Table of ContentsView AllTable of ContentsAllergy vs. SensitivitySymptomsCausesOther FactorsTreatmentWhen to Call 911
Table of ContentsView All
View All
Table of Contents
Allergy vs. Sensitivity
Symptoms
Causes
Other Factors
Treatment
When to Call 911
A true chocolate allergy is rare, and the symptoms you experience may be due to chocolate or other ingredients used in the manufacturing of chocolate.It is also possible to have a non-allergic sensitivity to chocolate, cocoa, orcacao(the bean from which cocoa, cocoa butter, and chocolate are derived).
Understanding the difference between atrue allergyand afood sensitivityis important as the treatment and risks are very different. With a true allergy, you may be at risk of a potentially life-threatening allergic reaction calledanaphylaxisrequiring immediate emergency treatment. Carrying a prescribed epinephrine auto-injector is recommended for people with life-threatening food allergies.
This article explains the symptoms of a chocolate allergy, the difference betweenfood allergiesand food sensitivities, and ways to manage and avoid allergic reactions.
Chocolate Allergy vs. Chocolate Sensitivity
A chocolate allergy and chocolate sensitivity can often cause similar symptoms, but the underlying mechanisms are very different.
Food Allergies
A food allergy involves a specific immune response to an allergy-causing substance (allergen). When exposed to an allergen—in this case, chocolate—the immune system is sensitized to it and producesimmunoglobulin E (IgE)(a type of antibody) specific to the allergen.
When exposed to the allergen, the specific IgE binds to it and sets off a chain reaction. This causes the immune cells to release an inflammatory chemical calledhistamineinto the bloodstream.
Histamine is the chemical responsible for the characteristic symptoms of a true allergy, both in the skin, digestive tract, and respiratory tract.
Food Sensitivity
In contrast, food sensitivities do not involve IgE or histamine. Instead, when certain foods are eaten, the body is unable to break them down as they should. This may be due to a lack of digestive enzymes (such as the lack of lactase in people withlactose intolerance) or a general intolerance of food additives and chemicals.
With food sensitivity, the response is often limited to the digestive tract.
Why the Difference Is ImportantThe distinction between a food allergy and food sensitivity is important as exposure to even a small amount of an allergen can cause anaphylaxis in people with a true allergy. In those with food intolerance, anaphylaxis will not occur no matter how much of the food is consumed.
Why the Difference Is Important
The distinction between a food allergy and food sensitivity is important as exposure to even a small amount of an allergen can cause anaphylaxis in people with a true allergy. In those with food intolerance, anaphylaxis will not occur no matter how much of the food is consumed.
Chocolate allergies are rare. Symptoms range from mild and transient to life-threatening.
With atrue chocolate allergy, a person may experience symptoms like:
Symptoms may develop soon after eating chocolate or within two hours.
There is little data on how common chocolate sensitivities are. This is because it is hard to determine if the sensitivity is due to chocolate or some other ingredient in the chocolate confection.
With chocolate sensitivity, a person may experience symptoms like:
Food allergies almost always occur quickly, within two hours of eating, but in food intolerances, symptoms may be a little more delayed but still generally occur within a few hours.
Causes of a Reaction to Chocolate
When you buy a chocolate bar, chocolate is not the only thing you are consuming. In addition to cocoa and cocoa butter derived from cacao, there may also be added ingredients like milk, milk powder, soy, vegetable fats, and flavorings like vanilla.
As such, you may be allergic to the cacao derivatives or some other ingredient in the confection, such as:
Milk
Dairy allergiesare very common, especially in children, and almost all chocolate contains at least some milk.
Dairy-free chocolates are on the market from brands like Tropical Source, Amanda’s Own, Premium Chocolatiers, and Chocolate Decadence.
Peanuts and Tree Nuts
Some chocolates are filled with peanut butter or whole nuts. Even when they aren’t, they may be manufactured in plants where peanuts and tree nuts are used. In such instances, cross-contamination can occur, placing people withpeanutortree nut allergiesat risk of exposure.
Labeling rules do not require manufacturers to mention this on food labels so if you have a severe allergy, consider only buying products marked “manufactured in a dedicated nut-free facility.” You can also buy chocolate from nut-free manufacturers like Vermont Nut-Free.
Wheat
People withwheat allergiesmay need to avoid filled chocolates that often use flour or wheat starch as a binder. Wheat allergies are relatively uncommon, affecting around 1% of the general population, mostly children.
A wheat allergy is not the same thing asgluten intolerancein which you react to gluten found in wheat and other cereal grains. With a true wheat allergy, you may be allergic to any of the four main proteins in wheat, including albumins, globulins, gliadins, and glutenins.
Soy
Technically, chocolate is an emulsion (a mixture of two liquids that would otherwise separate). Most utilize some form of emulsifier to keep the chocolate solid at room temperature.
Among the most common is soy lecithin, which may be problematic for people withsoy allergies. This should be listed clearly on food labels, so double-check if you have a known allergy or buy products marked “soy-free.”
Corn
Corn is incredibly difficult to avoid in the industrial food supply, and chocolate is no exception. In addition to high-fructose corn syrup used to sweeten many chocolate candies, some manufacturers use corn on their production lines. Be especially alert for the presence of corn in white chocolate.
Corn allergies are more common than most people think, but they are not as common as milk, peanuts, tree nuts, or soy allergies.
Caffeine
Contrary to popular belief, chocolate is extremely low in caffeine; one ounce of milk chocolate contains only around six milligrams. In comparison, one 12-ounce can of cola has 34 milligrams, while a 2-ounce double espresso can range from 45 to 100 milligrams.
However, if you are highlysensitive to caffeine, chocolate can cause a reaction. Dark chocolate has far more caffeine than milk chocolate.
Other Reasons for Allergy-Like Symptoms
In the absence of a true chocolate allergy, there are other possible explanations for why you react to chocolate, cocoa, or cacao.
Celiac Disease or Gluten Intolerance
If you have digestive symptoms after eating chocolate, it may be the result ofceliac diseaseornon-celiac gluten sensitivity (NCGS),
Celiac disease is anautoimmune diseasein which the immune system attacks the lining of the intestine wheneverglutenis consumed. It differs from a wheat allergy in that IgE is not involved; rather, the immune system releases “auto-antibodies” that directly target and attack tissues.
NGCS is a food sensitivity that occurs in response to eating gluten. NCGS is not well understood but has no auto-antibodies associated with celiac disease or IgE antibodies associated with wheat allergies.
If you have celiac disease or NGCS, most plain chocolates are safe as they don’t contain gluten. Problems may arise when you eat filled chocolates made with wheat binders. The same can occur with crisped rice which often includes barley malt (another rich source of gluten).
Gluten-free chocolatiers include Endangered Species Chocolate and Equal Exchange.
Drug Interactions
Chocolate can cause allergy-like symptoms in people who take Prozac (fluoxetine) or Zoloft (sertraline), both of which belong to a class of antidepressants calledselective serotonin reuptake inhibitors (SSRIs), Eating lots of chocolate while taking an SSRI can cause itchiness and burning sensations of the scalp, torso, and back.
The reaction is seen primarily in people who eat a lot of chocolate regularly.
Managing Chocolate Allergies
The main approach to dealing with any food allergy is to avoid the allergen. Even so, chocolate may not be the actual culprit, and additional testing may be needed to ascertain which ingredient you are allergic to.
An allergy specialist known as anallergistcan perform tests to pinpoint the likely cause or causes, including:
Allergy shotsused to desensitize people to respiratory allergens do not work for food allergies. The avoidance of food allergens is the frontline approach.
White Chocolate as an AlternativeIf you’re allergic to chocolate, you may still be able to eat white chocolate. Despite its name, white chocolate doesn’t contain any chocolate and is instead made from cocoa butter, sugar, and milk or milk powder. Soy lecithin is also sometimes used.If allergy testing reveals that cocoa is the cause of your food allergy, white chocolate may be a safe alternative.
White Chocolate as an Alternative
If you’re allergic to chocolate, you may still be able to eat white chocolate. Despite its name, white chocolate doesn’t contain any chocolate and is instead made from cocoa butter, sugar, and milk or milk powder. Soy lecithin is also sometimes used.If allergy testing reveals that cocoa is the cause of your food allergy, white chocolate may be a safe alternative.
If you’re allergic to chocolate, you may still be able to eat white chocolate. Despite its name, white chocolate doesn’t contain any chocolate and is instead made from cocoa butter, sugar, and milk or milk powder. Soy lecithin is also sometimes used.
If allergy testing reveals that cocoa is the cause of your food allergy, white chocolate may be a safe alternative.
When to Seek Emergency Care
On rare occasions, exposure to chocolate can lead to anaphylaxis, a dangerous, whole-body allergy that can lead to coma, shock, respiratory distress, and death if left untreated.
Call 911 or rush to your nearest emergency room if you developsigns and symptoms of anaphylaxis, including:
Anaphylaxis is a medical emergency requiring an immediate injection ofepinephrineto avoid a dangerous drop in blood pressure that can lead to shock.
Summary
A true chocolate allergy is rare, affecting less than 1% of the population, but it can cause anaphylaxis in certain people. By contrast, chocolate intolerance can cause food allergy-like symptoms but without the risk of anaphylaxis. Allergy testing can reveal if you are truly allergic to chocolate or simply have a non-allergic food sensitivity.
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16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lopes JP, Kattan J, Doppelt A, Nowak-Węgrzyn A, Bunyavanich S.Not so sweet: true chocolate and cocoa allergy.J Allergy Clin Immunol Pract. 2019;7(8):2868-2871. doi:10.1016/j.jaip.2019.04.023Rodriguez-Lagunas MJ, Vicente F, Pereira P, Castell M, Perez-Cano FJ.Relationship between cocoa intake and healthy status: a pilot ctudy in university students.Molecules.2019 Feb;24(4):812. doi:10.3390/molecules24040812Manea I, Ailenei E, Deleanu D.Overview of food allergy diagnosis.Med Pharm Rep. 2016;89(1):5-10. doi:10.15386/cjmed-513National Health Service (UK).Food intolerance.American College of Allergy, Asthma, & Immunology.Milk and dairy.Food Allergy Research and Education Foundation.Prevent cross-contact.Cianferoni A.Wheat allergy: diagnosis and management.J Asthma Allergy. 2016;9:13-25. doi:10.2147/JAA.S81550American College of Allergy, Asthma & Immunology.Soy.American College of Allergy, Asthma & Immunology.Corn allergy.National Institute of Diabetes and Digestive and Kidney Diseases.Definitions and facts for celiac disease.Volta U, Bardella MT, Calabrò A, et al.An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity.BMC Med. 2014;12:85. doi:10.1186/1741-7015-12-85Gahir KK.Chocolate coating: managing an SSRI-related adverse cutaneous reaction.Progress Neurol and Psychiat.2021;25(2);11-12. doi:10.1002/pnp.703National Institue of Allergy and Infectious Diseases.Diagnosing food allergy.American Academy of Allergy, Asthma & Immunology.Allergy shots (immunotherapy).Rodríguez-lagunas MJ, Vicente F, Pereira P, Castell M, Pérez-cano FJ.Relationship between cocoa intake and healthy status: A pilot study in university students.Molecules. 2019;24(4). doi:10.3390/molecules24040812American Academy of Allergy, Asthma & Immunology.Anaphylaxis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Lopes JP, Kattan J, Doppelt A, Nowak-Węgrzyn A, Bunyavanich S.Not so sweet: true chocolate and cocoa allergy.J Allergy Clin Immunol Pract. 2019;7(8):2868-2871. doi:10.1016/j.jaip.2019.04.023Rodriguez-Lagunas MJ, Vicente F, Pereira P, Castell M, Perez-Cano FJ.Relationship between cocoa intake and healthy status: a pilot ctudy in university students.Molecules.2019 Feb;24(4):812. doi:10.3390/molecules24040812Manea I, Ailenei E, Deleanu D.Overview of food allergy diagnosis.Med Pharm Rep. 2016;89(1):5-10. doi:10.15386/cjmed-513National Health Service (UK).Food intolerance.American College of Allergy, Asthma, & Immunology.Milk and dairy.Food Allergy Research and Education Foundation.Prevent cross-contact.Cianferoni A.Wheat allergy: diagnosis and management.J Asthma Allergy. 2016;9:13-25. doi:10.2147/JAA.S81550American College of Allergy, Asthma & Immunology.Soy.American College of Allergy, Asthma & Immunology.Corn allergy.National Institute of Diabetes and Digestive and Kidney Diseases.Definitions and facts for celiac disease.Volta U, Bardella MT, Calabrò A, et al.An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity.BMC Med. 2014;12:85. doi:10.1186/1741-7015-12-85Gahir KK.Chocolate coating: managing an SSRI-related adverse cutaneous reaction.Progress Neurol and Psychiat.2021;25(2);11-12. doi:10.1002/pnp.703National Institue of Allergy and Infectious Diseases.Diagnosing food allergy.American Academy of Allergy, Asthma & Immunology.Allergy shots (immunotherapy).Rodríguez-lagunas MJ, Vicente F, Pereira P, Castell M, Pérez-cano FJ.Relationship between cocoa intake and healthy status: A pilot study in university students.Molecules. 2019;24(4). doi:10.3390/molecules24040812American Academy of Allergy, Asthma & Immunology.Anaphylaxis.
Lopes JP, Kattan J, Doppelt A, Nowak-Węgrzyn A, Bunyavanich S.Not so sweet: true chocolate and cocoa allergy.J Allergy Clin Immunol Pract. 2019;7(8):2868-2871. doi:10.1016/j.jaip.2019.04.023
Rodriguez-Lagunas MJ, Vicente F, Pereira P, Castell M, Perez-Cano FJ.Relationship between cocoa intake and healthy status: a pilot ctudy in university students.Molecules.2019 Feb;24(4):812. doi:10.3390/molecules24040812
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National Health Service (UK).Food intolerance.
American College of Allergy, Asthma, & Immunology.Milk and dairy.
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Cianferoni A.Wheat allergy: diagnosis and management.J Asthma Allergy. 2016;9:13-25. doi:10.2147/JAA.S81550
American College of Allergy, Asthma & Immunology.Soy.
American College of Allergy, Asthma & Immunology.Corn allergy.
National Institute of Diabetes and Digestive and Kidney Diseases.Definitions and facts for celiac disease.
Volta U, Bardella MT, Calabrò A, et al.An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity.BMC Med. 2014;12:85. doi:10.1186/1741-7015-12-85
Gahir KK.Chocolate coating: managing an SSRI-related adverse cutaneous reaction.Progress Neurol and Psychiat.2021;25(2);11-12. doi:10.1002/pnp.703
National Institue of Allergy and Infectious Diseases.Diagnosing food allergy.
American Academy of Allergy, Asthma & Immunology.Allergy shots (immunotherapy).
Rodríguez-lagunas MJ, Vicente F, Pereira P, Castell M, Pérez-cano FJ.Relationship between cocoa intake and healthy status: A pilot study in university students.Molecules. 2019;24(4). doi:10.3390/molecules24040812
American Academy of Allergy, Asthma & Immunology.Anaphylaxis.
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