Erythritol is a sugar alcohol used as a low calorie sweetener. But eating a large amount of it may cause digestive issues, including nausea. 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 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.

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 contains 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.


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 appears to be very safe.

Multiple studies on its toxicity and effects on metabolism have been performed in animals. Erythritol has been found safe for both human and animal consumption (2).

However, there is one major caveat to most sugar alcohols: They can cause digestive issues.

Due to their unique chemical structure, your body can’t digest them, and they pass unchanged through most of your digestive system, until they reach your colon.

In your colon, they’re fermented by the resident bacteria, which produce gas as a byproduct.

Consequently, eating large amounts of sugar alcohols may cause bloating and digestive upset. In fact, they belong to a category of fiber known as FODMAPs.

However, erythritol is different from the other sugar alcohols. Most of it gets absorbed into your bloodstream before it reaches your colon (3).

It circulates in your blood for a while, until it’s eventually excreted unchanged in your urine. About 90% of erythritol is excreted this way (4).


Most of the erythritol you eat is absorbed into your bloodstream and excreted in urine. It seems to have an excellent safety profile.

Erythritol side effects

Erythritol has come under fire recently because of a new study linking it to adverse cardiac events and thrombosis, but it was a very small study of only 8 participants who were instructed to drink 30 g of erythritol in water in less than 2 minutes, far more than the amount found in any foods.

In addition to this, the participants were never asked whether they consumed erythritol as part of their regular diet, and all of them had already presented with signs of heart disease, raising questions about the reliability of the study (5).

More research is needed to confirm these potential side effects of erythritol are a valid concern.

About 90% of the erythritol you eat is absorbed into your bloodstream. The remaining 10% travels undigested down to your colon.

Unlike most other sugar alcohols, it seems to be resistant to fermentation by colon bacteria (4).

Feeding studies providing up to 0.7 to 1 grams per kilogram (2.2 pounds) of body weight show that it is very well tolerated (6).

However, one study showed that 50 grams of erythritol in a single dose increased nausea and stomach rumbling (7).

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


About 10% of ingested erythritol is not absorbed into the blood and travels down to the colon. For this reason, a very high intake of erythritol may cause some digestive side effects.

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 (8).

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


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

May reduce the risk of heart disease

Studies in rats with diabetes have found that erythritol acts as an antioxidant, possibly reducing blood vessel damage caused by high blood sugar levels (9).

Another study in 24 adults with type 2 diabetes found that taking 36 grams of erythritol every day for a month improved the function of their blood vessels, potentially reducing their risk of heart disease (10).

However, in light of the small 2023 study that found an association between erythritol and thrombosis, more studies are needed before any definitive claims can be made about the health relevance of these findings (5, 11).


Erythritol acts as an antioxidant and may improve blood vessel function in people with type 2 diabetes. These benefits may potentially reduce the risk of heart disease, but more studies are needed.

May benefit dental health

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

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

As a result, sweet-tasting sugar alcohols like 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 (12).

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 (13, 14, 15).

However, a 3-year study in 485 schoolchildren found that erythritol was even more protective against dental caries than xylitol and sorbitol (16).

A 2016 research review reached the same conclusion, noting that erythritol is more effective against dental plaque and caries than xylitol or sorbitol (17).


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

The bottom line

Overall, erythritol appears to be a good alternative sweetener.

  • It contains almost no calories.
  • It has 70% of the sweetness of sugar.
  • It doesn’t raise blood sugar or insulin levels.
  • 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 for long periods of time show no adverse effects.

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 generally safe, though more studies are needed.