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Cocoa extract is a bitter mixture made up of xanthine molecules (theobromine and caffeine) and procyanidins. Supplementing with cocoa extract might provide cardiovascular and cognitive benefits by improving blood flow and providing antioxidant effects.

  • Cocoa seed is used orally for infectious intestinal diseases and diarrhea, asthma, bronchitis, and as an expectorant for lung congestion.
  • The cocoa seed coat is used for liver, bladder, and kidney ailments, diabetes, and as a tonic and general remedy.
  • Cocoa powder, enriched with flavonoid constituents, is used for preventing cardiovascular disease and cognitive impairment, whereas cocoa butter is used for hypercholesterolemia.
    Cocoa butter has been used topically to treat wrinkles on the skin and to prevent stretch marks during pregnancy.
  • Cocoa seed is used as a flavoring agent in foods, and chocolate is produced from cocoa powder.
  • Cocoa butter is used as a compounding base for various pharmaceutical preparations in manufacturing.

Also known as:  3, 7-dihydro-3, 7-dimethyl-1h-purine-2 6-dione, Beurre de Cacao, Cacao, Chocolat, Chocolat Noir, Chocolate, Cocoa Bean, Cocoa Butter, Cocoa Oleum, Cocoa Seed, Cocoa Semen, Cocoa Testae, Dark Chocolate, Dutch Cocoa, Fève de Cacao, Graine de Cacao, Theobroma, Theobromine, Théobromine

Diseases and Conditions

Cocoa is possibly effective for treating hypertension. Most research has suggested that consuming dark chocolate or flavanol-enriched chocolate/cocoa products for two to eighteen weeks can reduce systolic blood pressure by two and eight-tenths to four and seven-tenths millimeters of mercury and diastolic blood pressure by one and nine-tenths to two and eight-tenths millimeters of mercury. Cocoa is possibly ineffective for hypercholesterolemia. Most clinical evidence suggests that cocoa products do not improve cholesterol levels in hypercholesterolemic patients.


Cocoa is likely safe when used orally, topically, and appropriately. Cocoa butter is generally considered as safe and is widely used as a base for ointments. It may possibly be safe for pregnant and breastfeeding women to consume cocoa, but due to its caffeine content should be used with caution and under the supervision of a physician. Infants whose breastfeeding mothers consumed chocolate had higher rates of developing colic. Children may safely use cocoa under the supervision of a physician. Cocoa is generally well tolerated when consumed as chocolate for up to 12 weeks.

Consuming cocoa in large amounts may cause the following side effects:

  • Obesity
  • Kidney failure
  • Increased risk for dental cavities
  • Skin reactions such as eczema.

Its caffeine content may also lead to an increase in blood glucose levels. Other possible side effects include:

  • Decreased bone density in older women
  • Headaches
  • Migraines
  • Abnormal behaviors.

It may not be safe for individuals with anxiety, bleeding disorders, cardiac conditions, diabetes, diarrhea, gastroesophageal reflux disease (GERD), glaucoma, hypertension, irritable bowel syndrome, migraine headaches, osteoporosis, and arrhythmias to consume cocoa. Cocoa may affect blood glucose levels during and after surgery; discontinue use at least 2 weeks before the procedure.

Medication Interactions

Cocoa has minor interactions with the following medications:

  • Cimetidine
  • Contraceptive drugs
  • Fluconazole
  • Mexiletine
  • Terbinafine

 Cocoa has moderate interactions with the following medications:

  • Ace inhibitors
  • Adenosine
  • Alcohol
  • Antidiabetes drugs
  • Antihypertensive drugs
  • Beta-adrenergic agonists
  • Clozapine
  • Dipyridamole
  • Disulfiram
  • Ephedrine
  • Ergotamine
  • Estrogens
  • Fluvoxamine
  • Lithium
  • Monoamine oxidase inhibitors
  • Pentobarbital
  • Phenylpropanolamine
  • Quinolone antibiotics
  • Riluzole
  • Stimulant drugs
  • Theophylline
  • Verapamil

Cocoa has a major interaction with anticoagulant/antiplatelet drugs. Human research suggests that intake of cocoa can inhibit platelet adhesion, aggregation, and activity and increase aspirin-induced bleeding time, which means cocoa may increase the risk of bleeding when used with other antiplatelet or anticoagulant drugs.

Supplement and Food Interactions

Cocoa may interact with the following supplements, herbs, or foods:

  • Anticoagulant/antiplatelet herbs and supplements
  • Bitter orange
  • Caffeine-containing herbs and supplements
  • Calcium
  • Ephedra
  • Herbs and supplements with hypotensive effects
  • Iron
  • Magnesium

Cocoa also interacts with grapefruit juice due to its caffeine effects.


Studies have shown that five to twenty-six grams of dark chocolate contains sixty-five to one thousand nintey-five milligrams of flavanols. The standard dose for cocoa flavanols is five hundred to one thousand milligrams a day taken with meals. Supplementing cocoa extract can be replaced by consuming dark chocolate. The recommended dosage is twenty-five to forty grams of dark chocolate, containing at least eighty-five percent cocoa, which is about two hundred calories of dark chocolate. More research is necessary to determine an optimal dose of cocoa extract.


Cocoa can be found in chocolate, especially dark chocolate. Cocoa is also found in soft drinks and alcohol, jams and marmalades, cocoa butter, cocoa powder, and cocoa liquor. 

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