Medically Reviewed by Suzanne Falck, MD on November 4, 2016— Written by Stephanie Watson
Overview
Chocolate is found in many popular desserts and even in some savory dishes. For some people, though, chocolate isn’t a sweet treat. Some people have a sensitivity or an allergy to chocolate or an ingredient in a chocolate-based food.
Do you think you might have a problem with chocolate? Here’s how to tell whether cocoa or chocolate-based foods should be on your “no eat” list.
Symptoms
Chocolate allergies and chocolate sensitivities aren’t the same thing. If you’re allergic to chocolate, your immune system responds to it.
If you are allergic to chocolate and eat it, your immune system will release chemicals like histamine into the bloodstream. These chemicals can affect your:
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eyes
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nose
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throat
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lungs
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skin
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digestive system
If you have an allergy to chocolate, you may have some of these symptoms after eating it or even just coming into direct contact with it:
These symptoms are part of a severe allergic reaction called anaphylaxis. This condition can be life-threatening if you don’t treat it right away.
A chocolate sensitivity is different from an allergy. It’s not caused by an immune system reaction. And most of the time it isn’t life threatening.
If you have a sensitivity, you may be able to eat small amounts of chocolate without any problem. But in larger amounts, chocolate can trigger a reaction in your GI tract or elsewhere in your body.
People who are sensitive to chocolate can have symptoms like:
The caffeine in chocolate can trigger its own set of symptoms, which include:
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shakiness
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trouble sleeping
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fast or uneven heartbeat
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high blood pressure
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headaches
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dizziness
Causes
You’re more likely to have a reaction to chocolate if you’re allergic to it or its source, which is cocoa. But ingredients in chocolate-based foods, such as milk, wheat, and nuts, can also set off a reaction.
People with a gluten intolerance or celiac disease sometimes react to chocolate, especially milk chocolate. One theory is that this reaction is caused by cross-reactivity.
In people with celiac disease, the body reacts to gluten. Gluten is a protein found in wheat. And chocolate contains a protein that’s similar in structure, so the immune system sometimes mistakes it for gluten.
The immune system produces antibodies in response to gluten. These antibodies trigger symptoms like:
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bloating
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abdominal pain
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diarrhea
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vomiting
RISK FACTORS
Risk factors
Some people react to the chocolate itself. For example, chocolate contains caffeine, which is a stimulant that’s considered a drug. It can cause shakiness, headaches, and other symptoms in people who are sensitive to it.
Others are allergic or sensitive to ingredients in chocolate-based foods, such as:
It may not seem obvious, but chocolate can also be a problem for people who have a nickel allergy. About 15 percent of the population are allergic to nickel. Dark and milk chocolate, cocoa powder, and many of the nuts found in chocolate bars are high in this metal.
Foods to avoid
If you’re sensitive or allergic to chocolate or ingredients in chocolate products like nuts or milk, know what’s in your food. At restaurants, ask to have your meals and desserts prepared without chocolate. And when you go to the supermarket, read package labels. Make sure the product doesn’t contain chocolate or cocoa.
Along with candy bars and other desserts, chocolate can hide in places where you might not expect. Cocoa is used to make certain soft drinks, flavored coffees, and alcoholic beverages, like brandy. You can also find it in some jams and marmalades. And, it’s an ingredient in the savory Mexican sauce, mole. Even some medicines, including laxatives, contain chocolate.
Food substitutes
People who are sensitive to chocolate may want to try carob. This legume is like chocolate in color and taste. And it can replace chocolate in just about any recipe, from chocolate bars to cookies. Carob is also high in fiber, low in fat, and sugar- and caffeine-free, so it can be a healthier dessert alternative.
If you’re sensitive to the milk in chocolate, consider switching to dark chocolate. Dark chocolate usually doesn’t list milk as an ingredient. But many people with milk allergies have reported reactions after eating it. When the FDA did a review of dark chocolate bars, they found 51 out of 100 bars they tested contained milk that wasn’t listed on the label.
If you have a severe allergy to nuts or milk, you might want to avoid any chocolate products that don’t say nut- or dairy-free.
SEEK HELP
Seeking help
If you suspect you might have an allergy or sensitivity to chocolate, see an allergist. Skin prick and blood tests, or elimination diets can pinpoint whether chocolate is causing your reaction. Depending on the severity of your response to chocolate, your doctor might tell you to avoid it. Or you may only need to limit chocolate in your diet.
If you have a severe allergy, carry an auto-injector wherever you go. This device delivers a dose of the hormone epinephrine to stop the reaction. The shot should relieve symptoms like shortness of breath and swelling of the face.
Outlook
Chocolate allergies are rare. If you are having a reaction when you eat chocolate, you may be reacting to something else. You also may have a sensitivity instead of an allergy.
Talk to your doctor about your symptoms. If you continue to experience discomfort when eating chocolate, explore alternatives.
Many children outgrow allergies to foods like milk and nuts as they get older. But if you were diagnosed as an adult, you may be stuck with your sensitivity.
