The sugar alcohol erythritol has become a popular alternative sweetener for people who follow a ketogenic or low-carb lifestyle. As with any sugar substitute, erythritol comes with both benefits and drawbacks.
Advantages
Erythritol is nearly carb-free and calorie-free because 90% of it is absorbed without being metabolized, it has a glycemic index of zero, and its insulinemic index is extremely low at 2. It’s less likely to cause digestive issues than other sugar alcohols because very little is fermented in the large intestine.
Studies have shown that erythritol may also be beneficial for dental health by reducing plaque and inhibiting the growth of Streptococcus mutans, a bacterium that is considered the main cause of tooth decay.
Erythritol tastes similar to sugar, although it is only 70% as sweet. Its texture works well in baking, and it’s available in both granulated and confectioners (powdered) formulations.
Drawbacks
So, what are erythritol’s downsides? Although it tends to cause less bloating, gas, and other gastrointestinal symptoms compared to most sugar alcohols, erythritol may still trigger these side effects in some people. One clinical trial found that very large amounts of erythritol can cause digestive issues. However, some people who have used erythritol report that their digestive systems can’t tolerate even modest amounts of the sweetener.
A recent concern is the potential link between erythritol and blood clots. A 2023 study reported that high levels of erythritol in the blood were associated with increased platelet reactivity and risk of blood clots based on research in mice and humans. However, there are a few things to consider.
First, the body can produce erythritol from glucose (endogenous production) via the pentose phosphate pathway. Since the authors did not measure erythritol intake when they examined data from large observational studies, the elevated blood erythritol levels might have reflected endogenous production. Researchers who analyzed this study noted that the increased blood clot risk seen when erythritol was injected into mice is not supported by most long-term animal studies, which show that regular erythritol consumption does not affect blood clotting. Moreover, they stated that it can’t be concluded that dietary erythritol causes platelet activation, blood clots, or cardiovascular issues until more research from randomized controlled trials is available. In a 2024 small randomized trial of 10 healthy volunteers, a single serving of erythritol was found to increase platelet reactivity, suggesting a potential risk for blood clotting, but further research is needed to confirm these findings. Finally, a comprehensive analysis of the research to date found no evidence that erythritol consumption raises the risk of coronary artery disease or other cardiometabolic diseases.
Should You Use Erythritol?
At Keto-Mojo, we believe in providing reliable information about foods and ingredients but letting people decide what is best for them. Erythritol might be a good sweetener option due to its minimal impacts on blood glucose and insulin levels, fewer GI side effects than other sugar alcohols, and versatility. However, some people may experience digestive discomfort from using even modest amounts of erythritol. Concerns have been raised about its potential link to blood clotting and increased cardiovascular disease risk, although most studies do not support this. We look forward to more research on this topic.
Importantly, some individuals might notice that using alternative sweeteners, including erythritol, can lead to sugar or carb cravings. Others may find that they struggle to stop eating “keto” treats once they start. For those who experience these reactions, the best approach might be to avoid all sweeteners and sweets, whether keto-friendly or not.
When it comes to erythritol, it’s important to pay attention to how your body responds to it and stay informed about new research when deciding whether to consume it in small amounts as part of your ketogenic lifestyle.
