Erythritol: Is It Safe? 5 Potential Side Effects and Risks

Erythritol is an artificial sweetener used in low-sugar and sugar-free foods, but does it have any side effects you should be aware of?

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by
Mia Barnes
— Signos
Staff Writer
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Reviewed by

Mia Barnes
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Updated by

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Science-based and reviewed

Published:
April 23, 2024
August 20, 2023
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Table of Contents

Erythritol is one of the more common sweetener alternatives people mention when avoiding sugar. It’s an increasingly popular option that’s supposedly better for your body than sugar or aspartame, but is it really? Learn more about erythritol so you make an informed decision before including it in your diet. Here are erythritol's side effects and risks to be aware of.

What Is Erythritol and What Is It Made From?

Sweetener manufacturers make erythritol by deriving it from plants or creating it through fermentation.1 Erythritol is a sugar alcohol with negligible energy, meaning it’s a zero-calorie alternative to sugar.

Sugar alcohols don’t have any alcohol. Instead, they’re hydrogenated carbohydrates that also don’t contain sugar.2 This makes them gentler on your blood sugar.

When you digest something containing erythritol, your small intestine absorbs the sugar alcohol before your body excretes it through your urine.3 Comparatively, the digestive system stores sugar as glycogen for when you need more energy.4

Erythritol isn’t the only sugar alcohol in low to zero-sugar products. You’ll also find sweeteners like:

  • Xylitol
  • Sorbitol
  • Maltitol
  • Mannitol
  • Isomalt
  • Lactitol
  • Hydrogenated starch hydrolysates

These sweeteners have minimal effects on blood sugar, but it’s crucial to know how your body responds to each before consuming them in large amounts. Some sensitive people could experience more significant blood sugar effects.

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Erythritol vs. Stevia vs. Xylitol

It’s easier to decide which sweetener is best for you when you know the differences between the most commonly discussed sugar alternatives.

Erythritol is a sugar alcohol with a glycemic index of zero.6 It’s made from plants or an industrial fermentation process, creating a sweetener without an aftertaste.

Stevia is a plant from the Amambai mountains that grows sweet leaves.7 Drying and crushing them into a powder creates stevia extract. It’s also 200-300 times sweeter than sugar and doesn’t affect your blood sugar, so many people use it in coffee or desserts.8

Xylitol is an all-natural sugar in vegetables and fruits.9 Microorganisms make it during their life cycle within the xylitol sources, resulting in the sugar alcohol.

How Is Erythritol Used?

People use erythritol as a replacement for sugar in various recipes. It can dissolve in liquids and blend into mixes because it easily dissolves.

Companies also use erythritol to bulk their products with other artificial or alternative sweeteners. It doesn’t raise the calorie or sugar count while increasing the product’s sweetness.

There’s an additional benefit for companies to use erythritol instead of sugar or artificial sweeteners. Research shows only 36% of consumers pick sugar to sweeten their beverages and food.10 The rest will likely buy sweeteners with an all-natural label, like products with erythritol.

Artificial sweeteners can also cause glucose intolerance when consumed in high amounts. It may be better to replace them with natural sources if you’re already at risk of developing or have developed diabetes.

Is Erythritol Safe?

It’s important to research how safe something is before introducing it to your diet. Below are the most important things to remember when deciding if you’re more at risk of erythritol side effects.

What Are the Side Effects and Dangers of Erythritol?

Even something that comes from a plant can unintentionally impact your well-being and wellness journey. These erythritol side effects and risk factors could influence your decision to include it in your diet and in which amounts.

It Can Be Genetically Modified

Corn naturally produces erythritol. Some types feature genetic modifications to make them more robust against pests or bacteria, so any erythritol from that corn will also have changes. Research shows no health effects from GMOs in corn, although you can ask your doctor for more advice if corn-based erythritol concerns you.

Erythritol can also be made from microbial strains when production facilities use fermentation. Certain ones can have genetic modifications, including common yeast variations like Yarrowia and Candida.11

It May Cause Gastrointestinal Problems

Digestive upset (such as bloating) is one of the more common dangers of erythritol. The little bit that doesn’t pass through a person’s urine will draw water to the colon. It’s a natural effect of this sugar alcohol, making it a helpful ingredient in dry ingredients like bread dough and other pastries.12

The body expels the excess water in the colon through cramping and diarrhea. It’s an uncomfortable side effect that can become more concerning if you’re already dehydrated.

It Can Create Allergic Reactions

The first allergic reaction to erythritol appeared in a study from 2000 and reappeared in the years since.13 A collective study found that erythritol can cause allergic reactions like atopic dermatitis, eczema, bronchial asthma, and allergic rhinitis.14 

More research is necessary to find out why erythritol can cause allergic reactions. If you think you might experience these symptoms, a basophil activation test (BAT) or skin prick test (SPT) could reveal a positive allergic result without risking these adverse symptoms.14

It May Influence Hormonal Problems

Erythritol can make the digestive system excrete essential hormones that typically regulate when you feel satiated or energized by your meal.6 The result can make some people feel less hungry after digesting erythritol, which may affect individuals on specialized diets or recovering from eating disorders.

It Might Relate to Cardiovascular Issues

The dangers of erythritol also include the potential risk of cardiovascular events like heart disease. A recent study found that people with high levels of erythritol in their daily diets are likelier to have strokes and heart attacks due to the sweetener’s influence on blood clotting.15 It’s something to note if chronic heart challenges run in your family or if you have a history of cardiovascular events.

Does Erythritol Have Any Benefits?

Erythritol has a few benefits, making it widely appealing to those avoiding sugar. Here are the positive effects you could experience if you start using it as a sugar substitute.

It Doesn’t Cause Blood Sugar Spikes

Erythritol’s glycemic index of zero means it doesn’t cause significant blood sugar spikes after consumption.6 Most of what you ingest will pass through to your urine instead of entering your bloodstream. It’s the leading reason erythritol is safe for those more sensitive to glucose.

It May Be Better for Dental Health

When you eat or drink something with sugar, the sweetener feeds lingering bacteria along the gumline.16 The bacteria begin to thrive, causing tooth decay, gum sensitivity, and cavities.

Erythritol increases the pH of saliva and encourages salivary glands to produce more.17 The increased amount washes bacteria away more easily without feeding them. Dental problems are less likely to occur with erythritol-sweetened foods and drinks.

It Supports Weight Management

Erythritol doesn’t store itself as glycogen since deposits pass through the urinary tract. It also doesn’t cause the same weight gain in lifestyles with continually spiking blood sugar, so it’s more effective for anyone trying to manage their weight or lose body weight.

It Helps Increase Satiety and Satisfaction

The hormonal changes after digesting erythritol make your brain more satiated with less food.6 This can be helpful when adjusting to a new dietary plan with healthier portions or getting used to healthy alternatives to your favorite foods.

It May Have Antioxidant Effects

Researchers who tested the antioxidant effects of erythritol found it inhibits lipid accumulation that contributes to nonalcoholic fatty liver disease.18 It may be a helpful dietary tool for people reducing their chances of liver disease or recovering from it.

How to Avoid Erythritol

If you’d like to avoid the dangers of erythritol, you only need to check ingredient labels. Although some products may advertise erythritol on their packaging, it’s also a common bulk ingredient that doesn’t appear on front-facing labels.

Read ingredient lists to see if erythritol is part of what makes each product sweet or low-calorie. You can also keep a list of other sugar alcohols on your phone to ensure different versions of this sweetener type don’t sneak into your daily diet. 

Healthier Sugar Substitutes  

Erythritol isn’t your only sweetener option to reduce or eliminate your sugar intake. Look into these other sugar substitutes while making dietary adjustments to improve your health.

Stevia

People often compare erythritol vs. stevia because they appear on ingredient labels together. They’re all-natural sweeteners that are easy on your blood sugar (unlike table sugar), but stevia comes from a plant and isn’t a sugar alcohol. A popular brand of stevia that you may recognize in grocery stores is Truvia. 

Xylitol

Xylitol is another sugar alcohol with minimal effects on blood sugar levels. It blends well into recipes and doesn’t cause dental problems like sugar. You’ll find numerous benefits when researching xylitol vs. erythritol because they’re essentially the same thing.

Raw Honey

Raw honey has a few health benefits compared to regular honey because it undergoes a different straining process. The natural sweetener is an alternative to erythritol, although it shows differing effects in recent research.

Some people can use it to reduce their blood glucose readings, while others experience no effects or a significant increase in blood sugar readings after consuming honey.19 If you want to use this sweetener instead of sugar, start with slow amounts and watch your glucose readings to ensure it’s safe for your body.

Monk Fruit

Monk fruit is naturally sweet, so people convert it into powder, liquid, and syrup. It has no known side effects and is gentle on blood sugar readings, but check ingredient labels on any products, including monk fruit. Manufacturers often add artificial sweeteners to bulk their products and complement monk fruit’s fruity aftertaste.

Coconut Sugar

You can also try coconut sugar instead of artificial sweeteners or sugar. It comes from sap in palm trees and is easier on blood sugar readings because it contains fiber and inulin.20 However, it still has a glycemic index of 35.21 It’s a low-impact sweetener but higher than other glycemic readings for alternative, all-natural sweeteners.

Learn More About Healthy Sugar Substitutes Signos’ Expert Advice

You might find you need erythritol’s benefits in your diet. As you research if erythritol is safe, comparing the plusses with potential risks is important. Once you know more about this natural sweetener, you can make an informed choice about adding it to your diet.

It’s much easier to make those decisions with help from experts like those on Signos’ team. They help people use continuous glucose monitoring (CGM) devices, so there’s no mystery in regulating blood sugar spikes.

You can also find more research on other dietary additions on the Signos blog. Learn more about your options by scrolling through the latest posts or taking a quiz to discover if the Signos plan could help you achieve your health goals.

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References

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About the author

Mia Barnes is a health writer and researcher who specializes in nutrition, fitness, and mental health.

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Please note: The Signos team is committed to sharing insightful and actionable health articles that are backed by scientific research, supported by expert reviews, and vetted by experienced health editors. The Signos blog is not intended to diagnose, treat, cure or prevent any disease. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider. Read more about our editorial process and content philosophy here.

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