Cacao Herbal Monograph

I’ve decided to be really cliché and do a Valentine’s kind of theme for my herbal posts this week.  I will start by sharing this short monograph on Cacao that I wrote for Natural Herbal Living Magazine in February of 2015.  ~ Stephany 

One of my fondest childhood memories is coming indoors on a cold winter day and waiting impatiently while Mom whipped up a batch of homemade hot cocoa. Our modern love affair with cocoa and chocolate go back to the days when the early Spanish and British explorers first brought it back from the New World. Although preparations and uses for the plant have changed over the centuries, the fact remains that cacao holds a special place in our culture. Few people stop to consider that what is now considered a confection was once widely used as a medicinal preparation.

 Scientific NameTheobroma cacao
Family: Malvaceae
Other Names: cacao tree, cocoa tree

Origin of Cacao
The cacao tree is native to the Amazon Basin, but its range spread north to Central America when more cultures began cultivating it. The cacao tree will only flourish in very specific climatic
conditions. It’s a tropical undergrowth plant, and it depends upon high temperatures and humidity only found near the Equator. The trees also require the presence of the Forcipomyia midge, which inhabit these ecosystems, for pollination.

Each of the roughly 12- inch (30 cm) pods growing from the trunk and main branches produce anywhere from 25 to 40 bitter-tasting seeds, or beans, which are surrounded by a white pulp. Cocoa powder and chocolate are both products that come from processing the cacao bean. The beans are processed into powder, cocoa butter, and chocolate; the pulp is harvested for other uses.

You can see how these would be hard to break.

The pods will not open without some sort of mechanical assistance from animals or humans. Spider monkeys,who use the pods as a food source, earned the reputation as the “bringers of cacao” due to their efficient dispersal of the seeds.[1]

The Science

There are a lot of claims about cacao’s superfood status, and even more traditional and modern
suggested uses. I’ve included below a brief summary of what has been investigated through scientific methods.

Cacao contains the xanthines theobromine and caffeine. It also contains the fatty acids stearic
acid and oleic acid. Recent scientific research into the phenol content of chocolate has identified thousands of various polyphenols in chocolate including the flavonoid quercetin and the flavonols epicatechin and catechin.[2]

The theobromine in cacao acts as a central nervous system stimulant, working on both the cardiac and respiratory systems. Theobromine is also a diuretic, a vasodilator, and a smooth- muscle relaxant.[3] Caffeine is a central nervous system stimulant and diuretic too. Unlike theobromine, it is a vasoconstrictor.[4]

It seems worth noting that these opposing actions of vasodilation and vasoconstriction could have a toning effect on the vasculature, although more research is needed to confirm this theory. The various phenolic compounds act as antioxidants and have anti-inflammatory actions, which contribute to cacao’s positive “metabolic, antihypertensive,anti-inflammatory, and anti- thrombotic effects.”[5]

In addition to these actions, chocolate has been termed a euphoric, as it has been theorized to impact serotonin and endorphin levels in the brain.[6]

Cacaos Many Uses
There is an incredibly rich history of ethnobotanical use that continues up to the present day. While today cacao is thought of as food, historically cacao has been considered ceremonial, medicinal, and nutritive.

History and Tradition
Cacao’s long history of both medicinal and ritual use began in Mesoamerica. The similarity between Aztec and Mayan use of the plant, point towards its use by a common ancestor.[7] According to both cultures, cacao was gifted to humans by the divine and was an integral part of religious rituals.







The most common preparation was a drink made from cacao powder or paste cakes mixed with water. Depending on the area, the drinks contained additional ingredients such as chili powder, vanilla, or ground maize. The drink was typically frothed by making it in a special cacao pot with a spout for blowing into it, or by quickly transferring the drink between two vessels.[8] Traditional cocoa powder preparations were considered to have antiseptic, diuretic, ecbolic (stimulating uterine contractions), emmenagogue, and parasiticidal actions.

Early Spanish explorers reported that indigenous peoples used cacao to treat angina, constipation, dental problems, dysentery, asthenia, gout, and many other diseases [9] including alopecia, burns, cough, dry lips, eyes, fever, diarrhea, listlessness, malaria, nephrosis, rheumatism, snakebite, and wounds.[10]

The use of cacao as a medicinal plant spread to Spain and Great Britain as these empires settled the Americas. In 1624, Spanish physician Santiago de Valverde Turices was the first to assign energetic qualities to both cacao powder and chocolate. He claimed that while the powder was cold, chocolate drinks were hot, dry, and suitable for cold, damp conditions.[11] Henry Stubbe was one of the first Europeans to write extensively on cacao. His text, titled The Indian Nectar; or A discourse concerning chocolate wherein the nature of the cacao-nut is examined…, was published in 1682. Axtextli, a beverage he mentioned as an aphrodisiac, was a mixture of cacao paste, maize, mecaxochitl (black pepper),and tlilxochitl (vanilla).

InThe English American published in 1648, Thomas Gage mentioned that black pepper mixed with cacao was a remedy for a “cold liver.”[12] King’s American Dispensatory recommends a mixture of cacao and milk as a restorative drink for “persons convalescing from acute diseases.” M. Grieves mentions in A Modern Herbal that in her time, cacao was given as a diuretic along with digitalis to relieve “accumulation of blood in the body resulting from cardiac failure” and as a remedy for hypertension due to the vasodilative action.

Modern Day
Although human studies of theobromine have confirmed its potential usefulness in inhibiting
coughs,[13] for the most part, the use of cacao as a medicinal has faded out of practice. It is,
however, still widely considered a dietary supplement with health- promoting qualities. There is a great deal of research available on the health benefits of adding cacao to our diets.

The phenolic compounds seem to protect against chronic diseases related to oxidative stress, one study concluding, “Several in vivo studies have provided strong support for the hypothesis that the consumption of flavanol-rich foods, such as certain cocoas and chocolates, may be associated with reduced risk for vascular disease.”[14] A study released last year has addressed the potential of cacao polyphenols in preventing “metabolic diseases and chronic inflammation associated with obesity.”[15]

Since “milk proteins inhibit absorption of flavonoids” dark chocolate may be the best way to
consume chocolate for the dietary benefits.15 Cacao may also have mental health benefits.

Ask many people, and they will tell you that they self-medicate on down days with chocolate. This practice seems to be supported by research on how eating chocolate impacts mood. Cocoa butter, which is another by-product of processing the beans, is used extensively in modern cosmetic preparations, due to its rich emollient properties, as well as in the chocolate-making process.

Using Cacao Safely
As with any food plant that is also a medicinal herb, there are some precautions to keep in mind
as you incorporate it into your daily regimen.

Side Effects
Cacao can cause allergic reactions in some people, although that is rare, and it may trigger migraines in some individuals.[16] Many of its side effects are related to the caffeine content.
As with all caffeinated beverages, moderation is key.

Contraindications and Drug Interactions
Avoid cacao if you have an allergy to any member of the Sterculiaceae family. People who suffer from kidney stones or gout may also want to avoid cacao as it increases urinary oxalate levels.[17]

There are a number of pharmaceutical drugs that interact with caffeine including clozapine, beta-adrenergic antagonists, lithium, and drugs used for testing for heart conditions. Be sure to discuss your caffeine intake with your physician before starting a new prescription. The flavanols in cacao may also interact with blood- thinning medications. (Sorry you all…gotta include the CYA disclaimers. The main thing here is to communicate with your providers about excessive consumption.  I am looking at you people who drink a pot a day!)

Use During Pregnancy and Lactation
Follow your physician’s recommendation regarding daily caffeine intake during pregnancy and while breastfeeding. In some studies, excessive caffeine in the maternal diet has resulted in colic in infants.[18]

 Dosage and Administration
There are no established dosages for cacao powder. Administration is generally in the form of a beverage or confection. Half of a 3-ounce chocolate bar contains 86 – 240 mg of theobromine and 9 – 31 mg of caffeine.[19]

[1] 1 Nisao Ogata, Arturo Gómez-Pompa, and Karl A. Taube, “The Domestication and Distribution of Theobroma cacao L. in the Neotropics,” Chocolate in Mesoamerica: A Cultural History of Cacao ed. Cameron L. McNeil (University Press of Florida: Gainesville, 2006), 87.

[2] 2 Chiaki Sanbongi, Naomi Osakabe, et al., “Antioxidative Polyphenols Isolated from Theobroma cacao,” Journal of Agricultural and Food Chemistry 46, (1998).

[3] Lisa Ganora, Herbal Constituents, (Herbalchem Press, 2009), 155.

[4] Ibid.

[5] G. Lippi, M. Franchini, et al., “Dark chocolate: consumption for pleasure or therapy?” Journal of Thrombosis Thrombolysis 28, (2013).

[6] Gordon Parker, Isabella Parker, and Heather Brotchie, “Mood state effects of chocolate,” Journal of Affective Disorders 92 (2006).

[7] “Caroline Seawright. Life Death and Chocolate in Mesoamerica,”(archaeological essay, 2012). Full text:, pp. 13.

[8] Hillary Christopher, “Cacao’s Relationship with MesoamericanSociety.” Spectrum 3, (2012).

[9] Donatella Lippi, “Chocolate and medicine: Dangerous liaisons?”Nutrition 25, (2009).

[10] 10 “Chocolate,” National Standard Food, Herbs and Supplements Database (2014).

[11] Lippi, “Dangerous liasons.”

[12] Gage, Thomas. The English American. London, England: Printed by A. Clark, and are to be sold by J. Martyn, Robert Horn and Walter Kettilby, (1677). pp. 241.

[13] OS Usmani, MG Belvisi, et al., “Theobromine inhibits sensory nerve activation and cough.” The Journal of the Federation of American Studies for Experimental Biology 19 (2005).

[14] Carl Keen, Roberta Holt, “Cocoa Antioxidants and cardiovascular health,” American Journal of Clinical Nutrition 81, (2005).

[15] Faisal Ali, Amin Ismail, and Sander Kersten. “Molecular mechanisms underlying the potention antiobesity-related diseases effect of cocoa polyphenols Molecular Nutrition Food Research 00 (2013).

[16] Leira, R. and Rodriguez, R. [Diet and migraine]. Rev Neurol. 1996;24(129):534-538.

[17] Massey, L. K., Roman-Smith, H., and Sutton, R. A. Effect of dietary oxalate and calcium on urinary oxalate and risk of formation of calcium oxalate kidney stones. J Am.Diet.Assoc. 1993;93(8):901-906.

[18]Evans, R. W., Fergusson, D. M., Allardyce, R. A., and Taylor, B. Maternal diet and infantile colic in breast-fed infants. Lancet 6-20-1981;1(8234):1340-1342

[19] Mumford GK, Evans SM, Kaminski BJ, et al. Discriminative stimulus and subjective effects of theobromine and caffeine in humans. Psychopharmacology (Berl) . 1994;115(1-2):1-8.