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HeadWay, Issue #035 -- Tyramine and Tiger Balm
June 21, 2006

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In this month's issue:

The tyramine-free diet

Rub it on your temples

Say what?! Valsalva maneuver

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The tyramine-free diet

People come to for a variety of reasons.  But one of the biggest reasons is to find out about the tyramine-free diet.  This type of diet has been a help to many migraineurs over the years.

What is tyramine?

Tyramine is a compound called an amine, found in many foods.  It helps the body regulate blood pressure.  Too much tyramine in the body can significantly increase your blood pressure, and even lead to stroke.

Why avoid tyramine?

Tyramine is broken down in the body naturally, and so most people don't need to worry about skyrocketing levels of tyramine.  However, it may be that certain levels of tyramine in your food could trigger migraine.  Studies have not been 100% convincing, but the number of people that report improvement is significant.

Some drugs also inhibit the natural breakdown of tyramine.  If you're taking monoamine oxidase inhibitors (MOAIs) for depression, you'll need to be on a low-tyramine diet.  Also, the newly approved drug Azilect (Ragasiline), for Parkinson's Disease, must be taken along with a low tyramine diet.  If your levels of tyramine get too high, due to the properties of these drugs, you can not only get a migraine attack but stroke.

How do I avoid tyramine?

Tyramine is in so many foods that many people find it difficult to avoid it altogether.  It may be sufficient to cut down on your consumption.  Better yet, start by eliminating it as much as you can for a few weeks, and then gradually re-introduce small amounts into your diet.  If you're keeping a headache diary you should be able to see if it's a help.

There's a list of many of the high-tyramine foods here, but be especially wary of foods that have been in the fridge for too long - especially meats.  They don't have to be "bad" - if they're more than a day or two old they have high levels of tyramine.  Watch out for fermented foods such as sauerkraut, aged cheeses, teriyaki sauce and alcohol.  Processed meats usually have high levels of tyramine.

Some people find that just one of these is a major trigger for them, and avoiding that one food solves the problem.  Whether it's the tyramine or another factor is uncertain, especially in cases like that.

A major proponent of the tyramine-free diet is Dr Seymour Diamond.  He has detailed information about his tyramine migraine diet in his book Conquering Your Migraine.  If you're serious about trying this diet, get this book or borrow it from your local library.  The Mayo Clinic has a smaller list of foods with tyramine here.

Rub it on your temples

Most of us at one time or another have taken Tylenol, otherwise known as acetaminophen or paracetamol, for a headache.  But we're also on the lookout for ways to avoid taking pills, and an Australian study came up with a suggestion.  Why not try rubbing Tiger Balm on your temples or forehead?

The study found that Tiger Balm was just as good as acetaminophen when it came to beating headaches.  Why?  Well, for one thing, Tiger Balm is often used to relax sore muscles, which may help when it comes to tension headache.  But with ingredients such as camphor, menthol, clove oil and mint oil, it also serves as a form of aromatherapy.

If you want to try something less strong, try plain old peppermint oil.  It's a promising treatment for headaches of various kinds, and migraine too.  Just make sure it's pure 100% essential oil.  Trust me, you can end up with some weird stuff if you're not careful.

Say what?! Valsalva maneuver

No, it's not a new exercise to keep away the headaches.  It's actually something you're quite familiar with, even though you may not know it.  The valsalva maneuver is pressure - either when you close your mouth and nostrils and try to breath out, forcing air into your ears, or when you push air against a closed glottis.  This happens when you cough or sneeze.

There is evidence that the valsalva maneuver can trigger a migraine in some people.  It can also block the blood returning to the heart.
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