Posted by King Vultan on September 25, 2004, at 11:28:49
In reply to Re: correction....mozzarella probably excluded too » Larry Hoover, posted by cubbybear on September 25, 2004, at 8:29:31
> Absolutely NOT true--many MAOI users, including myself, have been able to enjoy a pizza with mozzarella cheese (with precautions about adding other cheeses or certain meats) or plain mozzarella itself.
The information available on mozzarella seems to be somewhat ambiguous. On the one hand, the work originally done by Shulman, et al, in 1989 shows the tyramine content of mozzarella to be 2.4 mg per 15 g serving. To my way of thinking, that seems like kind of a lot. The exact amount of tyramine that is needed to precipitate a hypertensive crisis varies according to the individual, dosage, and drug, but in a study in "Clinical Advances in Monoamine Oxidase Inhibitor Therapies", the median effective dose of tyramine (in capsules) needed to raise systolic BP by 30 points was 8 mg for 12 subjects on 20 mg of Parnate. The median amount needed to raise BP a similar amount for 6 people on 60 mg Nardil was 33 mg. Contrast this with a median amount of 428 mg of tyramine needed to raise systolic BP 30 mm Hg for 56 unmedicated subjects.OTOH, I also have the results of the pizza analyses performed by Drs. Shulman and Walker in 1998, where the tyramine content of mozzarella cheese was retested, and the amount was a mere 0.5 mg per 30 gram serving. The amount of tyramine measured in half a Pizza Hut medium pizza with double cheese and pepperoni was a completely harmless 0.0628 mg total, that in a sample of pizza toppings (the crust was not included) with a mass of 136.5 grams. The authors do caution that this doesn't necessarily mean that all pizzas are safe, as for instance, some gourmet pizzas may contain cheeses of a more aged variety. I also have concerns about pepperoni variations between different chains. I have read two anecdotes of different people experiencing hypertensive crises eating pepperoni pizza at small, local pizza joints while on Parnate.
Todd
poster:King Vultan
thread:394544
URL: http://www.dr-bob.org/babble/20040921/msgs/394858.html