Natto may cause migraine with aura and blood pressure rise in some

Yesterday, I had a migraine with an aura attack. Typically, it is caused by high levels of tyramine in foods.

The aura in this type of migraine consists of distortions in the field of vision. In my case, I saw a shimmering light on the lateral part of my left eye. It, of course, interferes with vision. For example, there would be some letters that are difficult to read.

I talked about migraine with aura in Migraine Aura Without Headache.

Migraine with aura is uncommon and typically misdiagnosed. It is due to the lack of tyrosine kinase enzyme that degrades tyramine. Tyramine is from the amino acid tyrosine, which is present in many foods.

The foods with the highest tyramine content are processed meat, aged hard cheese, over-ripe bananas, and meat refrigerated for more than four days. I discussed the food sources in the following:

The other problem with migraines with aura due to high tyramine is that it can raise your blood pressure. The tyramine causes a rise in epinephrine, leading to vasoconstriction and high blood pressure. A situation called the tyramine pressor effect.

In some people, there can be a rise from 10 to 40 mm Hg. Some may even develop intracerebral bleeding. This was most notable when a monoamine oxidase inhibitors (MAOIs) were prescribed for depression.

MAOIs prevent the brain’s dopamine, norepinephrine, and serotonin breakdown. However, adding MAOIs can lead to cumulatively high blood pressure in those prone to the tyramine pressor effect when they eat some tyramine-rich foods.

Foods That Can Cause Monoamine Oxidase Inhibition

Getting back to my experience, there were several tyramine-rich foods that I have eaten. I had peanuts, ham, more than the usual barako coffee from the Philippines (4th mug), and natto.

I think it is most likely the coffee because I started to have an aura right after I finished the fourth cup.

I had migraine with peanuts and ham two years before, but I have adjusted to them since I have not had migraines with them in the past few months.

The latest natto I made is different. The soybeans expanded rapidly when I soaked them, and the Bacillus Subtilis bacteria grew faster. The amount of growth that I saw in it in 18 hours is what I will typically see after 24 hours of fermentation, and I presume it has a higher tyramine content.

Research by Kim et al. in 2012 analyzed twenty-one Natto products in Korea for biogenic amine contents.

Biogenic amines are synthesized by microbial, vegetable, and animal metabolisms. In food and beverages, biogenic amines are formed by enzymes of the microbes and the raw materials. Tyramine, together with histamine, are examples of biogenic amines.

Kim et al. found nine products (about 43%) with tyramine contents greater than the toxic dose (100mg/kg). To them, this indicates that the amounts of biogenic amines in some Natto products are not within the safe level for human health.

Since that 2012 research, several efforts have been made to reduce biogenic amine formation in commercially produced natto, including irradiation, the addition of nicotinic acid, and using specific Bacillus subtilis cultures.[2]

Efforts to decrease tyramine also happen for processed meat, cheeses, and other foods that contain biogenic amines.

Other fermented soybean foods like miso, soy sauce, and tempeh are also rich in tyramine. Fortunately, MAOIs like selegiline, tranylcypromine, and phenelzine have been surpassed by other antidepressants.

Conclusion

If you are getting headaches with soy sauce or other tyramine-rich foods. Be careful when you eat natto. Note what happens after eating natto. Any aura? Any increases in blood pressure?

If so, then switching to nattokinase may be a better alternative. Nattokinase also has anticoagulant, antifibrinolytic, cholesterol, blood pressure, and blood sugar-lowering effects that natto has. It also contains vitamin K2.

Another way to prevent tyramine from increasing with homemade or store-bought natto is to keep them in the freezer to avoid tyramine from accumulating. I store mine in an egg tray and put it in a zip-lock bag in the freezer. A small container is enough for one serving.

I had one tablespoonful of natto this morning and less coffee, and I did not have an aura.

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References:

Kim B, Byun BY, Mah JH. Biogenic amine formation and bacterial contribution in Natto products. Food Chem. 2012 Dec 1;135(3):2005-11. doi: 10.1016/j.foodchem.2012.06.091. Epub 2012 Jul 3. PMID: 22953951.
Mah JH, Park YK, Jin YH, Lee JH, Hwang HJ. Bacterial Production and Control of Biogenic Amines in Asian Fermented Soybean Foods. Foods. 2019 Feb 25;8(2):85. doi: 10.3390/foods8020085. PMID: 30823593; PMCID: PMC6406601.

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