stage of development and control sprays used during the growth cycle.
>
> There are a lot of things that I havent tried, so I can't give an answer on your question regarding Provolone. However based on its characteristics I would say that it would have high levels of Tyramine.
>
> I have come across some research that may be of interest. The drug Selegiline ( Eldepryl. Deprenyl) is selective for MOA type B, which is the accepted triggering agent for the Tyramine reaction. It appears that with small doses of this drug the MOAB levels are inhibited to the extent that significant levels of Tyramine can be tolerated before there is any reaction.
>
> The down side to this is that if you take too much with your MAOI you could end up in BIG trouble. For more info consult the following site ( It may not appear like a relavent site but carefully read the info): http:www.parkinsons-information-exchange-network-online.com/drugdb/120.html
>
> RE: Parnate. Have you checked out what this supposed salvation drug can and will do to you???? For more info. check out the following site:
> http://www.psyweb.com/Drughtm/tranyl.html
> Rather you than me is all I can say.
>
> Regards and best of luck to all
>
> Cornycon
>Thanks for the heads up Cornycon. :) I won't be self medicating as that costs too much money that I don't have ATM.
A snip from that page http://www.psyweb.com/Drughtm/tranyl.html
"Uses: Treatment of major depressive episode without melancholia. Not a first line of therapy; is used when clients have failed to respond to other drug therapy. Investigational: Alone or as an adjunct to treat bulimia, obsessive compulsive disorder, and manifestations of psychotic disorders. Also, treatment of social phobia, seasonal affective disorders, adjunct to treat multiple sclerosis, and to treat idiopathic orthostatic hypotension (e.g., Shy-Drager syndrome) refractory to conventional therapy."
This med looks nearly like it was made for me as I am having a "major depressive episode without melancholia"(Atypical) + some social phobia + some problems with obsession + nil drive or motivation. I guess if I end up on Parnate I will soon work out what I can & can't have to eat. :)
Cheers,
Panda.
Posted by Sad Panda on February 20, 2004, at 8:33:34
In reply to Re: Nardil and MAOI diet restrictions » cornycon, posted by gardenergirl on February 20, 2004, at 6:17:29
> Provolone, like mozzarella, is not an aged cheese. It is fresh, and thus, unless it is well past an expiration date, it usually contains low to insignificant levels of tyramine.
>
> I'm not sure what you were highlighting with the link. Perhaps the list of side effects? I have to admit, I've seen as long a list on many other drugs. Most of MAOI side effects are tolerable and/or go away in time. Like any drug, there are some SE's that are deal-breakers. This is an individual decision between a patient and doctor. And of course you know that everyone does not respond alike to meds.
>
> I respect your opinion based on your needs, but please do not disrespect the decisions made by others.
>
> gg
>
>That web page would be just the drug monograph that typically comes with any drug. It list every possibly side effect for legal reasons I guess.
When my doc wanted to put me on Efexor, I was fearful of my BP going up since, every bit of data I have seen on the net seems to indicate Efexor's main side effect was to make BP rise. I already have high BP & am taking an ACE inhibitor for it & my doc assured me that if Efexor worked for me that it would lower my BP & so far this has been the case. So I guess when people say YMMV it really is true. :)
Cheers,
Panda.
Posted by Sad Panda on February 20, 2004, at 9:26:09
In reply to Re: Nardil and MAOI diet restrictions » Chairman_MAO, posted by cornycon on February 20, 2004, at 5:50:04
> I have come across some research that may be of interest. The drug Selegiline ( Eldepryl. Deprenyl) is selective for MOA type B, which is the accepted triggering agent for the Tyramine reaction. It appears that with small doses of this drug the MOAB levels are inhibited to the extent that significant levels of Tyramine can be tolerated before there is any reaction.
>Below 20mg/day you don't need to be on the diet, but being an MAO-B inhibitor means that it doesn't increase the levels of Serotonin or Norepinephrine which makes it not an anti-depressant. Above 20mg/day makes it no longer selective & you have to be on the diet. It will be awhile before we get to see the patch.
"In controlled clinical trials, selegiline caused slight improvement in motor performance at the start of therapy and worsening at its discontinuance; it also delayed the development of disability that requires the addition of levodopa. Selegiline was approved by the FDA in June 1989."
In Australia you can't have Selegiline until AFTER you are on levodopa--decarboxylase inhibitor combinations. We are a backwards country.
Cheers,
Panda.
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