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NOTE: This question is not seeking medical advice. I am just trying to understand the chemistry behind why bitter almonds are poisonous but bitter almond extract (presumably) isn't.

A friend made pancakes and decided to add flavor by adding almond extract, the ingredients of which were "water, organic alcohol, glycerin, natural bitter almond oil". She added about a teaspoon.

Later she was feeling very nauseated and had a stomach ache. After a couple hours, the nausea went away followed by the stomach ache. Other people in the house ate the same pancakes and she was the only one who got sick. (And there similarly wasn't evidence that it could be food poisoning from the night before since she ate the same as others.)

(She does have an allergy to sunflower seeds and certain nuts, but she has no problem eating regular sweet almonds.)

I read that eating a small number (like 10) of bitter almonds can be fatal because of the cyanide. Does almond extract made from bitter almonds contain any cyanide, and could this be related to her getting sick? I tried to Google it and found lots of info about bitter almonds being dangerous, but nothing that mentioned problems eating a lot of almond extract.

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    $\begingroup$ If the extract were that poisonous, it probably wouldn't be allowed by FDA. However, I'd be unwilling to bet my life on it. Don't they print any warnings on the label, or at least something about amygdalin? $\endgroup$
    – Ivan Neretin
    Jun 13, 2016 at 7:20
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    $\begingroup$ Welcome to Chemistry.SE! Take the tour to get familiar with this site. Personal medical questions are off-topic on Chemistry. We can not safely answer questions for your specific situation and you should always consult a doctor for medical advice. That being said, it would probably be a good idea to formulate it more in general. I think the following article would be quite helpful to understand why bitter almond is toxic and what it means for the natural oil extract. $\endgroup$
    – Martin - マーチン ♦
    Jun 13, 2016 at 7:25
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    $\begingroup$ Related: How do I extract cyanide from apple seeds? $\endgroup$
    – user7951
    Jun 13, 2016 at 8:53

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Crude extracts from bitter almonds or apricot seeds do contain amygdalin, which is hydrolyzed in the human body and releases cyanide.

Food-grade bitter almond extract does not contain amygdalin, because the crude extract is typically treated with a with a mixture of calcium hydroxide and $\ce{FeSO4}$. In this process, the amygdalin is decomposed and the cyanide is extracted in the form of $\ce{Ca2[Fe(CN)6]}$.

The typical flavour of the resulting product stems from benzaldehyde.

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