What foods need to be avoided with MAOIs?

Basically foods that are aged, preserved, dried, fermented, pickled, cured (meats), rancid, old, outdated, overripe, or even slightly spoiled.

The following foods are recommended to be avoided with MAOIs:

- Meat that is not fresh, especially unfresh liver (fresh meat and fresh liver are safe)
- Bologna, pepperoni, salami, corned beef, sausage, hot dogs, any cured meats
- Smoked, fermented, pickled (herring) and otherwise aged or dried fish, lox; any fish that is not fresh
- Fermented tofu, fermented bean curd, fermented soybean paste, miso soup (contains fermented bean curd)
- Soy sauce (soy sauce even in very small quantities has been implicated in a number of anecdotal reports on this forum)
- Teriyaki sauce
- Cheeses, especially aged cheeses (ricotta cheese, mozzarella cheese, cottage cheese and cream cheese are safe)
- Protein extracts
- Liquid or powdered protein dietary supplements
- Canned soups, or soups made with protein extracts or bouillon
- Gravies and foods made with meat extracts
- Dried egg whites
- Defatted peanut flour
- Brewer's yeast, yeast vitamin supplements, yeast extracts, foods with yeast in ingredients
- Sourdough bread
- Shrimp paste
- Sauerkraut
- Pickled foods
- Olives (unless you can get fresh ones)
- Fruits that are bruised or overripe
- Avocados that are very soft, mushy, overripe or starting to turn grey (slightly underripe avocados are fine in moderation). Guacamole should be avoided.
- Banana peels (as though you'd eat them anyway) and bananas that are overripe (turning brown or black). Bananas that are not overripe or bruised are totally fine, and are often eaten around Ayahuasca ceremonies in the Amazon.
- Dried fruits, such as raisins and prunes
- Fruit cake and candied fruits
- Cranberries, canned
- Red wine, especially Chianti; sherry, vermouth, champagne, brandy; beers and ales, including nonalcoholic; whiskey and liqueurs such as Drambuie and Chartreuse
- Dairy products that are close to the expiration date or that have been unrefrigerated (fresh yogurt is safe)
- Any food that has the word "hydrolyzed" or "autolyzed" in the ingredient list

In addition to the preceding foods (which are aged, fermented, preserved, overripe, etc) avoid the following in large quantities:

- Broad beans (fava and lima beans) - in large quantities
- Navy beans - in large quantities
- Peanuts - in large quantities
- Brazil nuts - in large quantities
- Coconut and coconut oil - in large quantities (coconut juice or coconut milk is safe)
- Raspberries - in large quantities
- New Zealand or Hot Weather Spinach (Tetragonia tetragonioides, a different plant from regular spinach, Spinacia oleracea, which is safe) - in large quantities
- Parsley - in large quantities
- Dill weed - in large quantities
- Dried seaweed - in large quantities
- Nutmeg - in large quantities
- Kombucha - in large quantities
- Dark chocolate - in large quantities (the theobromine in it may be potentiated, causing fast heartbeat)
- Caffeine in large quantities (in a few rare individuals, there may be a severe interaction with even small amounts of caffeine)

Also avoid:
- Aspartame (Nutrasweet)
- Monosodium Glutamate (MSG) (or anything with the word "hydrolyzed," code for MSG)
How long do they need to be avoided?

24 hours before and after drinking Ayahuasca should be sufficient.

Is it really important to avoid those foods?

The warnings about tyramine interaction sound very serious, because they are adapted from warnings about interactions with pharmaceutical MAOIs. There are nearly 100 fatalities on record from food interactions with pharmaceutical MAOIs.

However, food interaction with Ayahuasca is frankly not as serious a matter as it is with pharmaceutical MAOIs, because Ayahuasca is a reversible (short-acting) MAOI, or RIMA. There are no fatalities on record from food interactions with Ayahuasca.

However, food interaction with Ayahuasca can be unpleasant, manifesting as a headache (which can be severe and may sometimes last for days) or as uncomfortable rapid heartbeat. Informal ongoing surveys on this forum have shown about 30% of people who eat proscribed foods get reactions. But while for most people the reaction is merely unpleasant, it could conceivably be life-threatening for a person with severe high blood pressure or heart disease. People with these conditions, therefore, should follow the MAOI safety diet very strictly when taking Ayahuasca.

But, except for people with serious heart conditions and/or serious high blood pressure, food interactions with Ayahuasca are not life-threatening, and the effects go away after hours or days with no lasting harm.

Many people have eaten proscribed foods with no problems whatsoever. In fact, in informal surveys taken on this forum, the percentage of people who have experienced adverse reactions from consuming MAOI-proscribed foods before or immediately after an Ayahuasca session consistently hovers around only 30%.

On the other hand, people who have no reaction on one occasion may have a reaction on another occasion. And people who have reported reactions often have eaten very small amounts of the proscribed food.

The main symptom of MAOI reaction is a headache that can be severe and can last for days. This is caused by a sudden spike in blood pressure.

(We have also had a number of anecdotal reports of blood pressure crashes, which may or may not be food related. The main symptom of a blood pressure crash is a sensation of being very cold, as well as weak and perhaps faint or dizzy.)

Furthermore, there is significant anecdotal evidence on this forum that not following the MAOI-safety diet increases the chances of panic attack.

And people with heart problems or high blood pressure, in particular, are advised to err on the side of caution as far as food interactions.

Please note: Peganum harmala (Syrian rue) is a stronger MAOI than Banisteriopsis (Ayahuasca vine) and has potentially more serious interactions.

What can I eat?

In terms of the MAOI safety diet, basically foods that are as fresh as possible and not overripe, preserved, fermented, cured, aged, or even slightly spoiled.

Starchy foods such as rice, bread, potatoes, etc are also fine.