Can I mainline dark chocolate?

May 17, 2022 9:50 PM

I'm dealing with pretty severe anxiety, managed these days by Lexapro. Mornings are still a bit tough. I have what I'm pretty sure are big rushes of cortisol, (my doctor agrees). One thing that helps is eating a small amount of dark chocolate. It lifts my mood and smooths out my morning anxiety. But all the anxiety has done a number on my stomach lining and I have gastritis. Dark chocolate and gastritis are not a great combination. Is there any way I can minimise the gastritis-triggering effects of dark chocolate?

I take my dose of Lexapro in the morning with a small snack, which helps to minimise its effects on my stomach.

I have had *all* the tests and scopes and all the treatments and diets to deal with the gastritis including testing for H pylori, testing my thyroid, being on a ppi, having a gastroscope, x ray, and colonoscopy, avoiding dairy and gluten, and the only thing that's made a difference so far is the anxiety medication.
So I'm pretty sure the most effective way to manage the gastritis is to manage the anxiety, which I am doing with the meds, exercise, therapy, and so on.
And hopefully a little bit of dark chocolate?

posted by Zumbador to Health & Fitness (13 answers total)

I believe that a lot of the trouble with chocolate and GI problems comes either from milk content or sugar content. If you are eating a very dark chocolate with low amounts of each of those triggers, that might not only be better but also might help you figure out if chocolate itself is a problem for you or just the add-ins. One way you might try is having some dark drinking chocolate, made with hot water, and only the smallest amount of sweetener. A warm drink can also help signal the body to produce chemicals that calm anxiety, too. Try sourcing chocolate with the least amount of sugar you can find to start with. You’re in South Africa so unfortunately I can’t suggest any specific ones. I do love Marou chocolate and they make a 100% cacao bar that is quite good on its own if you like that sort of thing (I do), if you can find it.
posted by Mizu at 10:34 PM on May 17, 2022 [1 favorite]

Response by poster: Sorry I should have mentioned, I seem to have the same gastritis discomfort when I have cocoa without milk or sugar. So sadly I think it is the chocolate.
posted by Zumbador at 10:43 PM on May 17, 2022

This is a shot in the dark, but perhaps experiment with (no sugar no milk) Dutched / alkalinized cocoa, if your prior was not? Just one variable to try.
posted by away for regrooving at 10:56 PM on May 17, 2022 [2 favorites]

You could try theobromine and/or tryptophan supplements. It may be one or both of these components of chocolate that helps your mood.

Tha tannins in chocolate may be what cause gastric upset. High-tannin substances like coffee, chocolate, and wine are extreme triggers for acid reflux (not sure about gastritis).
posted by Flock of Cynthiabirds at 11:00 PM on May 17, 2022 [9 favorites]

I may be reading too much into your follow-up, but it makes me wonder if the milk and sugar in cocoa might have a protective effect compared to straight chocolate.

Do you have anything that soothes your gastritis that you could eat or drink along with the dark chocolate? For example, toast is easy to digest, and chamomile tea soothes anxiety.
posted by Former Congressional Representative Lenny Lemming at 1:18 AM on May 18, 2022 [7 favorites]

Yeah, you need something to soothe and shield your stomach from the tannins. For me that's usually dairy, but soy milk works to keep my stomach from triggering acid with coffee. Maybe try a plant milk hot chocolate?
posted by I claim sanctuary at 1:30 AM on May 18, 2022 [2 favorites]

I take a Med like Lexapro, have struggled with both morning stomach pain and anxiety… one thing I’ve learned is that breathing profoundly impacts my gastritis. When you notice your stomach hurting, take long, slow, deep-expanding-stomach breaths for a few minutes. It works faster than an antacid for me!
posted by Dressed to Kill at 2:56 AM on May 18, 2022 [1 favorite]

Chiming in to say I'm in a somewhat similar boat and after about 5 years of trying to find ways to tolerate chocolate, I finally gave it up. The passing moment of pleasure wasn't worth the extended discomfort, inflammation and the compounded anxiety around all that. It was a shame, but a net positive on my quality of life. I've more recently given up nuts too.
posted by brachiopod at 3:02 AM on May 18, 2022 [1 favorite]

Response by poster: You could try theobromine and/or tryptophan supplements. It may be one or both of these components of chocolate that helps your mood.

I had a look into this. Tryptophan seems risky to use along with an SSRI like Lexapro?
Theobromine doesn't have that warning, but it says the supplement form might increase anxiety?
posted by Zumbador at 5:53 AM on May 18, 2022

Response by poster: I take a Med like Lexapro, have struggled with both morning stomach pain and anxiety… one thing I’ve learned is that breathing profoundly impacts my gastritis. When you notice your stomach hurting, take long, slow, deep-expanding-stomach breaths for a few minutes. It works faster than an antacid for me!

Thanks for this. I'm going to focus on that. For anyone else in the same situation, I've also found that a warm bag (one of those you warm in the microwave) or a warm bath helps a lot. Just not always practical!
posted by Zumbador at 5:57 AM on May 18, 2022 [2 favorites]

Thanks to an offhand comment by my nurse practitioner, I started having a couple ounces of probiotic drink with my lexapro - originally I was buying those little Activia shots but it's so much packaging I switched to the strawberry kefir pretty much all stores carry now.

And then thanks to my GP, I added a quarter cup of All Bran Buds (MUST BE ABB for maximum colonic effect, apparently, as it's well ahead of competitors on fiber count, but it's tastes very nice so don't worry) to my bit of strawberry kefir that is now all part of my lexapro ritual.

You could try adding your bit of dark chocolate to that whole ritual. I really do advise the ABB, it will ward off digestive difficulties of all kinds, but you may want to start at less than 1/4 cup your first week. Also, annoyingly, only the stores I don't regularly shop at carry it here so if you don't see it at your regular place you might check Instacart to see who does.

For additional consideration: some of the neurochemicals we need for mental health are produced in the gut so taking care of your gut health should be part of your treatment protocol anyway. Also it may be worth considering whether the actual beneficial effect you're getting from the chocolate is bowel stimulation and part of what is triggering your early morning cortisol spike might be needing to poop. I'm not up to googling that this morning but light constipation is not just uncomfortable, it triggers a bunch of neurological mechanisms meant to keep your primitive mammal body functioning and safe.
posted by Lyn Never at 8:01 AM on May 18, 2022 [3 favorites]

I'm having a little trouble following the order in your question, but are you sure that Lexapro is not affecting the gastritis? I get GERD from Lexpro, Wellbutrin, and Cymbalta. This is super common with SSRI/SNRI meds.

Also I am just going to throw this out there, but there is a new PPI called Dexilant that has been game-changing for myself and my aunt. My doctor waved me off when I asked about it, and said all PPIs are the same (Prilosec didn't help me). I pushed and he prescribed it, and immediately felt better after taking it.
posted by radioamy at 1:25 PM on May 18, 2022 [1 favorite]

Chocolate soy milk.
posted by Oyéah at 7:28 PM on May 18, 2022 [1 favorite]