Chocolate is a delicious and popular food that is found in a range of desserts, snacks, and drinks. However, for some individuals, it can cause an allergic reaction. Because chocolate has a variety of ingredients, the reaction could be due to any one of them.
In this article, we discuss the causes of chocolate allergies and the most common symptoms. We also explain when to seek help, and how chocolate allergies differ from chocolate sensitivity.
Chocolate contains a mixture of ingredients. The main ingredient is typically cocoa powder, which is a processed version of the cacao bean. This powder is then mixed with sugar, fat, and emulsifiers, such as soy lecithin.
Many types of chocolate are also made with milk products.
For people who are allergic to chocolate, it can be difficult to work out exactly what is causing the reaction because of the various ingredients. There are many possibilities.
Symptoms of a cocoa allergy
One possibility is a reaction to cocoa. If the body is allergic to cocoa, the immune system will respond when it enters the body. This response can create symptoms such as:
- trouble breathing
- swollen tongue, lips, or throat
- a wheezing cough
- nausea or vomiting
- stomach cramps
These symptoms may be signs of anaphylaxis, which can be life-threatening if it is not treated immediately.
Symptoms of a milk allergy
Some people who display an allergic reaction to chocolate may be allergic to milk products.
A person who is allergic to milk may experience some immediate symptoms in the first hours after eating milk products, such as hives, a wheezing cough, or nausea. However, some symptoms might be delayed and appear after hours or days. These symptoms can include:
- mucus secretions in the nose or lungs
- stomach upset
- skin rash or hives
- abdominal cramps
- loose stool or diarrhea that may or may not contain blood or mucus
Some cases of extreme milk allergy can send a person into anaphylactic shock, which can cause the throat and mouth to swell and may lead to cardiorespiratory arrest. These cases require immediate medical attention.
Symptoms of caffeine sensitivity
It is also possible that a person who has a reaction to chocolate is sensitive to caffeine.
The U.S. Department of Agriculture (USDA) estimates that a 100-gram bar of chocolate has around 43 milligrams of caffeine in it, which is about the same as half a cup of coffee. For people who are very sensitive to caffeine, this is enough to produce symptoms.
Symptoms of caffeine sensitivity (intolerance) include:
- jittery or nervous behavior
- digestive issues, such as diarrhea, nausea, or stomach pain
- increased heart rate
- trouble sleeping
Some people who are truly allergic to caffeine, which is rare, may also experience skin reactions, such as hives, rashes, or swelling. Individuals who are sensitive to caffeine will also notice these symptoms when drinking coffee, tea, energy drinks, or certain herbal beverages, such as guarana.
Some people who have an allergy to chocolate may be reacting to other ingredients in the chocolate. Other ingredients found in chocolate, such as tree nuts, peanuts, and soy, are common food allergy triggers.
Someone who is severely allergic to peanuts or tree nuts may have a reaction to plain chocolate made in the same facility as chocolate that contains these ingredients.
A person with a soy allergy typically has an allergy to the protein in the soy itself. Less commonly, the person may be reacting to the trace amount of soy protein in a soy-derived ingredient found in the chocolate, such as soy lecithin. A soy protein allergy can cause complex symptoms, such as:
- cold-like reactions, including a runny nose, watery eyes, nasal congestion, and sneezing
- digestive problems, including abdominal pain, stomach cramps, gas, and bloating
- symptoms of asthma caused by too much histamine in the lungs
- skin reactions, including itching, hives, or eczema
In some severe cases of soy protein allergy, people may experience more serious symptoms, such as:
- mental fog or confusion
- difficulty breathing
- dizziness or fainting
- difficulty swallowing
- redness of the skin
These symptoms may be the sign of an extreme reaction to soy and should be treated immediately.
It is also possible for people who are allergic to wheat to react to chocolate. This reaction may be due to contamination in the factory where the chocolate is made or from ingredients, such as wheat starch, which is in the chocolate itself.
Anyone with an allergy needs to take great care to educate themselves about what is in the food they eat. In stores, this means reading ingredient labels to be certain they do not contain known allergens.
At restaurants, people with food allergies should ask that their food be created away from potential allergens. It may also help to ask friends and family not to eat foods that trigger allergies near them.
Anyone who is certain they are allergic to cacao or cocoa in chocolate should avoid candy bars, which contain chocolate, as well as drinks such as milkshakes or hot cocoa.
Chocolate may even be found in unexpected baked goods or used to flavor drinks, such as coffee, soft drinks, or alcohol. Chocolate is even used as a flavoring in some medications. People with allergies to chocolate should always read food labels to be sure their diet is free of chocolate.
The most common substitute for chocolate is a legume called carob. It is processed and creates a cocoa-like powder that can be used just like chocolate.
Often used as a chocolate alternative in baked desserts, drinks, and chocolate bars, carob is also free of caffeine. This may make it a good choice for people with caffeine sensitivity as well.
Many times, a person who complains of symptoms caused by chocolate is only sensitive to it, not allergic to it.
Cocoa sensitivity is very different from an allergic reaction. A person who is allergic to chocolate may go into anaphylactic shock if they eat it or come into contact with it. A person who is sensitive to chocolate may be able to eat small amounts with no symptoms. When larger amounts are eaten, however, symptoms often show up.
Symptoms of chocolate or cocoa sensitivity can include:
- stomach upset
- bloating, gas, or cramps
- skin problems, such as rashes, hives, or acne
Luckily, chocolate or cocoa sensitivity is not life-threatening in most cases. Many people can manage symptoms by limiting their intake of chocolate or eating chocolate substitutes.
When to get an allergy test
Anyone who suspects they have an allergy but are uncertain what they are allergic to should get an allergy test. An allergist might recommend a blood test to check for allergies, or they may just ask the person to eliminate a food or ingredient from their diet to see if symptoms improve.
In the case of more severe reactions, allergists will advise people to avoid chocolate altogether until they can determine what the allergy is. Doctors may also recommend people carry epinephrine injection pens (EpiPen, for instance) in case of anaphylaxis that could lead to anaphylactic shock. This can relieve symptoms, such as a fast heartbeat, shortness of breath, and swelling of the face and throat in emergency situations.
A true allergy to cacao or cocoa is rare. Most cases of chocolate allergy are caused by an allergic reaction to an ingredient in chocolate or only a sensitivity to chocolate. Cases of severe allergy should be taken seriously and can be life-threatening.
Doctors can help people discover their allergies and discuss treatment options and alternatives to help them avoid the feeling that they are missing out.