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Q. What foods to avoid in serotonin syndrome?

Answered by
Dr. Janrao Smit Uttam
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 28, 2017 and last reviewed on: Oct 11, 2022

Hello doctor,

My 39-year-old son was hospitalized for five days with serotonin syndrome. He was given intravenous and Ativan. He was discharged from the hospital, and he will go to his doctor regarding his meds. The problem is he was never told if he needed to stay away from certain foods that might cause his serotonin levels to elevate. I was just reading online about foods to avoid with serotonin syndrome, and after reading this, I am not sure what he can eat. Sadly, the hospital did not give him any information on what he could eat. There is a list of foods that increase serotonin levels which include foods rich in omega-3 fatty acids, such as tuna, and those high in tryptophan, an amino acid found in eggs, soy and soy beverages, turkey, eggs, pumpkin seeds, peanuts, and peanut butter, chicken and cheeses. A diet rich in folate may also contribute to increased serotonin levels. Some foods rich in folate include leafy green vegetables, beans, legumes, nuts, bread, and cereals. It sounds like there really is nothing he can eat without worrying about causing any additional problems. After reading all this, what can he eat? This is extremely scary as I have no clue about what he can and cannot eat. If possible, please reply as soon as possible because I did not realize that all these foods were included in things he might have to stay away from, other than turkey, perhaps. Thanking you in advance for any advice.

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Hello,

Welcome to icliniq.com.

Yes, it is true that diet is very difficult for patients with serotonin syndrome. But, there are many myths as well about diet.

1. Most cheese and cheese products nowadays are low in tyramine levels. So, they are not that harmful. To be called yogurt, milk must be fermented by Lactobacillus and Streptococcus thermophilus (no decarboxylase activity, so no tyramine). So, it is also safe.

2. All fermented soybean products like sauce and paste are prone to have significant tyramine levels. So, do not consume them.

3. Fresh and frozen meat and meat products are safe, but if they are not fresh, then they could be risky. Chicken should be consumed fresh or maximum within one day. With time, bacteria grow and produce tyramine.

4. Avoid maize, walnut, banana, pizza, etc., which carry high risk.

For more details about his diet, you should consult a professional dietitian.

I hope I answered your questions. Take care.


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