Date amended:
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Statements of Principles

Intracerebral haemorrhage - Tyramine and an MAO inhibitor drug Factor

There are two means of ingesting tyramine: in food and/or in medications (sympathomimetic drugs or agents containing tyramine).  Tyramine (or tyrosamine) is an amino acid found in many popular foods and alcoholic beverages, including chocolate, bananas, avocados, green bean pods, broad beans, sour cream, yoghurt, raisins, soy sauce, pickled herring, salami, canned meats, matured cheeses, wine and ergot.  Ergot (cock's spur), a fungus developed on rye plants, has a pharmacological use including as a common migraine treatment (ergotamine).  Tyramine is also used in a range of decongestants, anti-hypertensives and antihistamines.  However, tyramine is contraindicated if undergoing treatment with a monoamine oxidase inhibitor (MAOI), or within six weeks of cessation of such treatment, as it may cause a rapid rise in blood pressure.  While everyone would have ingested tyramine, few people would ever have been prescribed a MAOI, and without this, the tyramine factor requirements cannot be met.  First consider whether or not the person was treated with MAOIs at any time within the 6 weeks before the cerebrovascular accident.   If so, you will need to research the particular foods and/or drug/s that are contended to establish whether or not tyramine was present while there was a residue of MAOI.

Last reviewed for CCPS 24 May 2007.

Investigative Documents
Type Title PDF Format Word Format
Medical Report
Ingesting Tyramine while having a Residue of MAOI Drugs - Cerebrovascular Accident
Document
Document
Preliminary questions [37240]

37242 there is some evidence that ingesting tyramine while having a residue of MAO inhibitor drugs may be a factor in the development of the condition under consideration.

37276 the veteran experienced ingestion of or treatment with tyramine in circumstances as specified in the Statements of Principles within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident.

37278 the veteran has established the causal connection between ingesting tyramine while having a residue of MAO inhibitor drugs and VEA service for the clinical onset of cerebrovascular accident.

37279   the veteran has established the causal connection between ingesting tyramine while having a residue of MAO inhibitor drugs and operational service for the clinical onset of cerebrovascular accident.

or

37280   the veteran has established the causal connection between ingesting tyramine while having a residue of MAO inhibitor drugs and eligible service for the clinical onset of cerebrovascular accident.

Clinical onset and operational service [37279]

37886 the veteran ingested tyramine-rich food in circumstances as specified in the Statements of Principles within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident.

37281 on operational service, the veteran ingested tyramine-rich food in circumstances as specified in the Statements of Principles within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident.

37887 as a causal result of operational service, the veteran ingested tyramine-rich food in circumstances as specified in the Statements of Principles within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident.

37284 the ingestion of or treatment with tyramine on operational service in circumstances as specified in the Statements of Principles within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident, was due to the veteran's serious default, wilful act or serious breach of discipline.

or

37286 the condition implicated in the veteran's treatment with tyramine or an MAO inhibitor drug is an illness or injury which is identifiable.

37287 the identified illness or injury, for which the veteran received treatment with tyramine or an MAO inhibitor drug, is causally related to operational service.

Clinical onset and eligible service [37280]

37886 the veteran ingested tyramine-rich food in circumstances as specified in the Statements of Principles within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident.

37282 on eligible service, the veteran ingested tyramine-rich food in circumstances as specified in the Statements of Principles within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident.

37283 as a causal result of eligible service, the veteran ingested tyramine-rich food in circumstances as specified in the Statements of Principles within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident.

37285 the ingestion of or treatment with tyramine on eligible service in circumstances as specified in the Statements of Principles within the 24 hours before the clinical onset of the condition under consideration, a cerebrovascular accident, was due to the veteran's serious default, wilful act or serious breach of discipline.

or

37286 the condition implicated in the veteran's treatment with tyramine or an MAO inhibitor drug is an illness or injury which is identifiable.

37288 the identified illness or injury, for which the veteran received treatment with tyramine or an MAO inhibitor drug, is causally related to eligible service.