An allergy involves a mild to life threatening immune response to an external substance. A sensitivity, on the other hand, is typically a milder reaction associated with difficulty digesting food.

An allergy to chocolate or cocoa is rare. Other ingredients in chocolate-based food are more likely to cause an allergic reaction.

It’s also possible to be sensitive to chocolate or another ingredient in the chocolate product.

An allergy to chocolate is rare, but it’s still possible. There are a few confirmed cases of chocolate allergy. In most cases, something else in the chocolate-containing food is the actual cause of the reaction.

Symptoms of a chocolate allergy can develop anywhere in the body.

When something in the food or the environment gets mistaken for an invader, the immune system tries to destroy the substance to protect the body.

In most allergy cases, the immune response releases an antibody called immunoglobulin E (IgE). IgE antibodies activate the release of histamine, which may cause a variety of symptoms.

Signs and symptoms of a chocolate allergic reaction may involve:

  • the digestive system with symptoms like nausea, stomach pain, vomiting, and diarrhea
  • the skin with symptoms like hives, swelling, discoloration, and itching
  • the cardiovascular system with symptoms like heart palpitations and a slower pulse
  • the respiratory system with symptoms like coughing, sensation of airways closing, difficulty breathing, and wheezing

An allergic reaction can be mild or become a medical emergency. Anaphylaxis is a severe allergic reaction that is often life threatening if not treated immediately.

If you experience any of the following symptoms after eating chocolate, urgent medical attention is essential:

  • breathing difficulty
  • swallowing difficulty
  • swelling of the face, eyes, tongue, or throat
  • reduced consciousness or loss of consciousness

Severe allergic reactions may not respond to over-the-counter (OTC) antiallergics. It’s important to get emergency medical attention.

Allergy symptoms may result from chocolate or other ingredients in chocolate like milk, wheat, or nuts.

Depending on how or where chocolate is made, it may also come into contact with additional food allergens.

For someone with a food allergy or a condition like celiac disease, cross-contamination may be enough to cause an allergic reaction.

Some foods are much more likely to cause an allergic reaction than others. About 90% of allergic reactions to food are due to:

  • eggs
  • dairy
  • peanuts and tree nuts
  • fish and shellfish
  • wheat
  • soy

Chocolate sensitivity, also called intolerance, may result from antibody production or, most often, a lack of certain enzymes needed to break down the food.

Food intolerance often causes mild to severe digestive symptoms and could also affect other organs.

Symptoms of chocolate sensitivity may include:

  • digestive symptoms such as bloating, cramping, nausea, heartburn, gas, or diarrhea
  • fatigue
  • headache
  • inflammatory symptoms like joint pain or swelling

If you have a chocolate allergy, any small amount of the allergen can trigger a reaction. If you have chocolate sensitivity, you may be able to tolerate small amounts or certain types of chocolate.

It can be hard to sort out what in the food actually causes allergy or sensitivity symptoms. Potential allergens in chocolate-containing foods may include:

  • milk
  • wheat
  • peanuts
  • other nuts
  • soy

If you live with irritable bowel syndrome (IBS), other triggers are also possible. Depending on what you’re eating, the fat and milk content, caffeine level, or types of sweeteners used could cause symptoms like gas, bloating, cramping, diarrhea, or constipation.

Chocolate contains some caffeine, which may lead to increased anxiety, headaches, or shifts in blood pressure in people who are sensitive to it. Dark chocolate contains more caffeine than milk chocolate.

One of the best ways to narrow down what’s causing your symptoms is to keep a food and symptom journal. You might be able to identify some patterns.

If you have persistent symptoms after eating certain foods, a healthcare professional may recommend a food allergy or sensitivity test. They will also ask about your specific symptoms and any patterns that you’ve noticed.

A test can measure the antibody response to specific foods and let you know which specific ingredients you’re allergic to.

This eliminates guesswork when determining whether you’re allergic to cocoa or another ingredient in chocolate foods.

If you have a confirmed food allergy, the first line of treatment is to completely avoid the allergen. However, this may not always be possible, so a healthcare professional may also recommend medications and other courses of action.

These may involve:

The recommended option may depend on how strong the allergic reaction to chocolate is.

If you’re sensitive to cocoa or some other ingredient in chocolate, you may need to completely avoid the food, or you may find you can tolerate small amounts without having major symptoms.

A doctor may also recommend medications that help you manage digestive symptoms like diarrhea and bloating.

Chocolate allergy is rare but possible. Most cases of suspected chocolate allergy are caused by another ingredient in the chocolate-containing product.

Food allergies may be mild to severe, and in some cases could be life threatening. Avoiding the food altogether and always having an antiallergic medication, like an epinephrine injector, is highly advisable.

A chocolate sensitivity may cause uncomfortable digestive symptoms and inflammation, but it’s usually not life threatening. You may be able to tolerate small amounts of chocolate or would need to avoid it completely.