Erythritol
A sugar alcohol that is almost entirely absorbed and excreted unchanged, so it adds virtually no calories and does not raise blood glucose. Its tolerability is well established; what is unresolved is a 2023 signal linking high blood erythritol to cardiovascular events.
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What the science says
- No effect on blood glucose or insulin Moderate evidence
Controlled human studies including a randomized study of acute erythritol administration in healthy subjects consistently show no meaningful rise in glucose or insulin. This is the basis for its use as a sugar substitute in diabetes.
- Better gastrointestinal tolerance than other polyols Moderate evidence
An interpretive summary of the biochemical, metabolic, toxicological and clinical data found that roughly 90% of ingested erythritol is absorbed in the small intestine and excreted in urine, which is why it causes much less gas and osmotic diarrhoea than sorbitol or maltitol. Tolerance limits are still around 0.5–0.8 g/kg in a single dose.
- Unresolved cardiovascular signal Limited evidence
A 2023 Nature Medicine study reported that higher circulating erythritol was associated with major adverse cardiovascular events in three cohorts, and that erythritol enhanced platelet reactivity and thrombosis in animal and ex vivo models. A subsequent review notes that erythritol is also produced endogenously during metabolic stress, so raised blood levels may be a marker of existing metabolic dysregulation rather than a cause of harm. A five-week randomized pilot in people with obesity found no adverse effect on vascular function.
Dosage & safety
How to take it
Frequently asked questions
Is erythritol bad for your heart?
Unresolved: a 2023 study linked higher blood erythritol with cardiovascular events and found it increased clotting in animal and lab models, but the body also makes erythritol under metabolic stress, so it may be a marker rather than a cause. If you have heart disease or clotting risk, you may reasonably moderate erythritol while the question is open.
Does erythritol raise blood sugar?
No, controlled human studies consistently show erythritol causes no meaningful rise in glucose or insulin, which is why it is used as a sugar substitute in diabetes (moderate evidence).
Does erythritol cause diarrhea?
Much less than other sugar alcohols, because roughly 90% of erythritol is absorbed and excreted in urine. Keep a single serving under about 0.5 g/kg body weight, roughly 35 g for a 70 kg adult, and have it with food rather than in a drink on an empty stomach.
Is erythritol toxic to dogs like xylitol?
Erythritol itself is not the sweetener that poisons dogs; that is xylitol. Sugar-free products often mix sweeteners, though, so keep them away from pets and check which one is present.
Scientific references
- The artificial sweetener erythritol and cardiovascular event risk
- Elevated Erythritol: A Marker of Metabolic Dysregulation or Contributor to the Pathogenesis of Cardiometabolic Disease?
- Effects of a 5-week intake of erythritol and xylitol on vascular function, abdominal fat and glucose tolerance in humans with obesity: a pilot trial
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