Amine diet investigation

The following guidelines are provided where amines, particularly tyramine, are suspect in headaches, migraines or other food sensitivity symptoms. Amines should not be the only exclusions since where they cause reactions other food chemicals are also likely to also be a problem. These include additive colours, flavours, preservatives, monosodium glutamate, and natural salicylates. So diet investigation should begin with a low chemical elimination diet such as that outlined in Are You Food Sensitive? This idea also works the other way in that all food sensitive people investigating their diet need to exclude amines as those who react to additives, spices and MSG are also likely to react to amines. [Where amine restriction accompanies the use of MAOI medication only tyramine needs to be excluded.]

So amines should be minimised, as part of the exclusions in an initial elimination diet for investigation into food intolerance.
The variation in amine content in food from the research is reflected in the variation in tolerance in practice.Some elimination diets begin by excluding all foods known to contain any amines at all. This is rarely necessary, as those who always react to the following foods are quite clear about the need for their exclusion. It is important that the suggestions provided for tolerance are followed as the amine content of foods is not an all-or-nothing position. Amines can increase dangerously as the food changes with age or ripening.

The following foods may be used in the initial diet trial using the diet detective method, with the stated qualifications:Bananas, avocado, and broccoli, figs, sugar bananas and cauliflower may be used as long as they are “just ripe”.
Mild flavoured spinach may be used.
Pork may be used, as long as, it is bought on the day the butcher gets it in and cooked that day or frozen.
Canned tuna or salmon can be used, as long as they are bought from a shop with a high turnover, and used that week. Once opened the food has to be eaten that day or frozen.
Ham and bacon may be used if bought fresh from a big self serve deli section where it has not been aged at all. The food has to be eaten that day or frozen. The amount must be limited so it is wise to use them just as a flavour in the initial diet trial.
Malt or white spirit vinegar may be used sparingly in a freshly prepared food.
Very fresh nuts [except almonds – excluded because of salicylates].
Copha is allowed.
Meat browned only until it smells good to the individual.
Add exclusion of any food that “smells stale” to the susceptible person
Add exclusion of any food that “tastes strong” to the susceptible person
The quality of the flavour matters greatly, and is a good guide to tolerance.
Food sensitive individuals have a very good sense of smell. Use it!!

Once diet is established, after 4 weeks, individual food trials can be taken
Note:- individuals vary in what they think they can tolerate. That is true as what is tolerated by one may not be tolerated by another. One person may tolerate ripe bananas, chocolate, and an occasional wine, but not aged rump or home-made gravy in the pan. Another may never tolerate chocolate, wines, but tolerate just ripe banana, mild avocado, canned fish, and limited fresh ham. So it is important to test each amine-containing food separately and not assume that where one is not tolerated another will also cause reactions.
Reactions also depend on “the total body load” of other suspect substances, such as salicylates, additives, MSG, stress, smells, hormone changes, and other factors listed as part of the total body load. Work with an experienced dietitian and read “Are you food sensitive?”
Each of the following can be trialled, one at a time, each in gradually increasing doses until symptoms appear, or for seven days.
Matured cheese, in small amounts, only if it smells very fresh.
Wine, as long as it has a “good quality bouquet” to the individual.
Chocolate is either tolerated or not tolerated. Unlike other amines the tolerance of chocolate is less likely to be related to quality of flavour, but it is sometimes.

What do people tolerate in the real world?There are two parts to thinking about amine sensitivity. One is what the research says from analysis of the amine content in foods. This is very useful and the content listed below is helpful. However since the amine content can vary greatly with the amount of aging, or stage of ripening of the food, the figures reported below may not relate to the very fresh food you may want to trial. Note that the figures do often give a range of content that is very wide. Where people are very motivated all food which contain any amines may be excluded initially.
The other aspect of amine sensitivity is what patients report tolerating or not. Individuals do vary in which amines they tolerate and the dose they tolerate. I have met many people who can eat an amine-containing food as long as they have bought it themselves making sure it is very fresh and it smells high quality to them. But they may not tolerate it if eaten two or three days in a row.
Irritable bowel syndrome [IBS] reactions reported are often after eating out probably because the food is more likely to be aged or “rich”, which is usually high in amines and other suspect chemicals. They report reactions after aged meats, including lambs fry [with a strong smell], and after cheeses that smell “stale” or “off” to the individual. It is of interest to note that chocolate is very often reported to cause migraines, but rarely produces the bad gut urgency and cramping of IBS.

What does the research say? Advice provided on lowering amines in diets is based on analysis data, and also on reports of foods reported to induce severe reactions in patients on Monoamine oxidase inhibitor [MAOI] medication.

Normally amines are oxidised by MAO enzymes in gut, nervous system and in platelets.
On MAOI medication amines are not oxidised and patients notice headaches and some have rises in blood pressure – hypertensive crisis – which can be fatal. They need dietary advice to exclude foods containing amines.

From the research analysis we can learn that amines are formed in food by a number of different processes, and that there is the wide variation in the amount of biogenic amines in suspect foods. So people can react to a food on one occasion and not on another.

Variations in amine concentration is caused by:
1. the source of the foodstuff – proteins can provide the nitrogen in amine production

2. storage conditions – amines increase in the aging of meats and maturing of cheeses

3. fermentation – in brown [fermented] sauces and in Vegemite, Promite and Marmite

4. method of preparation – amines increase at particular temperatures and in browning

5. time, amines increase with storage before and after cooking, and during aging

6. temperature – amines are produced at ideal temperatures for enzyme function

7. acidity – lower acidity increases the amount of amines produced

8. cooking – increases volatilisation and decreases content

An increase in flavour intensity – sharpness – is associated with increased levels of amines.
Different amines are increased during deterioration (putrefaction) of food.

The research literature does acknowledgement individual variation in tolerance. This is known from clinical reports of reactions in people on MAOI medication. Different people may react to particular amines, or at particular doses. Diet detective work can help you work out just what you need to be careful about. See Are You Food Sensitive?

We encourage your contribution. Please feel free to reply and comment below. Joan Breakey Specialist Food Sensitivity Dietitian - This page may be copied with acknowledgement

{ 12 comments }

Stacey April 15, 2014 at 10:03 am

hi,
I’ve recently been diagnosed as having an intolerance to Amines. If I stick to the allowable fruits, vegetables, nuts, limited dairy, and chicken or tuna I don’t seem to get any flare-ups (my skin goes red, dry, itchy, and swollen especially on my face). however, I am taking a daily antihistamine and most days a Prednisone tablet as well.
I really want to stop taking the medication but wonder what types of vitamins possibly mimic the tablets without the side effects?
I struggle with the bland diet and do occasionally cave and have high amines foods with terrible side effects!
Can you help???
Thank you kindly,
Stacey.

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joan April 19, 2014 at 8:46 am

Dear Stacey,
There are various lists of low amine foods so I suggest you look at different ones to see if you can expand what you can eat. My other idea is to use what others have found, particularly that there is individual variation in just which high amine foods are tolerated in you personally. This may not be the same as in other amine-sensitive people. For example one amine-sensitive person may react to chocolate, aged beef, brown sauces, but not react to just-ripe bananas or just ripe broccoli or mild avocado. Another may tolerate limited chocolate but not home-made gravy made in the pan.
I remember a patient who had migraines if she had milk one day after the milk carton had been opened and stored in the refrigerator. If she always had the milk only on the first day it was open she had no reaction.
It is worth reading my most recent book Tolerating Troublesome Foods which gives hints on how to use many foods so you have minimal reactions. [See the newly reduced prices for all books!] If you use all the information there you may be able to broaden your diet so you crave suspect foods less. You can learn tricks to make the diet more effective and so reduce your meds, but another way to look at it is that while taking the medication your system is better able to cope with some amines in the diet. Vitamin tablets do not replace antihistamines nor Prednisone [which should be reviewed by your doctor from time to time]. There is no reason why a low amine diet should be lacking in vitamins but do seek out a registered dietitian to check your overall nutrition if you are concerned. It takes a little time to enjoy your new way of eating, but you can become a gourmet of good quality foods that do not need sauces or marinades to make them palatable. Use the idea from Tolerating: “It’s got to be per-fect” to suit you! Joan Breakey

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Teresa Wilson January 21, 2014 at 7:01 pm

Hi. About seven years ago I went on an elimination diet to determine the cause of bad bone and joint pain and found I am gluten sensitive. That was my only food issue (other than difficulty chewing due to TMJ replacement) until about a year and a half ago. Around the time of some serious family stress I started reacting to a wide variety of foods including dairy, soy, rice (probably due to excess consumption after going gluten free), chocolate, pineapple, citrus sodas and port wine. My symptoms vary from slight cough, to violent coughing, congestion, itching, difficulty breathing, digestive upset, lethargy, etc. IGE testing showed no allergies, but IGG testing showed reactions to eggs, yeast and pecans. The difficult/frustrating thing is that some foods I may react to one day, but not the next so I am unsure which foods I really need to avoid. This inconsistency has made me wonder if there is something in foods that I’m reacting to once a certain threshold has been reached in my body – specifically thinking of salicylates and/or amines here. I tried doing a strict elimination diet, but got very discouraged when I had reactions after eating a supposedly safe meal of lamb, green beans and pears. This is why I began considering amines as I tend to prep a weeks worth of meals on the weekend, then eat leftovers all week. Anyway, I’ve gone through all that to ask this – if amines are the cause of my reactions am I doing damage to my body by continuing to eat amine containing foods?

Thank you,
Teresa Wilson

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joan January 25, 2014 at 6:33 am

Dear Teresa, Are you doing damage to your body by eating foods you suspect are causing reactions? This is a very interesting question. It appears that the only damage is the discomfort of whatever symptoms you get while they are happening. I know this as some people get very good results when they trial diet even though they have been putting up with symptoms all of their lives. So the amount of improvement diet can produce is more related to just how much improvement diet can give to that person, not to how long they have had the symptoms. If babies and children under age seven got great improvement and adults got much less we could worry that the suspect chemicals had caused some damage to the body. I have met people who once they know they are diet responders occasionally eat a food or foods that cause reactions because they really love some food and are prepared to put up with some symptoms knowing that the discomfort is all they have to cope with. Previously they may have worried they had a cancer or tumor and it is such a relief to know that symptoms only come with they relax their diet too much, or eat a particular high risk food. You can go to my Articles section and read the article “Is food intolerance and inborn error of metabolism?” You would probably also enjoy the chapters in Tolerating Troublesome Foods that provides information on how food tolerance can change for many reasons. These reasons can be factors in you which are constant, factors in you that vary, factors in the environment and factors in the food itself. And you can note all the tricks on 300 different foods in the Best Guess Food Guide that help increase the likelihood of them being tolerated. I wish you all the best in your search for your best diet for your particular lifestyle. Joan

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Rachel January 20, 2014 at 3:38 pm

Hi. I have been aware of my food sensitivities for about two years. I have eliminated gluten, dairy, leafy green vegetables, beans, oats, and limit my intake of peanuts. I’ve had brain fog for ages and have always assumed it had to do with sleep (because I frequently wake up at 4am wired and not able to go back to sleep). In the past 3 months I have started getting migraines and the brain fog has heavily increased, which has been more noticeable b/c I am a student and frequently having to concentrate! I recently had a meal of chicken, balsamic vinagrette (which I had not had in about 3-4 weeks), red wine, tomatoes and olives. The first night I woke up in the middle of the night and had a slight headache the next day. The next night (to which I added the red wine) I felt horrible, barely slept, and was extremely nasueaus the next day with heavy brain fog. That is when I began looking into sensitivity to histamines and different amines. I am looking into your book- but just wondering if you have any immediate advice. My diet is so limited already I am just a bit overwhelmed at where to start. Also, do you suggest any remedies for the day after a high amine diet (if I am still figuring out what I am sensitive to?) I find it quite hard to properly concentrate and go about the day. Thank you!

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joan January 21, 2014 at 10:41 am

Dear Rachel, I could write a book on all you need to know! And I have! Yes you need to get Are You Food Sensitive? and also read most of the articles on the Article section on the site for lots of information. As well as investigating amines you also need to look at additives, and it is worth considering salicylates and MSG. Remember the brain fog is similar to the problems re thinking that I deal with in ADHD kids who also wake wired. The immediate advice is to read the book and do the Family Sensitivity History and use what you find, especially whether you need to completely exclude the foods you have excluded. There is no quick remedy but take action to treat your symptoms eg headache with painkillers your doctor is happy with [and have no additive colour or flavour]. You could also discuss with your doctor use of urinary alkalisers for you as some report that helps. All the best as you work through the book to find the right diet for yourself from Joan

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Natalie Brown January 18, 2014 at 8:46 pm

Whenever I eat chocolate I get a very dried out feeling. It takes away my feeling of vitality and wellbeing. Also if I eat dark chocolate its way worse. I will feel like Im sucked dry of all dopamine. I will feel dull and wont be able to feel pleasure feelings. I actually will not eat dark chocolate especially because it makes me feel so bad. I was wondering if this could be due to an amine sensitivity since chocolate is mentioned.

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joan January 25, 2014 at 7:39 am

Dear Natalie, You certainly sound as if you are sensitive to chocolate. It contains only one type of amine [phenylethylamine] so the good news is that chocolate may be the only food you react to. However if you get similar symptoms after other foods – maybe rich foods that do not contain chocolate], then you can investigate them too.
You do sound clear about the connection to chocolate and it sounds like a reaction you want to avoid! If you get these symptoms when you have completely excluded all chocolate you can go to the Articles section on my site and look at the pages on Amines and you will see examples of foods that contain other types of amines and which foods contain them. you would not be alone if chocolate is the only food you react to, but that does not mean it is not important to you. Do tell your doctor and report to him or her if you get a similar reaction to any medicines. My best wishes in your increasing diet awareness. Joan

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Rebecca July 13, 2013 at 7:40 am

Hi. I have serious tummy problems and believe I have a dairy intolerance. However my tummy ( and wheezing) gets worse when I eliminate dairy and eat a ‘healthy’ diet of lots of fruit, vegetables, seeds, nuts and avocados and dark chocolate. I don’t eat meat but do eat fish. I’m beginning to wonder whether I have a problem with amines? Could you suggest an elimination diet or any advice? Thank you x

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joan July 18, 2013 at 6:46 am

Dear Rebecca, When we eliminate some food we increase another. Your healthy diet may include various foods or factors that do not help. This can include acidy fruit, spices and others, as well as rich food [which included chocolate too]. You did not mention bloating but if you have bloating as well you can get help from a dietitian about all the sources of wind, and there are quite a few. See the article in the Section – Articles – on http://www.FoodIntolerancePro.com in the section Food Intolerance. The article is called Which elimination diet should you begin with? and you can see why it can be confusing but solvable – http://www.foodintolerancepro.com/category/food-intolerance/which-elimination-diet/
You can learn that you need to consider the suspect additives, and the natural chemicals that cause reactions as well. You can get even more detail by reading Are You Food Sensitive? because diets cannot be summed up by a couple of pages of do’s and dont’s. It really makes a difference if you can understand how to use information in your family to decide which whole foods to consider, especially to use the tricks whereby dairy may just need to be limited but not excluded. You can also learn about Target organ sensitivity [in your case both your tummy and your lungs ], and the Total Body Load idea of all the foods and things in your environment that build up to your personal threshold. I call the whole process diet detective work and within 3 months you can be on your very own diet that suits just you. I wish you well. Joan.
PS There is additional info in Tolerating Troublesome Foods to help you make your diet as slack as possible, while still reducing your symptoms.

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Kerri-Anne Howse June 2, 2013 at 11:34 am

I am currently testing myself for amine intolerance by using an amine elimination diet. I have been doing this for that past month. I am concerned about the placebo effect and am wondering how accurate this testing can be. I really want to remain objective but am finding is very confusing. How can I get an accurate result in testing this?

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joan June 12, 2013 at 2:00 am

Dear Kerri-Anne, That is a very good question. I presume you have learnt much by using ALL the information on Amines on this site, and have been on the strict diet for four weeks. You can resolve your concern in a number of ways. The first is to blame anything besides diet for your symptoms when you begin challenges, making sure you use all the detail in ‘Are You Food Sensitive?’ testing only one food over 7 days in increasing amounts. So if you have had to deal with some change in the environment such as some strong smell, or increased stress, then blame that, and double the amount of the test food. If it was not the test food your symptoms will not get worse, but if it was the food they will. Of course it is best not to test a food when something else is changing but you cannot always plan for changes in the world around you! Kerri-Anne, it is complex and so I have gone to lots of trouble to write out the detail of all the factors that can change tolerance – in you, in the environment, and, importantly, in the food itself, in Tolerating Troublesome Foods. See http://www.foodintolerancepro.com/tolerating-troublesome-foods/ I can assure you that other amine sensitive people, after a time, become extreamly good at knowing when they are having a diet reaction and when it is something else. Kind regards Joan

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