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Moderate evidenceWeight management

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.

Evidence last reviewed: August 2026

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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

Studied doseUsed as a 1:1 to 1.3:1 sugar substitute in food; it is about 70% as sweet as sucrose. Keep single servings under roughly 0.5 g/kg body weight (about 35 g for a 70 kg adult) to avoid gastrointestinal symptoms.
SafetyThe most common issue is gastrointestinal upset at high single doses, and it can cause nausea more readily when taken as a drink on an empty stomach. The cardiovascular association reported in 2023 is observational plus mechanistic and has not been settled; people with existing cardiovascular disease or clotting risk may reasonably prefer to moderate intake or use alternatives while the question is open. Erythritol is highly toxic to dogs when it appears in xylitol-style products, so keep sweetened foods away from pets and check which polyol is present.

Scientific references

Where to buy

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