A Concerning Potential Side Effect of Erythritol Emerges

by | Mar 27, 2023 | Diet & Nutrition, Oral Health

spoonful of erythritol and scattered crystals in backlightWe’ve blogged before about erythritol, a sugar alcohol that’s become increasingly popular and, like xylitol, may offer some protection against tooth decay and gum disease by controlling harmful bacteria.

Because it’s a zero-calorie sweetener that doesn’t seem to affect blood glucose levels, it’s become especially popular in both food and drink for those who want or need to watch their sugar intake. The side effects you usually hear about are the ones that apply to other sugar alcohols: If you eat too much, your gut may complain – a lot.

But recently, other potential side effects have emerged that are far more concerning, especially since many who regularly consume erythritol-sweetened products, such as people with diabetes, are already at higher risk for the conditions: heart attack and stroke.

This emerged from a paper published a few weeks ago in Nature Medicine. Its authors studied the blood of more than 4000 patients, looking for anything that might raise the risk of a major cardiac event. Erythritol levels in the blood were just that sign. More of it in the blood meant a higher risk of heart attack and stroke.

Taking it a step further, the researchers gave erythritol to animal models. They saw enhanced clot formation in models of arterial disease. They added erythritol to blood outside of the body. And found that adding erythritol to blood made it “clump up,” or form a blood clot by activating platelets.

Platelets are the tiny components in your blood that rush to the site of an injury to stop us from bleeding. That keeps you from bleeding out. But when they’re activated within our bodies, they cause blood clots, which can lead to heart attacks and strokes.

“A serving of erythritol in common ‘keto-friendly’ processed food products made blood levels of erythritol go up 1,000-fold, well above the levels linked to enhanced clotting risks,” [lead author] Dr. [Stanley] Hazen states. “We found that the risk for clotting can be increased for several days after consumption of just one serving of artificially sweetened food containing erythritol.”

“It wasn’t a modest effect,” added Dr. Hazen. “It was a very large effect that we were seeing reproduced across multiple groups and across geographies.” And while the study doesn’t prove causality, it certainly gives cause for concern.

More research needs to be done to confirm or disprove these findings. Perhaps it’s not erythritol itself but something in how it is processed or that it’s most often made from GMO corn or some other factor. At this point, we just don’t know.

If you choose to use or consume erythritol, it may be wise to choose only non-GMO products or those marked as USDA Organic. But if it’s sweetness you’re after, there are alternatives such as stevia and monk fruit. Both of these are zero-calorie and have no impact on blood glucose. Just be sure to read the labels closely to make sure no GMO erythritol has been added, as it sometimes is with these other alternative sweeteners.

And consider reducing your intake of ultra-processed foods in general. They’re no friend to your health. Opt for real food, and you’ll not only avoid ingredients that your body was never designed to consume; you’ll get more of a nutritional punch from whole foods and meals you cook yourself.

More on erythritol and other alternative sweeteners from Dr. Axe

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