A migraine is a neurological condition often characterized by intense, throbbing headaches that can last for hours or days, frequently accompanied by sensitivity to light and sound. While triggers for these episodes are highly individualized, the belief that certain foods, particularly cheese, can initiate an attack is common. Scientific inquiry suggests that specific chemical compounds present in cheese, which result from the production process, may lower the migraine threshold in susceptible people.
The Key Chemical Culprit Tyramine
The primary substance linking cheese to migraines is tyramine, a naturally occurring monoamine. Tyramine forms when the amino acid tyrosine, found in many proteins, breaks down during aging or fermentation. Consequently, the longer a food is processed or allowed to sit, the higher its tyramine content tends to be.
Tyramine’s role as a migraine trigger relates to its vasoactive properties, meaning it affects blood vessel dilation. Once ingested, tyramine prompts nerve cells to release norepinephrine, a neurotransmitter that influences blood pressure and causes blood vessels to constrict. For individuals sensitive to tyramine, this sudden chemical influence and subsequent changes in cerebral blood flow may initiate a migraine attack. The body normally uses the enzyme monoamine oxidase (MAO) to quickly break down tyramine, but people with lower MAO levels or those taking MAO-inhibiting medications may experience a buildup, leading to adverse effects.
Other Potential Dietary Compounds
Tyramine is not the only monoamine in cheese that may contribute to a migraine episode. Cheese and other fermented foods also contain histamine, often elevated due to bacteria during the aging process. Histamine can act as a trigger by causing inflammation and dilation of blood vessels, which lowers the body’s threshold for a migraine.
Another compound under scrutiny is phenylethylamine (PEA), a naturally occurring amine found in some cheeses and chocolate. Like tyramine, PEA is a vasoactive substance that influences neurotransmitter levels in the brain. These various amines often exist together in fermented products, and sensitivity may be to the combined “load” of several compounds rather than one single chemical.
Identifying High-Risk Cheeses and Dairy
The risk of a cheese triggering a migraine correlates directly with its age and method of preparation, which determines its amine content. Aged, hard, and fermented cheeses consistently contain the highest levels of tyramine and are therefore considered high-risk. Examples include Parmesan, aged Cheddar, Swiss, Blue cheese, Feta, and Camembert. The longer a cheese has cured, the more time proteins have had to break down into tyramine.
Conversely, fresh, unaged dairy products are typically low in amines and well-tolerated by migraine sufferers. Safe choices include fresh mozzarella, cottage cheese, ricotta cheese, and cream cheese. Dairy products made from pasteurized milk also tend to have lower tyramine levels compared to those made with raw milk. Processed cheeses, like American cheese, are also considered low-risk alternatives.
Managing Dietary Triggers
Since the relationship between cheese and migraines is highly personal, identifying a specific trigger requires careful observation. The most effective method involves keeping a detailed food and symptom diary, noting everything consumed and any subsequent migraine symptoms. Tracking should include the type and quantity of cheese eaten, along with the time of consumption and the onset of an attack (which may occur 12 to 24 hours later).
If a pattern emerges, an elimination diet can confirm the trigger. This involves strictly removing all high-risk cheese and other suspected foods for a set period, often two months, to see if the frequency or severity of migraines decreases. After this phase, the suspected food is slowly reintroduced one at a time while monitoring for a return of symptoms.
Consult a physician or a registered dietitian before starting any restrictive diet, especially one that eliminates entire food groups. Professional guidance is important for individuals taking monoamine oxidase inhibitors (MAOIs), as combining these medications with high-tyramine foods can lead to dangerously high blood pressure. Dietary changes should be implemented under supervision to ensure nutritional adequacy and safety.