Erythritol is a sugar alcohol used as a low-calorie sweetener. Eating a large amount of it may cause digestive issues, including nausea. It may also be associated with blood clots and heart problems. Sensitivity and symptoms can vary.

The low-calorie sweetener erythritol may seem too good to be true.

It’s natural, doesn’t cause side effects, and tastes almost exactly like sugar — without the calories.

Basically, it has all the positive aspects of regular sugar without any of the negatives, although some media outlets question its benefits.

This evidence-based article reviews the benefits and possible side effects of erythritol.

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What exactly is erythritol?

Erythritol belongs to a class of compounds called sugar alcohols (1).

Food producers use many sugar alcohols such as xylitol, sorbitol, and maltitol.

Most of them function as low-calorie sweeteners in sugar-free or low-sugar products.

Most sugar alcohols are found in small amounts in nature, especially in fruits and vegetables.

Because of the way these molecules are structured, they can stimulate the sweet taste receptors on your tongue.

However, erythritol appears to be quite different from the other sugar alcohols.

To begin with, it contains many fewer calories:

  • Table sugar: 4 calories per gram
  • Xylitol: 2.4 calories per gram
  • Erythritol: 0.24 calories per gram

With only 6% of the calories of sugar, it still provides 70% of the sweetness.

In large-scale production, erythritol is created when a type of yeast ferments glucose from corn or wheat starch. The final product looks like powdery white crystals.

Summary

Erythritol is a sugar alcohol used as a low calorie sweetener. It provides only about 6% of the calories found in an equal amount of sugar.

Is erythritol safe?

Overall, erythritol may be safe for some people, but not for others. Older research on the toxicity and effects of erythritol on metabolism performed in animals has found it to be safe for both human and animal consumption (2).

However, more recent research has found that erythritol may be associated with the development of blood clots and heart attacks (3).

In addition, due to their unique chemical structure, most sugar alcohols pass unchanged through most of your digestive system into the colon, where they’re fermented using resident bacteria. This can produce gas as a byproduct and means you could experience bloating and digestive upset. In fact, sugar alcohols like erythritol belong to a category of fibers known as FODMAPs.

Erythritol is different from other sugar alcohols. Most of it gets absorbed into your bloodstream before it reaches your colon. It circulates in your blood for a while and is eventually excreted, unchanged, in your urine. About 90% of erythritol is excreted this way (4).

Feeding studies providing 0.7 to 1 gram per kilogram (2.2 pounds) of body weight show that it is very well tolerated (5). However, one older study showed that 50 grams of erythritol in a single dose increased nausea and stomach rumbling (6).

So unless you’re eating massive amounts of erythritol at a time, it’s unlikely to cause a stomach upset. However, erythritol sensitivity may vary from person to person.

Summary

Most of the erythritol you eat is absorbed into your bloodstream and then excreted in your urine. Erythritol has had a good safety profile, but more recently has been found to be associated with blood clots and heart problems.

Does not spike blood sugar or insulin

Humans don’t have the enzymes needed to break down erythritol.

It’s absorbed into the bloodstream and then excreted, unchanged, in the urine.

In animal studies, erythritol was found to inhibit the increase of blood sugar and insulin levels (7).

For people who are overweight or have diabetes or other issues related to metabolic syndrome, erythritol appears to be an excellent alternative to sugar.

Summary

Erythritol does not raise blood sugar levels. This makes it an excellent sugar replacement for people with diabetes.

May benefit dental health

One common negative effect of excessive sugar intake is poor dental health, including cavities and tooth decay.

The harmful bacteria in your mouth use sugar for energy. In the process, they release acids that can erode tooth enamel.

As a result, sweet-tasting sugar alcohols such as xylitol and erythritol have found their way into “tooth-friendly” products, as mouth bacteria cannot use them for energy.

Xylitol and erythritol also suppress the growth of bacteria directly. However, erythritol does a better job. According to a 2016 review, erythritol is more effective at inhibiting the growth of oral bacteria than other sugar alcohols, including xylitol (8).

Multiple studies have examined the effects of erythritol on cavities, and the results are mixed.

Some studies show a reduction in plaque and harmful bacteria, while others show no reduction in cavities. However, a 3-year study in 485 schoolchildren found that erythritol was even more protective against cavities than xylitol and sorbitol (9, 10).

The authors of a 2016 research review also concluded that erythritol is more effective against dental plaque and cavities than xylitol or sorbitol (8).

Summary

Erythritol may suppress the growth of bacteria in the mouth. Also, unlike sugar, it doesn’t feed the bacteria that cause cavities.

What does erythritol do for you?

Unlike the other sugar alcohols, most of the erythritol you consume is absorbed into your bloodstream and travels through your body before being excreted unchanged in your urine. That makes it relatively safe.

Is erythritol good or bad for you?

Overall, erythritol appears to be a good alternative sweetener. It contains almost no calories and has 70% of the sweetness of sugar.

Human studies have mostly shown very few side effects, though some have recently been found and need further study. Studies in which animals are fed massive amounts of erythritol for long periods show no adverse effects.

Is erythritol safer than sugar?

Unlike sugar, erythritol doesn’t raise blood sugar or insulin levels. That said, some people may experience adverse side effects. The best option is to read labels and reduce added sweeteners such as sugar alcohols and refined white sugar as much as possible.

The bottom line

Health-conscious people might choose to sweeten their food with stevia or honey. However, honey contains calories and fructose, and many people don’t appreciate the aftertaste of stevia.

Erythritol appears to be a generally safe alternative, though more studies are needed.