Is Spearmint OK With Tyramine? MAOI Safety Guide

Is spearmint ok with tyramine on an MAOI?

Yes, fresh spearmint in normal culinary amounts is generally considered fine on an MAOI. It is a fresh leafy herb, and fresh fruit and vegetables are low in tyramine. Tyramine concentrates in foods that have been aged, fermented, pickled, smoked or left to spoil, and a freshly picked herb leaf is none of those.

The phenelzine label spells out what to avoid: high-protein foods that have undergone protein breakdown by aging, fermentation, pickling, smoking or bacterial contamination, plus items such as aged cheese, pickled herring, beer, wine, liver and yeast extract. Spearmint is not on that list. The label also flags broad bean pods, yogurt, and excessive caffeine and chocolate, none of which a mint leaf resembles.

This is general guidance, not a personal clearance. Different MAOIs carry different rules, and your prescriber knows your dose and history. If you are new to an MAOI, ask before introducing anything concentrated.

• Fresh spearmint leaves — fine — fresh plant material, not aged or fermented
• Fresh mint tea made from leaves — fine in normal cups — a simple infusion of a fresh herb
• Mint sauce made at home with fresh mint — fine if the other ingredients are low tyramine — check the vinegar and any added sauces
• Shop-bought mint sauce or jelly — take care — read the label for yeast extract, soy sauce or fermented ingredients

Which other common herbs are safe on an MAOI?

Fresh culinary herbs such as basil, parsley, coriander, mint, thyme and rosemary are generally treated as fine on an MAOI because they are fresh plant foods used in small amounts. As with spearmint, nothing about a fresh leaf involves ageing or fermentation.

Watch the form the herb comes in, not the herb. A fresh bunch is simple. A paste, a pickled preparation or a ready-made seasoning blend can bring in ingredients that are not.

• Fresh basil, parsley, coriander, thyme, rosemary — fine — fresh herbs, low tyramine in culinary amounts
• Dried herbs in normal cooking amounts — fine — plain dried leaf, no fermentation; check blends for added extracts
• Herb pastes in jars or tubes — take care — check for yeast extract, fermented ingredients and storage claims
• Seasoning mixes and stock cubes — avoid where they contain yeast or meat extract — Oxo and Bovril-style extracts are on the label's avoid list
• Pesto with parmesan — avoid — hard aged cheese is high in tyramine, including as a topping
• Herbs in soy sauce or Worcestershire marinades — avoid — fermented sauces carry significant tyramine

Where do tyramine problems actually come from?

The real tyramine risks in the kitchen are aged cheese, cured meats, fermented foods and anything protein-rich that has been stored too long. On an MAOI your body cannot break tyramine down properly, so these foods can cause a dangerous rise in blood pressure. Herbs are a rounding error by comparison.

Spend your attention here. The comparison below follows the label's own categories and the FreshPlate checker's verdicts.

• Mature cheddar, Stilton, Brie, Parmesan, Gorgonzola, Gouda — avoid — aged and ripened cheeses are among the highest-tyramine foods
• Cottage cheese, cream cheese, fresh mozzarella, ricotta — fine — fresh, unripened cheeses are low in tyramine when in date
• Salami, Parma ham — avoid — dry, fermented and air-cured meats accumulate tyramine
• Fresh chicken, fresh fish — fine — if fresh, properly stored and cooked promptly
• Smoked salmon, pickled herring — avoid — smoked, pickled and cured fish are classic high-tyramine foods
• Liver — avoid — spoils quickly, and pâté is aged
• Marmite, stock cubes, soy sauce, miso, Worcestershire sauce — avoid — concentrated yeast and meat extracts and fermented sauces
• Sauerkraut, kombucha — avoid — fermented vegetables and drinks carry high or unpredictable tyramine
• Draught beer, bottled beer, red wine — avoid — the phenelzine label lists beer and wine to avoid
• Spirits — avoid — the label says not to combine an MAOI with CNS depressants such as alcohol
• Yoghurt — avoid — listed on the phenelzine label; ask your prescriber before having any

Does mint tea or a herbal supplement change the answer?

Fresh mint tea made by steeping leaves is generally fine, but herbal supplements, extracts and unregulated blends are a different category and should be cleared with your prescriber or pharmacist first. A leaf in hot water is a food. A capsule or concentrated extract has unknown potency and sometimes unknown additives.

There is no widely cited tyramine figure for spearmint, as there is for cheese or soy sauce, so the advice rests on it being a fresh plant food rather than on a measured number. That is reasonable grounds for treating culinary use as low risk, but not a guarantee for concentrated products.

Spearmint and peppermint essential oils and strong herbal preparations are not the same as a few leaves in a drink. If a product is not a plain food, ask a pharmacist, because MAOIs interact with a wider range of medicines and supplements than most people expect. The wider picture is covered in our pharmacist guide to drug-food interactions.

• Fresh mint leaves steeped in hot water — fine — a plain infusion of a fresh herb
• Shop-bought mint teabags with only mint listed — generally fine — check the ingredients list is short and plain
• Herbal blends with many ingredients — take care — read every ingredient and ask a pharmacist if unsure
• Capsules, tinctures and essential oils taken internally — ask first — concentrated and unregulated products are not covered by food guidance

How do I keep herb dishes low in tyramine?

Buy herbs fresh, use them in date, and build the rest of the dish from fresh ingredients. Tyramine rises with storage, so the freshness of the whole meal matters more than the herb on top.

The label warns against spoiled or improperly refrigerated, handled or stored protein-rich foods such as meats, fish and dairy products. A tabbouleh or a mint-and-pea dish is low risk. A lamb dish with mint that sat out all evening is not, because of the lamb, not the mint. For batch cooking, our batch cooking and freezer meals guide covers freezing safely.

• Leftovers — take care — refrigerate within an hour, eat within 24 hours, or freeze immediately
• Fresh meat and fish — fine — cooked the same day and eaten promptly
• Opened tins — take care — eat immediately; do not store opened tins
• Homemade mint sauce — fine — use fresh mint and plain vinegar, and make it close to serving
• Takeaway marinades — avoid — often contain soy sauce or other fermented sauces you cannot see

How does FreshPlate handle MAOIs?

FreshPlate builds recipes around your own medication list, so if you add an MAOI, tyramine-rich foods are a hard block: they are not put into the recipes made for you. Your recipes also have a For you tab that lists your medicines, so you can see what the app has taken into account.

FreshPlate also has a free food-medication interaction checker on the website: type in a medication or its brand name and you can see the foods to watch in seconds. It is a starting point, not a substitute for your prescriber or pharmacist, and any change to your diet on an MAOI is worth mentioning to them.

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