Chocolate causes a range of adverse reactions including migraines, heartburn, cramps, swelling, allergy cough, itching, and hives. In the worst cases, someone can experience a life-threatening reaction called anaphylaxis. It is very serious, and for some people, the only way to avoid these problems is to avoid chocolate. But… true chocolate allergies are quite rare. If you experience adverse symptoms after you eat chocolate, it is more likely that you are allergic to another ingredient in the chocolate, or that you are intolerant to chocolate. NYC allergists agree that the “Big 8” food allergens are eggs, milk, soy, wheat, peanuts, tree nuts, fish, and shellfish. Several of these ingredients are very common in chocolate bars, cakes, brownies, puddings, and more. If you react when you eat chocolate, it is probable that you are allergic to one of these major allergens. Intolerance Another type of reaction to chocolate is an intolerance. An intolerance is a reaction of your gastrointestinal system rather than your immune system, and it is a reaction to an ingredient or chemical in the chocolate, rather than the protein in the chocolate. Some of the chemicals in chocolate are soy lecithin, tyramine, phenylethylamine, theobromine, caffeine, flavorings, and emulsifiers. Diagnosing A Chocolate Allergy Drinking hot chocolate or eating a brownie is NOT the way to test for a chocolate allergy or intolerance. The only way to diagnose a chocolate allergy is to be tested by an allergist. Your allergist may suggest a blood test or a food challenge. A blood test for allergies measures Immunoglobulin E (IgE), an antibody that your immune system develops in reaction to a specific allergen. During a food challenge, you will be asked to eat a small amount of chocolate in a clinical setting only. Food allergies can be severe, so you must be around a board certified allergist during this test. They will keep an Epipen or Auvi-Q nearby in case you experience a severe allergic reaction. Chocolate Allergy Treatment Treatment for allergies begin with avoidance. If you’ve been diagnosed with a chocolate allergy, refrain from eating chocolate and its byproducts. Your allergist will also prescribe an epinephrine auto injector that you should carry with you. For less severe allergies, such as itching and hives, try over-the-counter treatment options. Cortisone creams can help with inflammation of the skin. Benadryl also helps with mild reactions. Summary If you are concerned about a chocolate allergy, the allergists at NY Allergy & Sinus Centers are here to help. NYASC has access to the latest testing & treatments and we offer seven convenient offices throughout NYC to help you find relief for your asthma, nasal and sinus problems, ENT (ear, nose, and throat) symptoms, respiratory allergies, and skin conditions. We see pediatric and adult patients. Please call 212-686-4448 to book your appointment.