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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by djmmm on August 20, 2001, at 8:41:04
What would cause someone to NOT have any sort of reaction to tyramine? I don't follow a MAOI diet, and never have, I also take protein supplements (in the form of a shake) which include (among others):
*L-Phenylalanine 3500 mg
*L-Tryptophan 1340 mg
L-Tyrosine 2780 mgMy doc has no clue...I'm a 23 yr old male, I take Nardil (60mg) for depression...and Neurontin (1800mg), Topamax (200mg) for epilepsy, and occasionally (1 or 2 x a week )Inderal (40mg) and trazadone (50mg)
any input would be appreciated..
Posted by Adam on August 20, 2001, at 16:44:23
In reply to No MAOI food reaction?, posted by djmmm on August 20, 2001, at 8:41:04
Some people are simply less prone to hypertensive reactions than others. The thing is, unless you monitored your blood pressure with an accurate instrument after ingesting a "forbidden food", there's no empirical way to determine if you are hypertensive or not. You may not experience anything noticible, but still have an elevated blood pressure. The amount of b.p. elevation may not be dangerous. There are many things to consider and possible explanations. In the case of your protein supplement, not knowing what all its ingredients are, it's hard to say. None of the amino acids that you mentioned have the sympathomimmetic properties that tyramine has, though.
The neurontin, acting as it does on the GABAnergic system, may lower b.p. a little. Phenelzine itself has some enhancing effects on GABA signaling (as does isocarboxazid), and this may explain, at least in part, why these MAOIs do not cause rare cases of spontaneous hypertension, like tranylcypromine can (tranylcypromine seems to have some amphetamine-like properties, which may be the source of the trouble). But none of these factors is as potent, I think, as simple person-to-person variability, and one's susceptibility to hypertensive reactions is something that presently cannot be determined beforehand. You would simply have to try and see, which could be dangerous if not done with caution.
Dose is also an important variable. The amount of tyramine you consume is going to determine how severe a response you are going to have. You may simply have not eaten enough of a questionable food to have seen an effect, but it would not mean you were incapable of having a hypertensive reaction to a sufficient dose of tyramine.
> What would cause someone to NOT have any sort of reaction to tyramine? I don't follow a MAOI diet, and never have, I also take protein supplements (in the form of a shake) which include (among others):
>
> *L-Phenylalanine 3500 mg
> *L-Tryptophan 1340 mg
> L-Tyrosine 2780 mg
>
> My doc has no clue...I'm a 23 yr old male, I take Nardil (60mg) for depression...and Neurontin (1800mg), Topamax (200mg) for epilepsy, and occasionally (1 or 2 x a week )Inderal (40mg) and trazadone (50mg)
>
> any input would be appreciated..
Posted by shelliR on August 20, 2001, at 18:35:56
In reply to No MAOI food reaction?, posted by djmmm on August 20, 2001, at 8:41:04
> What would cause someone to NOT have any sort of reaction to tyramine? I don't follow a MAOI diet, and never have, I also take protein supplements (in the form of a shake) which include (among others):
>
> *L-Phenylalanine 3500 mg
> *L-Tryptophan 1340 mg
> L-Tyrosine 2780 mg
>
> My doc has no clue...I'm a 23 yr old male, I take Nardil (60mg) for depression...and Neurontin (1800mg), Topamax (200mg) for epilepsy, and occasionally (1 or 2 x a week )Inderal (40mg) and trazadone (50mg)
>
> any input would be appreciated..Djmmm, I took nardil for over fifteen years and never once had a reaction to tyramine in food either. I never tried to figure it out; I had been told that only a small proportion of people had those reactions. On the other hand, I did have a slight reaction to adrafinil with nardil (BP went from 100 to 160) and my pdoc had warned me not to combine those meds. And as far as not knowing about reactions to food, I felt it in my body when I took nardil and adrafinil and just knew .Although I had been warned about a headache, I got instead extreme tightness in my shoulders, both times, and recognized that something was going on. I think in general tyramine reactions are statistically not all that common, it's just that they can be extremely dangerous --stroke, heart attack, etc.
Shelli
Posted by Elizabeth on August 22, 2001, at 14:19:58
In reply to No MAOI food reaction?, posted by djmmm on August 20, 2001, at 8:41:04
Hi there! < wave >
I'm not sure about phenylalanine. Tryptophan and tyrosine supplements have been known to cause reactions (serotonin syndrome with tryptophan, hypertensive crisis with tyrosine), although they won't necessarily cause problems for everyone or every time they're used. I don't know about the doses, I'd need to look that up.
-elizabeth
Posted by Lorraine on August 22, 2001, at 15:26:28
In reply to Re: No MAOI food reaction? » djmmm, posted by Elizabeth on August 22, 2001, at 14:19:58
Elizabeth:
I've read that you should not take phenylalanine with MAOs and my MD yesterday said the same.
> Hi there! < wave >
>
> I'm not sure about phenylalanine. Tryptophan and tyrosine supplements have been known to cause reactions (serotonin syndrome with tryptophan, hypertensive crisis with tyrosine), although they won't necessarily cause problems for everyone or every time they're used. I don't know about the doses, I'd need to look that up.
>
> -elizabeth
Posted by Adam on August 22, 2001, at 16:21:30
In reply to Re: No MAOI food reaction? » djmmm, posted by Elizabeth on August 22, 2001, at 14:19:58
When I said that the amino acids in the supplement lacked the sympathomimmetic properties of tyramine, perhaps I should have been more clear, in that they can have some effects after conversion, as Elizabeth perhaps has pointed out. Phenylalanine, I would think, would be roughly analagous to tyrosine: The former is converted to tyrosine by phenylalanine hydroxylase, and then tyrosine hydroxylase gives you L-DOPA, blah, blah, blah.Both, interestingly, can antagonize the effects of trypophan. Why, I'm not sure, unless this is all related to the neurotransmitter products.
Anyway, since catalysis is required to yield elevated catecholamines, and this process is feedback-regulated to maintain homeostasis, I was under the impression the real risk of reactions with reasonable consumption of these amino-acid supplements is low. Is this mistaken?
> I'm not sure about phenylalanine. Tryptophan and tyrosine supplements have been known to cause reactions (serotonin syndrome with tryptophan, hypertensive crisis with tyrosine), although they won't necessarily cause problems for everyone or every time they're used.
Posted by SLS on August 23, 2001, at 7:08:02
In reply to Re: No MAOI food reaction? » Elizabeth, posted by Adam on August 22, 2001, at 16:21:30
Hi Adam.
> Both, interestingly, can antagonize the effects of trypophan.
In what regard?
> Why, I'm not sure, unless this is all related to the neurotransmitter products.
Perhaps it is because they both compete with tryptophan to cross the blood-brain barrier.
- Scott
Posted by Adam on August 23, 2001, at 10:32:45
In reply to Re: No MAOI food reaction? » Adam, posted by SLS on August 23, 2001, at 7:08:02
>
> Perhaps it is because they both compete with tryptophan to cross the blood-brain barrier.
>
This has jogged my memory, and I think you are exactly right: Tyrosine and phenylalanine compete with tryptophan in that way. I guess, then, theoretically, taking tryptophan with tyrosine and/or phenylalanine might be safer than a tryptophan supplement by itself. That might be pushing it, though.I remember reading, a long time ago, when I was exploring ways to deal with insomnia on an MAOI, the potential problems with tryptophan and melatonin became rather obvious: Sure there's metabolic conversion, but (especially with melatonin), the supplement is likely contaminated with 5-HTP or serotonin. Melatonin may be manufactured from a pineal gland extract (chew on that, mad-cow vigilantes), where serotonin is converted to melatonin, and is likely not to be 100% pure. Same goes with a number of amino acid supplements: These things are likely extracts of some form or another. I think there were other issues with tryptophan, some kind of mystery contaminant that was even causing deaths in some instances. I don't know the full story with that, though, and don't want to speculate on it too much.
Suffice to say, supplements, used in moderation, are probably not a risk. However, if one is healthy and has a good, well-balanced diet, exercises, etc., there is little or no evidence that these health-food suplements do anything but waste your money. Your body makes or you ingest in food as much as your body will ever need, and taking more does very little to improve your health. Just my $0.02.
This is the end of the thread.
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