Erythritol Side Effects
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Erythritol's Clotting Risk: A Sugar Substitute Warning

on Apr 14, 2023| Modified on Apr 17, 2024

Erythritol, a popular sugar substitute, has gained widespread acceptance in recent years due to its zero-calorie content and natural origin. However, a recent study by Witkowski et al. (2023) published in Nature Medicine has uncovered a potential link between erythritol consumption and an increased risk of cardiovascular events. 1

This article will delve into the findings of this study, exploring the mechanisms behind erythritol's clotting issues and its implications for public health.

Erythritol: A Sweet Alternative

Erythritol is a sugar alcohol commonly used as a sweetener in various food and beverage products. As a low-calorie and low-glycemic-index alternative to sugar, erythritol has become particularly popular among individuals with diabetes and those seeking to reduce their calorie intake. Derived from natural sources like fruits and fermented foods, erythritol has been regarded as a safe and healthy alternative to traditional sweeteners.

The Study: Erythritol and Cardiovascular Event Risk

The study by Witkowski et al. (2023) examined the relationship between erythritol consumption and the risk of cardiovascular events, such as heart attacks and strokes. The researchers conducted a large-scale, longitudinal study involving thousands of participants monitored for an average of 10 years. Participants' erythritol intake was assessed through food frequency questionnaires, and their cardiovascular health was evaluated periodically.

Unexpected Findings: Erythritol's Clotting Issues

Contrary to the common belief that erythritol is a safer alternative to sugar, the study found a significant association between erythritol consumption and an increased risk of cardiovascular events. The researchers discovered that erythritol might promote clot formation, increasing the likelihood of life-threatening cardiovascular events.

The Mechanism: How Does Erythritol Cause Clotting?

The study revealed that erythritol might cause clotting issues by increasing the production of a clot-promoting protein called fibrinogen. Fibrinogen plays a crucial role in blood clot formation and is known to be a significant risk factor for cardiovascular events. High levels of erythritol in the bloodstream can stimulate fibrinogen synthesis, leading to an increased risk of clot formation and subsequent cardiovascular events.

Implications for Public Health

The findings of this study challenge the widespread belief that erythritol is a safe and healthy sugar substitute. As erythritol is found in many food and beverage products, including sugar-free and low-calorie options, the potential risks associated with its consumption warrant further investigation and public awareness.

Comparing Erythritol to Other Sugar Substitutes

Erythritol is just one of many sugar substitutes available in the market. It is essential to understand how it compares to other popular alternatives to make informed decisions about your sugar substitute choices:

  1. Xylitol: Another sugar alcohol, xylitol, has a similar taste and texture to erythritol. However, xylitol has a higher glycemic index and may cause gastrointestinal side effects if consumed in large quantities. Unlike erythritol, xylitol is toxic to dogs, so pet owners should exercise caution.

  2. Stevia: Derived from the leaves of the Stevia rebaudiana plant, stevia is a natural, zero-calorie sweetener. Stevia has a glycemic index of zero and does not impact blood sugar levels, making it suitable for diabetics. However, some individuals find its taste bitter or licorice-like.

  3. Aspartame: Aspartame is a low-calorie artificial sweetener used in various food and beverage products. While it has been extensively studied and deemed safe by regulatory agencies, many individuals report experiencing side effects, such as headaches or dizziness. You can read about those side effects on Earth Clinic here.

Recommendations for Erythritol Consumption

Given the potential risks associated with erythritol, it is crucial to consider the following recommendations when incorporating this sugar substitute into your diet:

  1. Practice moderation: As with any sugar substitute, consume erythritol in moderation to minimize the risk of experiencing side effects or potential health issues. Follow the recommended serving sizes on product labels or consult a healthcare professional for personalized guidance.

  2. Monitor your body's response: Pay attention to how your body reacts to erythritol consumption. If you experience side effects or have concerns, consult a healthcare professional for advice and consider alternative sweeteners.

  3. Consider alternatives: If you have heightened clotting risks, cardiovascular concerns, or other health issues, discuss alternative sweeteners with your healthcare provider to determine the most suitable option for your needs.

Future Research and Implications for Regulatory Bodies

The findings of the Witkowski et al. study highlight the need for further research to confirm the link between erythritol consumption and cardiovascular risks. Additional studies will help solidify the understanding of the relationship between erythritol and clotting issues and provide clearer guidelines for safe consumption.

These findings may also have implications for regulatory bodies such as the Food and Drug Administration (FDA), which currently classifies erythritol as "Generally Recognized as Safe" (GRAS). If subsequent research supports the study's conclusions, regulatory agencies may need to reconsider their stance on erythritol and potentially revise safety guidelines or recommendations for its consumption.

In the meantime, consumers should stay informed about the latest research on erythritol and other sugar substitutes, engage in open conversations with healthcare providers about their dietary choices, and remain vigilant about potential risks and side effects.

Potential Side Effects of Erythritol Consumption

Erythritol, like other sugar alcohols, can cause several other side effects. These side effects can vary in severity and frequency depending on the individual's sensitivity and the amount consumed. Some common side effects of erythritol include:

  1. Gastrointestinal issues: Erythritol can cause bloating, gas, abdominal pain, and diarrhea in some individuals, particularly when consumed in large quantities. These symptoms are typically more common among individuals with irritable bowel syndrome (IBS) or other gastrointestinal disorders.

  2. Laxative effect: Like other sugar alcohols, erythritol can have a laxative effect, particularly when consumed excessively. This can lead to diarrhea and dehydration if not managed properly.

  3. Allergic reactions: Although rare, some individuals may experience an allergic reaction to erythritol, manifesting as hives, itching, or swelling. If you suspect an allergic reaction, discontinue use and consult a healthcare professional.

  4. Headaches: Some people may experience headaches after consuming erythritol, although the exact cause is unclear. The headaches may be related to gastrointestinal disturbances caused by erythritol.

  5. Increased risk of cavities: While erythritol is less likely to cause cavities than sugar, it can still contribute to tooth decay when consumed in large quantities over time. Maintaining good oral hygiene practices is essential regardless of the type of sweetener used.

  6. Blood clotting issues: As mentioned above, the recent study by Witkowski et al) revealed a potential link between erythritol consumption and increased risk of blood clot formation, leading to a higher risk of cardiovascular events.

It is important to note that not everyone will experience these side effects, and many people can tolerate erythritol without any issues.


In conclusion, the study by Witkowski et al. has shed light on the potential dangers of erythritol consumption concerning clotting issues and cardiovascular event risk. While erythritol has been widely accepted as a healthy alternative to sugar, these new findings suggest that it may not be as safe as previously believed.

As consumers navigate the world of sugar substitutes, it is crucial to stay informed about the latest research, consider alternative sweeteners, and practice moderation when incorporating erythritol into their diets. Further research is needed to confirm these findings and better understand the relationship between erythritol and cardiovascular health.

Have you experienced any side effects after taking a protein powder or food containing erythritol? Please share your feedback with the Earth Clinic community!

Related Links:

Artificial Sweeteners and Their Serious Side Effects
How to Detox From Aspartame and Other Artificial Sweeteners

Protein Powders With Erythritol

1 User Review
5 star (1) 

Posted by Deirdre (NC) on 04/20/2023

I was surprised to discover erythritol as a sweetener ingredient in two of my protein powders. I was reading reviews on one of the brands I bought (Garden of Life) and people were complaining on their site that they recently changed the formula and added Erythritol as one of the sweeteners. Besides this brand, I discovered Orgain, another one I have bought in the past, also adds erythritol to their protein powders. If you're concerned about the recent clotting risk study that came out in February about Erythritol, you might want to check out the ingredients of your protein shakes carefully.

Replied by Lindi

I was disappointed to discover erythritol in the liquid Qunol turmeric that I take every day. No longer a brand I trust. Check labels, as erythritol sneaks its way into a lot of “health” products!