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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by MysteryMonk on June 12, 2003, at 16:40:54
Anyone know if soy milk is OK while on an MAOI? I forgot that it might not be and had a single sip of it today. My reaction (if I had one) was strange. I got a mild headache that lasted about 30 seconds. I then took my BP and it was up to 145/70. I had taken my BP about 1/2 hour b/f I took a sip of the soy milk and it was at 98/65.
Is it possible that I had a reaction to the soy milk? I am not sure if it is possible to have a mild food reaction while on an MAOI, or if every incident means full-on hypertensive crisis w/pounding headache and ultra-high BP.
Any thoughts? thanks
Posted by Paulie on June 12, 2003, at 18:01:45
In reply to MAOI and Soy Milk, posted by MysteryMonk on June 12, 2003, at 16:40:54
You can have a mild reaction to tyramine while on an MAOI. The reaction is dependent on the amount of tyramine ingested. Mild reactions usually occur with tyramine ingestion in the range of 6-8mg. More serious reactions occur when >10mg is consumed. From what I read, the dosage of the MAOI seems relatively unimportant.
Soy milk is unrestricted on 5 diet lists that I have and mentioned as something that should be avoided on 1 list. Soy milk is something that you should probably avoid. I had a reaction once to soy protein powder when I was on Nardil.
Also, if you are on parnate you can experience blood pressure increases for up to 2 hours after taking it.Paul
Posted by Maxime on June 12, 2003, at 19:35:24
In reply to MAOI and Soy Milk, posted by MysteryMonk on June 12, 2003, at 16:40:54
Soy isn't aged. I'm vegan and so it's a staple in my diet. The only soy products you have to stay away from are tempeh and miso - fermented soy.
Max
Posted by MysteryMonk on June 12, 2003, at 19:38:10
In reply to Re: MAOI and Soy Milk, posted by Maxime on June 12, 2003, at 19:35:24
What about soy sauce?
> Soy isn't aged. I'm vegan and so it's a staple in my diet. The only soy products you have to stay away from are tempeh and miso - fermented soy.
>
> Max
Posted by Maxime on June 12, 2003, at 19:45:20
In reply to Re: MAOI and Soy Milk, posted by MysteryMonk on June 12, 2003, at 19:38:10
Soy sauce is fermented and therefore a "no-no". Instead I use BRAGG - it taste better than soy sauce and is made up of amino acids. If you want information on it you can simply stick the name in a search engine.
Hope this helps.
Max
Posted by Maxime on June 12, 2003, at 19:48:06
In reply to Re: MAOI and Soy Milk, posted by Paulie on June 12, 2003, at 18:01:45
First, any information before 1996 is old and mostly outdated.
They re-did many of the tests and found there are many more things we
can eat safely. Second, the generally acceptable levels are 1-4mg of
tyramine per serving, 4-6 can be dangerous, and over 6 should be
avoided.Max
Posted by Maxime on June 12, 2003, at 19:52:33
In reply to Re: MAOI and Soy Milk-Paulie, posted by Maxime on June 12, 2003, at 19:48:06
Oops, i hadn't finished. My point Paulie, is that on several lists soy milk is unrestricted. I just want to make sure you are looking at updated lists so that you don't misinform anyone.
> First, any information before 1996 is old and mostly outdated.
> They re-did many of the tests and found there are many more things we
> can eat safely. Second, the generally acceptable levels are 1-4mg of
> tyramine per serving, 4-6 can be dangerous, and over 6 should be
> avoided.
>
> Max
>
>
>
>
Posted by Paulie on June 12, 2003, at 21:30:03
In reply to Re: MAOI and Soy Milk-Paulie, posted by Maxime on June 12, 2003, at 19:52:33
I don't believe that I am misinforming anyone. Yes, I know the old lists are outdated without much scientific evidence. As I mentioned before, five lists that I have list soy milk as UNRESTRICTED(as much as you want). However, if a person is getting a reaction to a certain food while on an MAOI it is recommended to avoid that food even if it is not on the list. That is common sense. I got a reaction to soy protein powder which was not on the list I had. It was not aged. It would be foolish for me to continue ingesting it though. There is even a reference to soy milk on a PB's MAOI DIET (short list). If you disagree with this then maybe Dr. Bob should change it. It says:
"SOY FOODS are controversial: one sample of soy sauce was reported to have quite a lot of tyramine in it, but there aren't any documented interactions. My experience has been that a little bit of soy sauce is okay. I would avoid other soy products, such as soy milk and tofu. The Taiwanese dish called "stinky tofu" is
probably right out. < g >"http://dr-bob.org/tips/maoi.html
This IS the opinion of one poster, but HAS been placed under PB's information for an MAOI diet.
As far as tyramine content needed to obtain a reaction I have based my infomation on scientific studies. There is even one here at PB.
It says:Walker, Scott E. MScPhm. Shulman, Kenneth I. MD, SM, FRCP(C). Tailor, Sandra A.N. PharmD. Gardner, David BScPhm. Tyramine Content of Previously Restricted Foods in Monoamine Oxidase Inhibitor Diets. Journal of Clinical Psychopharmacology. 16(5):383-388, October 1996"
"It has been clearly demonstrated that individuals who are taking MAOIs are more sensitive to the pressor effects of tyramine. [15] A critical issue in dietary restriction relates to the amount of tyramine that will produce an increase in blood pressure. Both Blackwell and Mabbitt [16] as well as Horowitz and associates [17] have observed increases in blood pressure with the ingestion of only 6 mg of tyramine. However, Blackwell and Mabbitt [16] were unable to reproduce these results on rechallenge with 6 mg in the same subject. Bieck and Antonin [15] demonstrated that an 8-mg oral dose of tyramine is sufficient to increase systolic pressure by 30 mm Hg in 50% of subjects receiving tranylcypromine. However, they also demonstrated a wide intra-individual variation in responses in some patients that may be due to variability in both the rate and extent of absorption. Furthermore, many foods have been reported to contain variable amounts of other pressor agents [18-21] that may also increase blood pressure, possibly contributing to variable response. [15,16] Therefore, we have used a conservative upper limit of 6 mg of tyramine as a guideline for safe ingestion. This is identical to the limit that we have used previously. [7,8,11]
http://www.dr-bob.org/babble/20010804/msgs/73614.html
Who's misinforming?
Paul
Posted by Paulie on June 13, 2003, at 8:46:04
In reply to MAOI and Soy Milk, posted by MysteryMonk on June 12, 2003, at 16:40:54
As an addition, It is POSSIBLE for ANY protein containing food to build up tyramine IF spoilage has begun to occur. This includes soy milk. Freshness of foods is important when taking an MAOI. ex. One person had a severe reaction to a hot dog from a street vendor. Hot dogs are normally O.K. to eat. It is wise to discard foods when close to expiration date.
Was the soy milk you drank fresh or was it near the expiration date?
As mentioned in first post parnate can also cause blood pressure increases for 2 hrs. after taking a dose. Your BP increase could possibly have been caused by that.
Also, one of the cautions stated while on an MAOI is "avoid any food that has caused unpleasant reactions previously".Paul
Posted by avid abulia on June 13, 2003, at 14:26:54
In reply to Re: MAOI and Soy Milk- Expiration Date? » MysteryMonk, posted by Paulie on June 13, 2003, at 8:46:04
they make acidophilus soy milk, similar to acidophilus cow milk. it wasn`t that, was it?
acidophilus produces a lot of tyramine in food it is growing in.
Posted by lawrence S. on June 13, 2003, at 21:29:41
In reply to Re: MAOI and Soy Milk, posted by Maxime on June 12, 2003, at 19:45:20
I'm on 90 mg. of Nardil. I drink about 2-3 quarts of soymilk a day. I checked my BP yesterday and it was 111/48! I wouldn't worry much
Posted by MysteryMonk on June 13, 2003, at 23:57:09
In reply to I drink 3quarts of soymilk a day with Nardil, posted by lawrence S. on June 13, 2003, at 21:29:41
Thanks for all of your replies. I tried drinking about a half cup of the same soy milk that I thought might have given me the reaction from a single sip. No reaction from the half cup so it appears that soy milk was not the culprit. Good thing, I like my soy milk.
Posted by MysteryMonk on June 14, 2003, at 9:32:29
In reply to Soy Milk Follow-up, posted by MysteryMonk on June 13, 2003, at 23:57:09
I finished the container of soymilk all at once (I'm just getting cocky now) and still no reaction.
This is the end of the thread.
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