FOOD INTOLERANCE NETWORK FACTSHEET
Amines
All foods are made up of
hundreds of naturally occurring compounds that can have varying effects on us,
depending on how much we eat and how sensitive we are.
Biogenic amines are formed
by the breakdown of proteins in foods. They can affect mental functioning,
blood pressure, body temperature, and other bodily processes. Some hormones,
such as adrenaline (epinephrine) are compounds containing an amine. There are
many different amines, including:
• tyramine (e.g. in cheese) • histamine (e.g. in wine) •
phenylethylamine (e.g. in chocolate) • agmatine, putrescine, cadaverine,
spermidine (e.g. in decomposing fish) • tryptamine • adrenaline (ephinephrine)
• serotonin • dopamine.
Biogenic amines are
normally quickly broken down in the body with the help of enzymes such as MAO
(monoamine oxidase-A) which render them harmless. Missing, sluggish or blocked
enzymes can lead to a build up of amines in the body.
• The ‘cheese effect’. In people who are taking certain drugs known
as MAOIs (monoamine oxidase inhibitors), the enzyme is inhibited and a build up
of tyramine can occur, leading to life-threatening high blood pressure as well
as a range of symptoms including headaches, itchy skin rashes, heart
palpitations and diarrhoea. A number of MAOI patients died from strokes or
heart attacks before doctors realised that patients taking MAOIs needed to
avoid foods high in tyramine. This is called the ‘cheese effect’ because it was
recognised in the 1960s by a British pharmacist who noticed that his wife
developed a headache every time she ate cheese - high in tyramine - while
taking MAOI antidepressants.
• Lacking the enzyme. There is a rare condition in which people who
are born without the MAOA gene lack the MAO enzyme. Researchers have long known
that this condition is associated with aggression in men.
• Low activity enzyme. Much more common is a low activity variant of
the gene known as MAOA-L, which seems to occur in about one third of the
population. A study with nine uncontrollable children in 1985 found that on
average there was five times more para-cresol in their faeces than for a control
group. Para-cresol is a breakdown product of tyramine. Could it be that these
children were failing to metabolise dietary tyramine due to a sluggish enzyme?
We don’t know because the study was never followed up, although the researchers
commented that ‘the results point to dietary involvement’. In 2002, a study
found that men with MAOA-L who had been badly treated as children were more
likely to exhibit antisocial behaviour than those who had been well treated.
Amines
and Behaviour
Behavioural effects fit
with what we see in the Food Intolerance Network. Children with oppositional
defiance are the ones whose parents are often told ‘he just needs a good
smack’. But smacking has the opposite effect – if you smack these kids, when
they are big enough they will hit you back. Or if they are scared of their
parents, they will hit other people, and this is defined as conduct disorder.
You have to treat these kids as if they are your friend – a calm approach – and
avoid backing them into a corner at all times. It can be difficult to maintain
a calm approach with someone who is extremely aggressive, and experts
acknowledge that this approach has limited success. Network members find that
it is easier to avoid the food chemicals that cause these effects.
Research suggests that
about 70 per cent of children with behaviour problems are affected by salicylates,
artificial colours and preservatives, compared to only about 40 per cent
affected by amines. Many mothers have reported that their child becomes silly
and hyperactive on salicylates whereas amines make them aggressive. In our
experience, children who are expelled from day care centres due to aggressive
behaviour are usually sensitive to amines as well as to other food chemicals.
Reader stories:
[435] Amines are the really big problem (August 2006)
My 14 year old son goes off
his face with food colouring but it only lasts a couple of hours so we can put
up with that. Salicylates aren’t too bad either, at home, although it must be
terrible at school. He gets bouncy and silly. In class he wouldn’t be able to
sit still or listen to the teacher. He would be too busy poking and prodding
the kid next to him. Amines are the really big problem though. When he eats
amines it’s World War III at our place. We need an air-raid siren. He’ll get up
in a foul mood, kick the wall, swear, throw things, yell. Absolutely revolting.
After we started the elimination diet we had five months of a perfect child but
when we started our challenges that was the end of our wonderful existence.
With his amine challenge he took nearly four weeks to calm down again.
[103] World war three (August 2001)
I contacted a dietitian through
the Base hospital and with their help we managed to get through the Elimination
Diet. ... We both reacted to amines and our symptoms were the same and severe -
aggressive behaviour with a lack of self-control, depression etc. It was like
world war three in our house by the end of the week and both of us took at
least a week to recover …
Amines
and migraines, depression and other symptoms
Amines have been associated
with migraines and headaches, as well as other symptoms of food intolerance,
including irritable bowel symptoms, eczema and depression.
Reader Stories:
[437] Amines and eczema (August 2006)
I am now 46, and have lived
for most of those years with dreadful eczema all over my body, some times much
worse than others. I went to many skin specialists, all who told me that diet
was not linked, not to scratch, bathe in the sea when possible, not to use
harsh soaps and apply cortisone creams. My eczema never got any better. I
started the elimination diet a few years ago with my daughter, who suffers
migraines, and not only did her headaches decrease, but my eczema also faded to
almost nothing! Amines were the trigger
for her migraines, and with keeping off amine rich foods in our house, I have
not had any eczema problems since, and I no longer need to apply creams to any
parts of my body. What a relief!
[436] Amines: depression and hungover (August 2006)
This father who was doing
the elimination diet to support his son chose to do the amine challenge first
because he thought he wouldn’t react. ‘How wrong can you get!’ he wrote in his
account of the challenge:
'I had a violent reaction
within a few hours and have never felt so awful in all my life. Here are some
of the symptoms: depression, suicidal tendencies not just thoughts, melancholy,
looking for an argument, feeling the whole world was against me, lethargy,
shakes, pressure on the skull and tingles in the extremities, feeling of
hangover, inability to focus on thoughts, ringing in the ears, inability to
sleep. The hungover feeling lasted until the next day. Not the best 24 hours
but at least I know there is a cause for symptoms that I have experienced in
the past.’
[400] Amine-related migraines since the age of 3 (March
2006)
My 7 year old daughter
Caitlin (not her real name) has had migraines since she was about 3 years old.
We had no idea what they were for several years. She usually gets a fever with
her migraines and because of the fever the doctor would always put it down to a
virus, prescribing painkillers. I would often give her panadol for 4 days
straight just to keep the headaches at bay. She goes limp and listless, her
eyes always droop, she lies there and sleeps for hours until the panadol wears
off and then the pain and fever return. Most times she will scream and cry,
grabbing her forehead and pleading with me to take the pain away, “Mummy Mummy
my heads hurts, please stop it.” She has always complained of feeling sick
(nausea) when she gets them too, and ‘sore legs’. As well, she has had problems
with nasal congestion and had been using Rhinocourt nasal spray daily. She has
always been a nail biter and a teeth grinder at night.
One year after she started
getting the migraines, we were referred to a pediatrician who could find no
medical reason for them either. He thought it may have been an attention
grabber or perhaps the start of a cold. The migraines continued on and off with
no regular pattern that I could work out, once a week, then maybe another in 6
weeks times, then 2 months. It varied greatly.
Two years later we started
taking a fish oil Supplement called ‘Eye-q’. (I later found ‘Eye-q’ has amines
in it). The migraines became more frequent and she started throwing up with
them. She would go to sleep with a migraine and wake at
We have been eating
failsafe since about March this year and have never looked back. On day 2 of
the amine challenge, Caitlin got a migraine, droopy eyes, became listless, and
a fever. School rang and asked me to collect her again. She stayed unwell for
several days with the headache.
During the challenge, she
also got a blocked nose, sore tummy, sore nose, nightmares and was badly
constipated. Since the end of the amine challenge (3 months ago) we haven’t had
one migraine! No more snotty nose or
blocked nose, nasal sprays, nightmares, sore tummies, nail biting, teeth
grinding, or sore legs - her nails are growing for the first time in her life.
So, no more amines for Caitlin! – by email, NSW
Amines
and a possible link with schizophrenia
A biogenic amine called
dimethyltriptamine (DMT for short) is the only known hallucinogenic compound
naturally produced by the body. Normally it is metabolised by the monoamine
oxidase enzyme before its effects can be noticed. It is used in tribal and
religious rites in
Which
foods?
Fish, cheese, wine, some
meats, some fruit such as bananas and avocados, some vegetables such as
mushrooms, and fermented foods such as chocolate, sauerkraut and soy sauce are
just some of the foods that have been listed as containing varying levels of
amines, but basically any protein food can contain amines depending on the way
it is handled. The amine content of foods varies greatly due to differences in
processing, age, ripeness, handling, storage, variety of grapes or other
produce, cooking method and many other factors. An Australian analysis of the
amine contents of fish-based oriental sauces found up to 6 times the legal
limit of histamines in some of the samples. Freshness is a key factor for
avoiding amines. The new method of meat distribution in our supermarkets is a
problem for amine responders. All meat is now vacuum packed, repacked and sold
as fresh which means it can be up to ten weeks old when you eat it. Studies
show that vacuum packing can inhibit the growth of bacteria but does nothing to
retard the development of amines.
Many drugs can contain
amines, including over the counter cold tablets, decongestants, nasal drops or
sprays, some pain relievers, general and local anaesthetics and some
antidepressants.
In 1996, researchers in a
medical journal reported a more user-friendly MAOI diet based on laboratory
analyses, claiming that many dietary restrictions were not necessary. Doctors
on an internet forum were reluctant about advising patients to relax their
diets. ‘It is easy but is it safe?’ asked one. Another reported a patient whose
diet infringement with a now supposedly safe food resulted in headaches, high
blood pressure and seizures: http://www.dr-bob.org/tips/maoi.html.
Experience suggests that
people who are sensitive to amines need to know a lot of about the history and freshness
of their foods and approach all possible amine-containing foods with caution.
Lists of amine-containing foods such as the one on the World Headache Alliance
website http://www.w-h-a.org/wha2/Newsite/resultsnav.asp?idContentNews=548)
are not complete from our point of view. People with migraines who have avoided
some amine-rich foods often say ‘I tried avoiding foods and it didn’t work’.
This is because migraines can be provoked by many other amine-containing foods
and/or other food chemicals such as additives, salicylates and glutamates. For
recipes that are free of additives and low in salicylates, amines and flavour
enhancers, see the Failsafe booklet.
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More information
People have different
reactions to various food chemicals. Some people are affected by any or all of
the following foods and food chemicals: artificial colours, natural colour
annatto 160b, preservatives, synthetic antioxidants, flavour enhancers,
salicylates, amines, dairy foods, wheat, gluten. See the Failsafe Booklet on
the website www.fedup.com.au under
Failsafe Eating. Some people find that reducing
their intake of these food chemicals helps. For best results, you can do a full
elimination diet with systematic challenges to find the cause of your problem.
You can email for our list of supportive dietitians: confoodnet@ozemail.com.au
The information given is not intended as
medical advice. Always consult with your doctor for underlying illness. Before
beginning dietary investigation, consult a dietician with an interest in food
intolerance. You can find a supportive dietitian through the Dietitians
Association of
© Sue Dengate Update August 2006
