April 26, 2024 0 Comments

Cacao, the main ingredient in chocolate, is celebrated for its rich flavour and numerous health benefits. Packed with antioxidants, essential minerals, and mood-boosting compounds, cacao has gained a reputation as a superfood. However, as with any food or supplement, it's crucial to be aware of potential side effects and precautions to ensure safe and healthy consumption.

Understanding Cacao's Active Compounds

Cacao contains several bioactive compounds that contribute to its potential health benefits and side effects:
  • Theobromine: A stimulant similar to caffeine that can affect heart rate and blood pressure.
  • Caffeine: Although present in smaller amounts than coffee, cacao does contain caffeine, which can cause jitteriness and sleep disturbances in sensitive individuals.
  • Flavonoids: Powerful antioxidants that may help reduce inflammation and support cardiovascular health.
While these compounds are generally beneficial, they can interact with certain medications and health conditions.

If in any doubt, consult your GP or healthcare provider.

Potential Side Effects and Precautions

Digestive Discomfort

Some people may experience digestive issues such as nausea, stomach discomfort, constipation, or gas after consuming cacao, especially in large amounts. If you have a sensitive stomach or conditions like irritable bowel syndrome (IBS) or gastroesophageal reflux disease (GERD), introduce cacao gradually and monitor your body's response.

Allergic Reactions

Though rare, some individuals may have an allergic reaction to cacao. Symptoms can include skin rashes, itching, or hives. If you experience any of these symptoms after consuming cacao, discontinue use and consult your healthcare provider.


For some people, the compounds in cacao may trigger migraine headaches. If you are prone to migraines, keep track of your cacao intake and note any potential correlations with headache onset.

Interactions with Medications

Cacao can interact with certain medications, potentially altering their effectiveness or causing adverse reactions. Some examples include:

  • Antidepressants: Cacao may interact with MAOIs and other antidepressants that affect serotonin levels.
  • Blood thinners: The flavonoids in cacao may enhance the effect of blood-thinning medications, increasing the risk of bruising and bleeding.
  • Stimulants: Combining cacao with other stimulants like caffeine or certain ADHD medications can lead to increased heart rate and blood pressure.


Cacao may interact with certain types of antidepressants, particularly monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs). If cacao is likely to be a concern for an individual taking antidepressants, healthcare providers will provide them with dietary guidelines on foods to avoid (usually those containing tyramine) to prevent interactions. This will typically be for those taking higher doses of medications.

In the absence of any dietary guidelines provided by your healthcare provider, it is advisable to consume lower doses of cacao (10-25g daily) and refrain from taking it for extended periods to prevent interactions.

Here's how these interactions can occur:

  • MAOIs: Monoamine oxidase inhibitors work by blocking the activity of enzymes that break down neurotransmitters like serotonin and dopamine. Cacao contains tyramine, an amino acid that can cause a sudden increase in blood pressure when consumed in high amounts or in combination with MAOIs. This interaction can potentially lead to a hypertensive crisis, a serious condition characterized by a rapid spike in blood pressure.
  • SSRIs: Selective serotonin reuptake inhibitors, such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil), work by increasing the levels of serotonin in the brain. Cacao also contains compounds like theobromine and caffeine that can enhance the effects of serotonin. Combining cacao with SSRIs may lead to serotonin syndrome, a potentially life-threatening condition caused by excessive serotonin levels. Symptoms of serotonin syndrome can include agitation, confusion, rapid heartbeat, high blood pressure, and even seizures.

5-HTP (5-Hydroxytryptophan)

This amino acid supplement is often used to boost serotonin levels and improve mood. However, combining 5-HTP with cacao may increase the risk of serotonin syndrome, as both substances can raise serotonin levels in the brain.

St. John's Wort

This herbal supplement is commonly used to treat mild to moderate depression. Like cacao, St. John's Wort can also increase serotonin levels. Combining the two may elevate the risk of serotonin syndrome, especially when taken with other serotonin-enhancing substances or medications.

Pregnancy & breastfeeding

Like coffee or tea, it is important to reduce the intake of stimulating foods. The theobromine in cacao, which is similar to caffeine, has a stimulating effect although much milder than caffeine.

To enjoy cacao safely during pregnancy and breastfeeding, consider the following guidelines:

Consume cacao in moderation, limiting intake to small amounts (e.g., 10-25 grams per day) to minimise the risk of adverse effects.

Be mindful of the total caffeine intake from all sources, including coffee, tea, soft drinks, and chocolate, to stay within the recommended limits (see the NHS advice here)

If you have a history of pregnancy complications or are concerned about your cacao intake, consult your healthcare provider for personalized advice.

While breastfeeding, observe your infant's behavior and mood after consuming cacao. If you notice any signs of irritability or sleep disturbances, reduce your intake or temporarily eliminate cacao from your diet.

Safe Consumption Guidelines

To enjoy cacao safely, keep these guidelines in mind:

  1. Start with small amounts: If you're new to cacao, begin with a small serving (around 10-20 grams) to assess your tolerance.
  2. Listen to your body: Pay attention to any adverse reactions and adjust your intake accordingly.
  3. Moderation is key: While cacao offers health benefits, excessive consumption can lead to unwanted side effects.
  4. Choose quality products: Opt for high-quality, minimally processed cacao products to maximize benefits and minimize potential contaminants.
  5. Consult your healthcare provider: If you have any pre-existing health conditions or concerns, discuss the safety of cacao consumption with your doctor.


Cacao is a delicious and nutritious addition to a healthy diet, but it's essential to be mindful of potential side effects and precautions. By understanding cacao's active compounds, being aware of possible interactions, and following safe consumption guidelines, you can enjoy the benefits of this amazing superfood while minimizing any risks.

Remember, everyone's body reacts differently, so tune in to your own experiences and consult with a healthcare professional if you have any concerns. With a balanced approach, you can savor the rich flavors and health-promoting properties of cacao safely and responsibly.

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