Does the diet work by reducing total tyramine "load” on brain?

I’ve been doing the HYH migraine diet for 2.5 months quite strictly. The only trigger I know for sure is balsamic vinegar. I just don’t think the diet is doing much for me but it’s hard to tell. My question is this… does the diet work by virtue of reducing the total tyramine “load” on the brain or does each person really only have a few potential triggers they need to figure out by doing the elimination diet? If it’s the case that I’m (even mildly) helping my progress by reducing total tyramine levels, then I will continue. If not, I freaking miss peanut butter!

I don’t think anyone really knows why the diet works. Seems like you gave it a valid shot and if you don’t notice any difference I would start adding foods one at a time every few days to see if you notice any increase in symptoms. Maybe start with peanut butter!

MAV is so hard to live with, no need to follow a strict diet unless it really helps (and for some it really does help). I eat about 80% HYH and that works for me. When I start increasing consumption of coffee, eggs, cured meats, or nuts then I know I’m headed for more head pressure… I can get away with one meal, but two in a row…that’s getting dangerous


As @ander454 says the answer to your question is nobody really knows. Interestingly few UK doctors prescribe any form of Diet at all. In fact the specialist I saw told me not to bother as it was a waste of time. I did have a go in desperation and nuts surprisingly are a big trigger. One of the few. And peanut butter a Big No No much as I love it. Any diet restricts food intake and surely can result in vitamin deficiencies eventually. The more restrictions the worse I imagine. If you crave something try it a few times and see. That’s the only way. @Naejohn posted a thread on Whow Butter I remember which she found a good substitute for peanut butter. Check it out


I think in the HTHYH book the author says the diet is basically a collection of food triggers that have been reported most often by migraineurs in research studies and anecdotally and cautions that some of your triggers may not be on the list. My specialist uses the simplest 6C’s diet which cuts out the most common known triggers. Like other posters above, most specialists I’ve seen don’t rate the diet that highly, unless there is a really obvious trigger e.g. most times you eat a cheese sandwich or have a glass of red wine you get a migraine so can clearly see the need to cut that out, then the impact on the migraine load they felt was too marginal for the amount of effort/worry that the diet required. However, since most of the forbidden or restricted foods listed on various migraine diet sheets are high in tyramine then it makes sense that following a low tyramine diet is sensible.

If I’m having a flare up I go very, very clean cutting out more foods than I have already but I don’t think in my case it has much effect other than the psychological one of feeling I’m doing something proactive. I agree with @ander454 about increased consumption, for example, I can get away with one decaff coffee with some frothed milk in once a day but can’t add in any other dairy that day or I’ll get more head pressure.


For some people maybe food triggers are cumulative like other triggers or maybe even cumulative with other triggers. Lower general intolerance levels would affect.

Caffeine restriction may be more important than diet. Some UK medics do suggest caffeine restriction. It has a migraine link to the man in the street after all. Strange how we are all different. Some people find they can get away with an occasional coffee but just the one. I find I have to have just one cup of tea with caffeine every day. If I don’t that will cause vertigo. However more than one will bring on head pressure. These days I take my caffeine with the same precision as the betablockers.

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How important is giving up alcohol? I drink pretty much everyday now because of this, not much, but a couple of beers.
sometimes it helps, or helps me feel a bit normal again for a while. Thoughts?

Thanks all for the input! I’m going to slowly add my favorite foods back in and concentrate more on the things I know are helping. My strict adherence comes from reading HYH (and The Dizzy Cook) that basically claims if you do the diet and take the pills your headache will be well managed la dee dah. I guess that’s not how VM works??

@Rob77 I read on here somewhere that alcohol hits the same pathways as benzos, which many find relief from, though there are less dubious options when it comes to long-term treatment.

Getting off topic here …

Very important to give alcohol up. To compensate as much as possible you are best to be sober. The less you compensate the more neurological issues you are going to have including migraines I suspect (more compensation = less stress on the brain) Also alcohol will mess with the bodies natural physiology. I think it’s very important to get the body into as natural a state as possible to rebalance itself.

When I say “give up” I mean very irregular. The odd tipple is fine but every day is unhealthy. I would stick to having a drink only at social occasions for a while.

Which is no recommendation at all really? Benzo’s are usually discouraged as they are highly addictive and again affect your ability to compensate. Don’t touch Benzo’s!!

They are ultimately just going to extend your suffering.