Cocoa can slow blood clotting, which may increase the risk of bruising and bleeding in people with bleeding disorders or those taking anticoagulant or antiplatelet drugs.
Notes on verification
Mechanistic effect (platelet inhibition) is well-supported by independent peer-reviewed studies, but real-world clinical significance is uncertain; a large RCT (COSMOS) found no increased bleeding risk versus placebo, suggesting the practical magnitude of risk is modest or inconsistent. [tier=gold indep_score=0.89 clusters=5 claim_tier=notable | framework convergence=partial on Natural Medicines Comprehensive Database (shared by WebMD, RxList, vital.ly) (upstreams: Natural Medicines Comprehensive Database (for the consumer-facing monograph wording), PubMed/Medline clinical studies on cocoa flavanols and platelet function) — publishers independent, evidence may not be | kind=empirical eligibility=high (extractor: empirical/medium)]
Sources
- Cocoa - Uses, Side Effects, and More - WebMD (seed:health_and_medicine)
- https://www.rxlist.com/supplements/cocoa.htm (corroboration)
- https://pubmed.ncbi.nlm.nih.gov/16794458/ (corroboration)
- https://www.ncbi.nlm.nih.gov/pubmed/26040467 (corroboration)
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2270724/ (corroboration)
- https://www.sciencedirect.com/science/article/abs/pii/S0049384802001287 (corroboration)
- https://hellopharmacist.com/drug-supplement-interactions/drug-herbal/cocoa-with-warfarin (corroboration)
- https://www.clinicalcorrelations.org/2022/09/29/is-cocoa-the-new-aspirin-81/ (corroboration)