By Bradley Chipps, MD
Q: Is there any such thing as chocolate allergy?
A: If there is, it’s very, very rare. More likely it’s milk or nuts in the candy that people are allergic to.
If someone comes to me with a suspected chocolate allergy, I would take a full history of symptoms and food exposure, then do skin-prick tests for food allergies — or specific IgE blood tests — both are equally sensitive.
Q: What if the tests come back negative but I’m still having symptoms — what’s next?
A: It may mean you are intolerant of an ingredient in the chocolate, that it’s not IgE-related. (IgE is the elements in blood that indicate immune-system-related allergies.) Intolerance is related to the gastrointestinal tract — for example, people who are lactose intolerant don’t digest milk well because they can’t break down the lactose. And sensitivity means something as simple as greasy food gives you an upset stomach or hot spicy foods cause you to sweat. And that’s a direct reaction to a food causing an autonomic cranial nerve overactivity. Allergy tests don’t measure these conditions. When in doubt, we can do an oral challenge in the office that is very safe and can settle the question once and for all.
Ask the Allergist is sponsored by the American College of Allergy, Asthma and Immunology (ACAAI).