Cacao Plant Medicine: Origins, Science and the Art of Working with Theobroma Cacao

By Dr Ifey Ihonor | Doctor, herbalist & founder of 8 Within

I first came across the state-shifting powers of real cacao plant medicine in a Costa Rican jungle in February 2023. And honestly, nothing I’d experienced before had prepared me for it.

The closest way I can describe it is… pseudo-psychedelic. Not in a dramatic, reality-bending way. It was more like moving into a different state of awareness.

That moment was the beginning of what has become kind of an obsession.

Since then, I’ve drunk cacao hundreds (maybe thousands) of times. I’ve tasted beans from across the world, made it from pod to cup, harvested it on farms, formulated blends and gone deep into the research - probably much deeper than any normal person would.

So, in this piece I’m sharing my unfiltered take on cacao plant medicine. That’s: what Theobroma cacao actually is, what it contains, what the science does (and doesn’t) say and how to work with it in a way that feels authentic.

There's no dogma here, just the plant, the evidence, and what I’ve seen - both in myself and in the hundreds of 8 Within customers who’ve shared their experiences with me.

So, get comfy as I take you through the workings of cacao as a plant medicine.

The origins of cacao plant medicine: a history stretching back 7,500 years

The story of Theobroma cacao plant medicine goes much further back than most people realise.

Before I properly looked into it, I assumed ceremonial cacao was an Aztec thing that was around a few hundred years old and later turned into hot chocolate by Spanish colonisers.

But the research showed something else.

Cacao Mayan history: from the Chinchipe to the Aztec Courts

I discovered that according to archaeological records, cacao was first used as a ceremonial drink by the Chinchipe civilisation in the Jaén region of northern Peru about 7,500 years ago, before spreading across Central America (Edo et al, 2023). It's actually this fact that inspired the decision to source 8 Within's cacao from northern Peru - for true authenticity.

Cacao then moved into Olmec, Mayan and Aztec culture, where it became part of the fabric of ritual life. It was often used to appease and curry favour with the gods, and therefore featured in marriage ceremonies, funeral offerings, warrior sacrifices and communication with the Divine.

The Maya creation text, the Popol Vuh, places cacao at the origin of humanity itself. And the botanist who named the plant in the 18th century called it Theobroma (Greek for "food of the gods") - which goes to show just how sacred cacao was.

The spiritual benefits of ceremonial cacao: an Andean perspective

It's thought that cacao has many spiritual benefits, but these benefits grow more and more elaborate depending on who you ask. Rather than dive into trying to separate fact from fiction, I'm going to stick to what I was taught from an Andean cosmology perspective.

In Andean cosmology (Peru and Ecuador), cacao symbolises life.

And when you look at the bean, it makes sense. It’s a seed, and everything begins there.

It tastes earthy and grounding - a reminder that we come from the earth and eventually return to it. And so, cacao is drunk in recognition of that full cycle: past, present, future.

This mirrors the three realms in Andean cosmology:

• Uku Pacha (past / underworld)

• Kay Pacha (present / physical world)

• Hanan Pacha (future / higher realm)

Remember this and your experience of drinking cacao transforms from being about chasing a feeling to one of remembering where you are in the cycle.

You’ll also hear people describe cacao as feminine.

Personally, I think that says more about the person than the plant, so if calling cacao “she” feels natural to you, go with it. If it doesn’t, don’t. 

And if you’re worried that not calling cacao ‘she’ is disrespectful (even though doing so feels weird to you), remember the etymology of the word cacao, which comes from kakawa. This is said to break down into:

• ka (masculine)

• ka (feminine)

• wa (spirit)

And this suggests that perhaps cacao isn’t feminine or masculine; it’s the unification of both and spirit.

"Cacao symbolises life. And when you look at the bean, it makes sense. It’s a seed, and everything begins there."

How ceremonial cacao makes you feel - and how quickly

Before Costa Rica, I’d been to a few Western cacao ceremonies.

And if I’m brutally honest, they felt off - very off.

Imagine drinking watered-down cacao with coconut oil added for no clear reason. Those leading the 'ceremony' often mashed up Hindu and native American words and practices, while mumbling something about "heart opening."

It's only since undergoing multiple indigenous cacao trainings with Andean and Mayan teachers that I've come to understand why many of those ceremonies felt weird, messy and contrived: they were.

So, in this section I'd like to share what the typical cacao experience looks and feels like (based on my own experience and that of hundreds of customers) so you have more realistic expectations.

But please keep in mind that everyone is different, and that factors like your physiology, what you have or haven't eaten, your emotional state, medical conditions and how familiar you are with cacao can all affect how you respond.

The timeline (based on reported experience)

20 to 30 minutes: This is when most people notice a subtle change in how they feel internally.  Some describe it as a warmth, a slight opening or a sense of being more present. Scientifically, this is consistent with theobromine's vasodilating effect, which increases blood flow to the heart.

30 to 45 minutes: You may become aware of a subtle shift in attention as you become more inward-facing and more emotionally present. Your thoughts may slow down or feel clearer. Anecdotally, this is the time most described by practitioners as the cacao heart opening phase.

45 to 90 minutes: Cacao's effects peak. At a ceremonial dose (35-40g), you may feel emotional - crying, laughter and euphoria can all make an appearance. This may change from day to day, so don't assume your first experience will be repeated the next time.

2 to 4 hours: You gently return to baseline. Unlike coffee, there's no crash with cacao. Most people describe feeling grounded, clear and quietly energised for 4 to 6 hours after a daily or ceremonial dose.

Important caveat: the timeline described is for a ceremonial dose. Smaller servings will produce subtler effects, but still deliver heart, brain and cell-protecting benefits.

What affects your cacao experience

• Dose: 15 to 20g produces mild, sustained energy and mood support, while 35 to 40g produces a deeper, more emotional experience. Don't start with a ceremonial dose if you're new to cacao.

• Intention and setting: Those who bring specific intentions tend to find they have richer experiences than those who drink it casually.

• Food: Cacao works best on an empty stomach because this allows maximum absorption of active compounds.

• Your physiology: Some people are very sensitive to theobromine, and those with lower serotonin and dopamine levels may notice a bigger mood boost. The key is to have your own experience and avoid comparing it to others.

Key bioactive compounds and Theobroma cacao benefits: what the science says

Cacao is probably one of the most biochemically complex and health-giving plants we consume daily - whether that's chocolate or cacao. Here’s what we actually know about what it does to the body.

Cacao theobromine effects: the compound that makes cacao different from coffee

First things first: yes, cacao has small amounts of caffeine, but theobromine is cacao's main stimulant... and it’s the one you need to get familiar with. 

It’s responsible for the awakening, uplifting, elevating feeling that's unique to a good cup of real ceremonial cacao.

Unlike caffeine (which stimulates the nervous system), theobromine works primarily on the cardiovascular system - opening blood vessels and increasing circulation.

That’s why cacao feels different. It’s

• warmer

• smoother

• more sustained

Research supports this.

A 2013 review (Franco et al., 2013) found that theobromine may act as an anti-inflammatory and cardiovascular protector. Large observational data (AHA, Circulation, 2021). links it to improved lipid profiles and lower blood pressure.

But more isn’t better.

A controlled double-blind study found that high doses can lead to overstimulation and a racing heart (Baggott et al., 2014).

Theobroma cacao benefits for brain and heart: flavanols

Flavanols are potent antioxidants that have been shown to significantly improve brain and heart function. They also protect cells from oxidative damage and increase stem cell production. And cacao is one of the richest dietary sources of flavanols - specifically epicatechin and catechin.

Flavanols are where cacao really shines though. These potent antioxidants can improve blood flow, support brain function and protect against oxidative stress.

Studies show:

• Increased brain oxygenation under stress 

• Improved cognitive performance 

• Better blood pressure and lipid profiles 

There's even some suggestion that drinking cacao for 4 weeks can double stem cell production, according to a University of California, San Francisco study. (Keep in mind this was a very small study, sponsored by Mars.)

Cacao phenylethylamine: the love molecule and emotional healing

You've probably heard that cacao contains a "love molecule" - and it's true… sort of.

That molecule is cacao phenylethylamine (PEA), a naturally occurring alkaloid also produced by the human brain during states of excitement, love and focused attention. PEA stimulates dopamine and norepinephrine release, producing feelings of pleasure, drive and emotional warmth. It’s actually one of the mechanisms behind cacao's reputation for emotional healing.

What few people mention is that PEA is broken down quickly in the gut by the enzyme monoamine oxidase (MAO), meaning it’s unlikely to have much effect in the body. 

But cacao paste also contains compounds that block the action of MAO, which may help PEA stick around longer. The picture is a little murky.

What is clear anecdotally is that many people feel a sense of connection and emotional openness after drinking cacao. Maybe that’s down to PEA, maybe not. 

Cacao anandamide: the bliss molecule

It's often said that cacao contains anandamide - that’s your body's own endocannabinoid. In reality, cacao and anandamide have a more convoluted relationship than many people realise.

Analyses of cacao has shown that it doesn't actually contain significant amounts of anandamide itself. What it does contain are three fatty acid derivatives called N-acetyl ethanolamides (NAEAs), which help prolong the action of your body's own anandamide by blocking the enzyme (FAAH) responsible for breaking it down. 

In other words, cacao doesn't deliver significant anandamide directly, but it does protect and prolong the action of the anandamide your body already produces.

Make sense?

Cacao tryptamine effects: the deeper compounds

Cacao also contains tryptamine - a compound that can be turned into serotonin and DMT (that’s the “God” molecule responsible for the feeling of ego dissolution many psychedelics trigger).

Research has confirmed the presence of tryptamine and tetrahydro-β-carbolines (THβCs) in cacao (Herraiz, 2000), and it’s also known that tryptamine in general acts on 5-HT2A receptors - the same serotonin receptors associated with neuroplasticity. 

Research has also shown that tryptamine affects the amygdala - the part of the brain responsible for fear - specifically reducing the fear response to negative stimuli, which in turn can improve mood and functioning (Castelhano et al., 2021).

The concentration of tryptamine in standard cacao is generally low. But when I was sourcing cacao to launch 8 Within, I stumbled across a variety from the Ancash region of Peru that is the exception. Lab tests found it has 13 times higher tryptamine content than standard varieties, and this cacao is now what you're drinking when you make a cup of 8 Within’s Inner Depths cacao.

Magnesium and tryptophan: the calming compounds

Finally, cacao is rich in magnesium, which is something many people in the UK are deficient in.

Magnesium matters because it supports:

• nervous system regulation

• muscle relaxation

• sleep

• mood

Cacao also contains tryptophan, which converts into serotonin and melatonin.

So, when you combine the actions of magnesium and tryptophan, it’s clear why regular cacao drinkers often report better sleep and mood.

How to work with cacao ritually: a guide to cacao ritual at home

Before diving in, it's worth pointing out something important: cacao hasn't belonged to just one culture throughout history and has never had one "correct" ritual. From the Chinchipe to the Mayans, Aztecs and Olmecs, every civilisation did it differently, using different ingredients, different contexts and different intentions.

Even across the numerous cacao trainings I've done with indigenous teachers, the message at the end was always the same: just do what feels authentic to you. So, with that in mind, here are some practical tips, but with the overriding message that you can't do cacao "wrong" if you follow what feels right to you.

Cacao plant medicine preparation

To reap the full benefits of cacao, use whole cacao paste (not powder, which is highly processed and stripped of its cacao butter). At 8 Within, I use whole paste in the elixirs, blended with plant extracts chosen for their synergistic action with cacao.

1. Gently heat water or plant-based milk to near-boiling and allow to cool slightly (boiling destroys some of the flavanols). 
2. Add 15 to 40g of cacao depending on your intention and desired dose. 
3. Stir until smooth and finish with a whisk to create a creamy drink. 
4. Drink slowly.

Many people find benefit in creating a ritual (that’s a repeated way of preparing and drinking cacao). This can be as simple as doing it at the same time of day in the same mug. Or it can be a more elaborate affair involving incense, mantras, music and anything else you feel drawn to.

 The details aren’t that important, what really matters is how it makes you feel.

Simple cacao ritual at home: practices for different intentions

For morning clarity: Try 17 to 20g daily, with the intention of focusing your attention. Sit with it for five minutes before opening any screen.

For emotional work: Go for a 35g ceremonial dose with a journal and a question you've been avoiding. Simply keep the question in your mind and see what comes up.

For creative practice: Try 20 to 25g before any creative work. Many writers, artists and musicians in the 8 Within community use cacao (especially our Brilliance elixir) as a tool for focus and flow.

For meditation: Drink 20 to 35g thirty minutes before your practice, preferably on an empty stomach. Our high-tryptamine Inner Depths is a firm customer favourite for deepening meditation.

Looking for step-by-step preparation tips? How to Make Ceremonial Cacao

Or explore the range of 8 Within cacao to find your perfect cacao elixir: Cacao Elixirs

Cacao contraindications and side effects: who should be careful

This section matters so much that I've written several dedicated blog posts just about cacao safety.

• For an overview: The Real Side Effects of Cacao

• For pregnancy and breastfeeding: Is Cacao Safe During Pregnancy? | Is Cacao Safe While Breastfeeding?

• For antidepressant interactions: Is Cacao Safe with SSRIs?

Absolute contraindication: MAOIs

If you are taking MAOI antidepressants, don’t take ceremonial cacao. Cacao contains tyramine, and MAOIs prevent its breakdown, causing levels to spike and blood pressure to rise to potentially dangerous levels. 

Heart conditions and blood pressure medication

Theobromine increases heart rate and acts as a vasodilator. If you have an uncontrolled heart condition or take antihypertensives, speak with your doctor before using cacao and begin with a low dose (15g). 

Pregnancy and breastfeeding

Cacao is generally considered safe at low, everyday doses (15 - 20g) during pregnancy and breastfeeding. However, some research suggests high doses in the last trimester may affect foetal development. Check with your doctor or midwife before taking cacao in pregnancy.

SSRIs and antidepressants

Moderate doses of cacao are usually safe alongside standard doses of SSRIs, but high-dose SSRIs may be less safe because cacao contains several compounds that increase serotonin levels. If you’re taking standard dose SSRIs, start with a low dose of cacao (10-15g) and see how you feel. But if you're on high-dose SSRIs, speak with your doctor first.

Blood thinners, caffeine sensitivity and migraines

Cacao can affect blood clotting, so if you take anticoagulants (blood thinners), speak with your doctor before taking ceremonial doses regularly. 

If you're sensitive to stimulants, keep cacao doses small and have your daily cup before 4pm. Theobromine can trigger migraines in susceptible individuals, so if chocolate has triggered migraines for you in the past, cacao probably isn’t the drink for you.

The take-home message

One of the things I love most about cacao as plant medicine is how much is still unknown. The research is growing, but cacao has been used ceremonially for thousands of years, and clinical science has only studied it seriously for perhaps two decades. There’s clearly still a lot to discover.

What I can tell you from my training as a doctor is that the physiological benefits for heart, brain and mood are well-evidenced and consistent with what regular cacao drinkers report.

What can I tell you from my practice as a herbalist? That’s simple. The whole plant does something that the individual compounds, isolated and studied in a lab, don't fully explain and can't replicate.

And what I can tell you from the hundreds of 8 Within customers that have personally written to me after trying cacao is that something magical (yet subtle) happens when this plant medicine is introduced into their daily lives.

Research references

1. Powis TG et al. Cacao use and the San Lorenzo Olmec. PNAS, 2011. https://www.pnas.org/doi/10.1073/pnas.1100620108

2. Franco R et al. Health benefits of methylxanthines in cacao and chocolate. Nutrients, 2013. https://pmc.ncbi.nlm.nih.gov/articles/PMC3820066/

3. Franco R et al. The relevance of theobromine for the beneficial effects of cocoa consumption. Frontiers in Pharmacology, 2015. https://pmc.ncbi.nlm.nih.gov/articles/PMC4335269/

4. Baggott MJ et al. Psychopharmacology of theobromine in healthy volunteers. Psychopharmacology, 2013. https://pmc.ncbi.nlm.nih.gov/articles/PMC3672386/

5. Berends LM et al. Flavan-3-ols, theobromine, and the effects of cocoa and chocolate on cardiometabolic risk factors. Current Opinion in Clinical Nutrition & Metabolic Care, 2015. https://pubmed.ncbi.nlm.nih.gov/25551798/

6. Gratton G et al. Dietary flavanols improve cerebral cortical oxygenation and cognition in healthy adults. Scientific Reports, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7687895/

7. Francis ST et al. The effect of flavanol-rich cocoa on the fMRI response to a cognitive task in healthy young people. Journal of Cardiovascular Pharmacology, 2006. https://pubmed.ncbi.nlm.nih.gov/16794461/

8. Martin MA et al. Effect of cocoa and cocoa products on cognitive performance in young adults. Nutrients, 2020. https://pubmed.ncbi.nlm.nih.gov/33265948/

9. Nehlig A. The neuroprotective effects of cocoa flavanol and its influence on cognitive performance. British Journal of Pharmacology, 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC3575938/

10. Herraiz T. Tetrahydro-β-carbolines, potential neuroactive alkaloids, in chocolate and cocoa. JAFC, 2000. https://pubmed.ncbi.nlm.nih.gov/11052752/

11. Castelhano J. et al. The Effects of Tryptamine Psychedelics in the Brain: A meta-Analysis of Functional and Review of Molecular Imaging Studies. Front Pharmacol, 2021. https://pmc.ncbi.nlm.nih.gov/articles/PMC8511767/
12. AHA Abstract 14006. Cardiovascular health benefits of theobromine in cacao and chocolate. Circulation, 2021. https://www.ahajournals.org/doi/10.1161/circ.144.suppl_1.14006

13. Edo et al. Review on the biological and bioactive components of cocoa (Theobroma cacao). 2023. https://www.nrfhh.com/Review-on-the-Biological-and-Bioactive-components-of-Cocoa-Theobroma-Cacao-Insight,174302,0,2.html

Written by Dr Ifey Ihonor - NHS-trained doctor, folk herbalist and founder of 8 Within. This article is for educational purposes and is not intended to be medical advice. If you have a medical condition or are taking medication, please consult your GP or healthcare provider before using ceremonial cacao.