Erythritol in 2025: Natural or Synthetic—and Is It Still Safe?

You’ve probably seen sweeteners labeled as ‘stevia’ or ‘monk fruit’ in big bold letters — but if you flip the package around, chances are, erythritol (pronounced Ah-REETH-ra-tall) is the main ingredient. Erythritol has been one of the most widely used sugar alternatives in the U.S. for over a decade — praised for being natural, zero-calorie, sugar-free, having zero effect on blood sugar levels, and gentler on the stomach than other sugar alcohols. But it’s not perfect.

It’s only about 70% as sweet as sugar, can leave a cooling sensation on your tongue, and it’s much more expensive than table sugar. That’s why most sweeteners in stores blend it with stevia, monk fruit, or other ingredients to boost sweetness and improve taste.

In my quest to help home cooks navigate the complex world of sugar alternatives, I've broken down everything you need to know about erythritol — with 60+ quick, fact-based, no-fluff answers in a format that’s easy to skim or dive deep into. It's all organized by topic, covering:

- chemistry

- source

- production methods

- appearance

- taste

- digestion & metabolism

- type of sweetener

- tooth-friendliness

- culinary roles

- safety

- 2023 & 2024 Studies

- price.

There is A LOT to unpack below — scroll down to explore it all or, if you are short on time, refer to the pros & cons at the end of this post. You can also visit my complete 2025 Guide to Buying Erythritol.

Is Erythritol a Chemical?

Yes. Chemically speaking, erythritol is a type of carbohydrate called polyol. I wrote a Polyol Buying Guide to break down all the details, calories, sweetness levels, and digestion info for each polyol. I’ll sum up the key points below:

• Polyols — better known as sugar alcohols — aren't actually sugars or alcohols. They're carbohydrates that resist digestion: some are only partially digested, others pass through the body mostly undigested. Based on how the body handles them, they’re classified as low-, slow-, or non-digestible carbohydrates.

• Polyols provide from 0.4 to 3 calories per gram. They are referred to as reduced-calorie sweeteners because, compared to sugars (which are simple carbohydrates and contribute 4 calories per gram), they provide at least 25 percent fewer calories.

• From chemistry class, polyol means "containing many -OH groups" (hydroxyl or alcohol group). Polyols' names end in -ol, such as in sorbitol, xylitol, lactitol, mannitol, maltitol, and isomaltitol.

Compared to other polyols,

erythritol is very unique due to the small size of its molecule.

What is Erythritol Made From?

• Erythritol is found in fruits, mushrooms, and fermented foods like wine, sake, soy sauce, miso paste, but only in minuscule amounts, so none of the natural sources are used to produce the store-bought erythritol. To give you a sense, the erythritol content in one pound of melons, grapes, or pears is less than 0.02 grams. So, you’d need 50 pounds to get just 1 gram. A quart of wine has 0.3 grams, and sake has 1.5 grams—less than ⅓ teaspoon (a full teaspoon of erythritol is 4 grams). Because the natural content is so low, it’s not economically feasible to produce erythritol from fruits or fermented foods.

• The store-bought erythritol is made from corn because it allows for more cost-effective production, higher purity, and greater consistency. The production process starts by converting corn starch into a simple sugar (glucose), which is then fermented to make erythritol. All the erythritol products listed at the end of this post are manufactured in China from corn-derived glucose.

Learn more about synthetic vs natural in previous blog posts:

1. Natural Sweetener: Not What You Might Think

2. 5 Misconceptions About Natural Sweeteners.

Is Erythritol Natural or Artificial?

• Erythritol is widely promoted as a natural sweetener because it is found in nature, but the version sold in stores is actually synthetic. A sweetener is considered synthetic if it doesn’t occur in the source from which it’s made. To be clear, synthetic isn’t the same as artificial, which means “not found in nature.” [Read about artificial sweeteners HERE]. Erythritol made from corn isn't artificial, since it’s chemically identical to the kind found in fruits — but it’s not natural either. At WhatSugar®, we refer to erythritol as a synthetic sweetener for clarity. In Food and Drug Administration (FDA) terms, it's a natural sweetener "manufactured artificially".

• Erythritol is not directly isolated or extracted from a plant. It is obtained through a process that chemically changes or breaks down components of the starting material. A sugar (glucose or dextrose) is converted into erythritol via fermentation.

• To be produced on an industrial scale, all polyols are artificially made from natural sources (sugars), but only some qualify as "natural". Not all polyols are found in nature, but erythritol is found in nature AND is derived from a natural source. As a result, according to the FDA, it may be labeled as "natural." More on that in a previous post: What does a natural sweetener mean to the FDA?

• Erythritol made by fermentation from corn starts with glucose (aka dextrose) obtained from starch. The steps can be seen here. Cornstarch is first converted to liquefied starch and then broken down into glucose through the use of enzymes. Glucose is fermented using microorganisms such as Aureobasidium or Moniliella sp. Genetically engineered yeasts may be used.
  

• Here's how Cargill, the top erythritol producer in the U.S. and co-developer of Truvia® — explains how they make erythritol using a yeast found in nature: "The yeast ferments or digests dextrose and other nutrients. In other words, dextrose is the food for the yeast – much like corn may be food for a cow that produces meat or milk. Erythritol is not derived from corn or dextrose feedstock (just as milk is not derived from cattle feed); it is derived from the yeast organism."

• Certified organic erythritol: Organic erythritol must be sourced from a plant grown according to the USDA's organic standards (National Organic Program or NOP) and be free of genetically modified organisms (GMOs). As I discuss in my 2025 Guide to Buying Organic Sweeteners, organic erythritol cannot come from processes that involve GM yeast — it must be fermented using a yeast found in nature — neither from GM seeds. And because most U.S. corn is genetically modified, certified organic erythritol is typically imported from abroad.

What is the Difference Between Granulated and Powdered Erythritol?

All twenty products listed at the end of this post contain over 99.5 percent pure erythritol. The difference lies in the fact that their crystals may be coarse or fine.

• Coarse crystal is labeled as granular, granulated, or crystalline erythritol. It resembles table sugar closely. It is the most commonly used filler in sugar substitutes sold in stores.
  

• Fine crystal is labeled as powdered or confectioners' erythritol. As the name implies, it looks a lot like powdered sugar. Fine crystals dissolve more quickly than granulated erythritol.
  

• The crystals are white, brilliant, odorless, and non-hygroscopic (don't readily absorb moisture from the air).

• When erythritol crystals are dissolved in water, it results in a transparent, low viscosity, and colorless solution.
  

• Erythritol does not dissolve as quickly as table sugar—especially in cold water. While sugar blends in smoothly, erythritol can leave a gritty texture in cold drinks or frostings because it’s less soluble. At room temperature, about 37 grams of erythritol dissolves in 100g of water — much less than table sugar, which dissolves at 130 grams per 100 grams of water.

What Does Erythritol Taste Like?

Sweetness

• Erythritol has a pleasant sweetness profile similar to table sugar (sucrose) with slight acidity and bitterness but no detectable aftertaste. Wondering what aftertaste means? Each sweetener has a specific taste profile, which means the sweetness sensation begins, peaks, and lingers differently for each sweetener. The "sweetness intensity over time" refers to how quickly the sweet taste is perceived (registered by our brain) and how long the taste perception lasts in our mouth. When the sweet taste subsides, what is left is called the aftertaste.

• Erythritol has a mild sweetness, advertised as 60 to 70% as sweet as table sugar (sucrose). It means that to get the same sweetness level as table sugar, you will need to add more erythritol. Taste preferences vary, so start with 1⅓ teaspoons to replace 1 teaspoon of sugar and add more until you reach your optimum sweetness level.
  

• Keep in mind that the perceived sweetness of erythritol varies depending on the temperature, pH level, interaction with other ingredients, and the amount of erythritol you add. If you eat erythritol simply dissolved in water (at room temperature), expect to add 30 to 40 percent more than sugar. However, if you add it to your iced tea, hot coffee, lemonade, yogurt, cereal, or fruit, you will need some experimentation to find the right sweetness.

• Erythritol is less sweet than sugar, so most products in stores blend it with high-intensity sweeteners, such as stevia, monk fruit, or sucralose. Some blends match the sweetness of sugar, while others can be up to 10 times sweeter. In all of these products, you are essentially having erythritol with just a hint of high-intensity sweeteners (HIS). The weight ratio in most blends is 200 to 2000 parts erythritol to 1 part HIS — meaning that although 99% of the weight comes from erythritol, 70 to 99% of the sweetness comes from the high-intensity sweetener. Explore all blends here.

Cooling Effect

• Erythritol in powder form creates a cooling sensation when dissolved in the mouth (the technical term is "a high negative heat of solution").
  

• The cooling effect (cold sensation) happens because erythritol absorbs energy from its surrounding (your mouth) as it dissolves, and you feel like sucking a mint.

• To counter the strong cooling, erythritol is blended with high-intensity sweeteners (as stevia or monk fruit) or low-digestible sweeteners (like xylitol or inulin).
  

• The cooling effect is observed with all polyols, but erythritol has the longest and highest of all. Read here some tips from a sweetener seller on how to minimize this cooling effect.

Click👆

What are the Side Effects of Erythritol?

Despite what you heard, it does have side effects. The side effects of erythritol are a result of the way it is absorbed in our bodies.

• Erythritol Goes Through a Fast & Partial Absorption in the Small Intestine: Unlike other commonly available polyols, erythritol is a very small molecule, which is quickly absorbed in the small intestine into the bloodstream. About 60 to 90 % of ingested erythritol is absorbed and is not metabolized. The kidneys remove erythritol from the bloodstream, and it is excreted unchanged [without any decomposition] in the urine. Consuming erythritol with food slows down its absorption.

• Bacteria Metabolize Erythritol in the Large Intestine: The erythritol that is not absorbed from the small intestine (10 to 40% of the amount we ingest) passes into the large intestine, where it may be fermented by microbes or excreted in feces. So, even though we cannot metabolize it, bacteria in the lower digestive tract can. The low caloric value attributed to erythritol is because microbes metabolize it, and we obtain their energy indirectly.

• Gas Production and Flatulence from Erythritol: Studies concluded that the fermented erythritol results in the production of gases (such as methane and carbon dioxide), which are absorbed and contribute energy. Nevertheless, according to an industry-funded study, gas production from erythritol is negligible, and it is very unlikely that bacteria in humans' guts would ferment it.

• Laxation from Erythritol: When erythritol enters the large intestine, which happens quickly after ingestion, it may act osmotically by drawing water from the body, causing loose stools or diarrhea, and nausea. However, erythritol is advertised as being the only polyol that does not cause laxation, bloating, cramps, or flatulence at normal consumption levels, because only small amounts reach the large intestine. Be aware that if we eat alone on an empty stomach or excessive amounts, erythritol may cause uncomfortable effects such as abdominal pain, nausea, intestinal rumbling and/or increased intestinal movements/cramps/spasms, flatulence, and thirst.

• The Maximum Dose of Erythritol Depends on a Person's Sensitivity and Varies from Person to Person: Daily consumption of up to 1 gram per kg (0,45 g per lb) of body weight is considered well tolerated when incorporated into foods. It means that a 150-lb person eating up to 68 g or 5.5 tablespoons of erythritol (added to foods throughout the day) should not have gastric discomfort. However, the same and lower doses consumed by simply dissolving it in water or in dry form after fasting might result in laxation and other digestive issues.

• Erythritol is Not Really Calorie-free: As said above, even though we cannot metabolize erythritol, bacteria in the large intestine can, and we obtain their energy indirectly. If your intake is less than 25g (about 6 teaspoons) per day, the caloric value for erythritol is 0.2 calories per g. If you are a regular well-adapted user, assume 0.4 cal/g (10% that of table sugar). It means 1.2 to 1.6 calories per teaspoon ( = 3g for powdered; 4g for granulated), 60 to 75 calories per cup (48 tsp; 144g to 192g). Since erythritol's caloric value per gram is very low, the Food and Drug Administration (FDA) regulations for nutrition labels rounded it to zero cal/g. Erythritol is the polyol with the lowest caloric value. To compare with other polyols: Isomalt—2.0, xylitol—2.4, maltitol—2.1, sorbitol—2.6, mannitol—1.6.

• Erythritol's "Net carbs" and Glycemic Index are Equal to Zero: Technically, erythritol is a carbohydrate and counts towards the "total carbohydrate" on the nutrition facts label, but it offers zero net carbs because it's not available for digestion. Net carbs are digestible carbs that break down into glucose and raise blood sugar levels. One serving of erythritol [which is 1 teaspoon and weighs 4g] contains 4g of non-digestible carbohydrates, meaning it offers zero "net carbs" (see the image below on how to calculate it). Since it's not metabolized into glucose, it has a glycemic index of zero and does not impact insulin levels in the body.

What Type of Sweetener Is Erythritol?

• Erythritol is a synthetic sweetener based on the method by which it is produced [or, to use FDA's words, a natural sweetener manufactured artificially]. The erythritol we buy in stores is, in fact, a "natural sweetener-like" ingredient, i.e., a synthetic copy of the erythritol found in plants. To draw a comparison, the FDA says vitamin C or ascorbic acid may be derived from an orange or artificially produced in a laboratory via fermentation.

• Erythritol is a natural sweetener in the FDA's view because erythritol is derived from a natural source AND is found in nature. As stated by the FDA, ingredients "found in nature can be manufactured artificially and produced more economically, with greater purity and more consistent quality, than their natural counterparts."
  

• Erythritol is a GMO-free sweetener, even though it can be made from GMO corn and yeast. Here's how Cargill, the top erythritol producer in the U.S., explains that erythritol is not GM, and does not contain any GM proteins, even though the process starts with GMO corn made in the USA, but uses a yeast organism that is found in nature: "The dextrose used as the feedstock for the yeast is a simple sugar that is derived from the starch component of U.S.-grown corn. Although genetically enhanced corn and non-transgenic corn are grown in the U.S. today, erythritol is not derived from corn or dextrose feedstock (just as milk is not derived from cattle feed); it is derived from the yeast organism. Erythritol is not genetically modified, and does not contain any genetically modified proteins."

• Erythritol is a bulk sweetener because it has the ability to add weight and volume (bulk) to foods, impacting mouthfeel and texture like table sugar. It will help thicken your foods and bind ingredients. Learn more here: Bulk-Free vs Bulk Sweeteners.

• Erythritol is a zero-calorie sweetener because, by law, a sweetener may be labeled calorie-free, no-calorie, or zero-calorie if it provides less than 5 cal per serving. One serving of erythritol is one teaspoon (4 grams), which provides 1.6 calories and is rounded to zero. But one cup (48 teaspoons) provides 95 calories. In my opinion, erythritol is a reduced-calorie sweetener based on the caloric value compared to table sugar. Even though erythritol provides a low amount of calories [and significantly fewer calories than table sugar], it is less sweet than table sugar. That means we have to add more of it to achieve the same sweetening effect.

• Erythritol is approved as a nutritive sweetener. According to the FDA, a nutritive ingredient adds caloric value to the foods that contain it, providing more than 2% of the calories in an equivalent amount of table sugar.

Is Erythritol Bad for Your Teeth?

No.

• Erythritol is non-cariogenic as it cannot be fermented by bacteria that cause cavities. Erythritol's label may carry health claims approved by the FDA, such as "does not promote," "may reduce the risk of," "useful in not promoting" dental caries.

• It appears that erythritol has some of the xylitol's anti-cavity effect, as it tends to starve harmful mouth bacteria (Streptococcus mutans) by inhibiting their growth and activity. It has been suggested that over time, use decreases dental plaque and reduces the overall number of dental caries.

How to Use Erythritol?

• When replacing table sugar with pure erythritol, remember it is 30 to 40% less sweet than table sugar. Therefore, it is recommended to use 1 1/2 or 1 1/3 cups of erythritol to replace one cup of sugar. Refer to the bright pink conversion chart above in this post.

• Erythritol does not lose its sweetness in acidic conditions and even when heated above its melting point (250ºF). Table sugar, on the other hand, decomposes upon heating close to its melting point (320 - 367 ºF) and is inverted by acid. So erythritol can be used in a wide range of foods and recipes.

• Erythritol does not undergo browning reactions during cooking or baking like table sugar’s components—glucose and fructose—do. As a polyol, erythritol does not contain an exposed C=O group, called carbonyl, necessary for browning.

• How to use erythritol in baking? Compared to baking with table sugar, erythritol behaves differently in three key ways: 1- It recrystallizes as it cools — meaning it doesn’t stay dissolved 2- It doesn’t attract or retain moisture — unlike sugar, it’s not hygroscopic. 3- It doesn’t brown or caramelize — no golden color or rich flavor. As a result, baked goods may turn out pale, dry, or gritty instead of tender and golden. Also, unlike sugar, erythritol doesn’t feed yeast, so it won’t help dough rise in yeast-based recipes. Recipes that use more than 20% of the total ingredients tend to be dry and hard — especially without other moisture-retaining ingredients.

• Erythritol improves the taste of other sweeteners: Erythritol can enhance flavors when used in beverages and mask off-flavors (bitter, metallic, cooling, or licorice-like) of high-intensity sweeteners. Don't like the taste of pure stevia or monk fruit? Erythritol can make them taste more sugar-like.

Is Erythritol Keto? Diabetic Friendly? Vegan? Paleo? Bad for IBS? Bad for Dogs?

✔️ Erythritol is safe for diabetics as it does not affect glycemic levels and insulin release.

✔️ Erythritol is paleo diet friendly.

✔️ Erythritol is low-carb and ketogenic diet friendly.

✔️ Erythritol is vegan and vegetarian friendly.

✔️ Erythritol is gluten-free.

✔️ Erythritol, unlike xylitol, is safe for dogs.

✔️ Erythritol is an antioxidant because it is a free radical scavenger. Read more here.

👎 Erythritol and all other low-digestible sweeteners are FODMAP carbohydrates, an acronym for Fermentable, Oligo-, Di-, Mono-saccharides, and Polyols. The term was coined to designate carbohydrates associated with negative gastrointestinal effects. Avoid FODMAPs if you have a sensitive digestive system or "irritable bowel syndrome" (IBS). 

How Much Does Erythritol Cost?

• At the time of publishing, the cost of a pound of pure granulated erythritol ranges from $4 to $12 in stores across the United States. By comparison, table sugar averages $1.05 per pound and is 30-40 percent sweeter than erythritol. When adjusted for sweetness, the real cost of erythritol per “sugar-equivalent” pound is 6 to 20 times more expensive than sugar.

  
  

• Even after the Cleveland Clinic study led to a noticeable price drop from 2022 to 2023, erythritol is still far from cheap—though it’s generally less expensive than other bulk sweeteners like allulose and xylitol.

• Certified organic erythritol prices range from about $4.50 to $12 per pound. All organic options are made in China from non-GMO corn. Certified organic erythritol doesn’t cost much more than conventional, yet it offers all the advantages I explain in my Guide to Organic Sweeteners.

• Save by buying large bags of erythritol, from 3 to 6 pounds, which cost around $4 a pound. Check out Microingredients and Whole Earth. Most 1-lb bags cost between $6 and $12.

• Powdered erythritol dissolves faster than granulated erythritol because it has finer crystals. It tends to cost more and is especially useful in frosting, glazes, and for a smoother consistency in soft, spoonable desserts such as mousse, curds, and custards. Check out my Guide to Powdered Sugar Replacement, where I compare erythritol products.

Is Erythritol Safe?

Yes. The safety of erythritol is well-established. It has been thoroughly studied and is approved for use in more than 50 countries, backed by regulatory and health authorities such as the U.S. FDA, the European Food Safety Authority (EFSA), and guidance from the World Health Organization (WHO).

• Since 2001, the FDA has recognized erythritol as safe. It means that when used under the intended conditions [moderate amounts that we can reasonably expect someone to consume] by most people [the general population], erythritol is safe. Erythritol is not a food additive. Instead, it has a Generally Regarded As Safe (GRAS) status. Erythritol is a relatively new sweetener that was first introduced in Japan as a sweetener in the early 1990s.

• The safety of erythritol was reviewed by scientific experts in the GRAS notices listed below. Manufacturers of erythritol submitted GRAS notices to the FDA and received "No Objection" letters. Erythritol is made by different microorganisms in each notice below and is intended to be used as a nutritive sweetener and a flavor enhancer:

1. GRAS Status in 2001, Cerestar, Belgium submitted GRAS notification 76 (GRN No. 76)

2. GRAS Status in 2007, Mitsubishi Kagaku-Foods Corporation, Japan (GRN No. 208)

3. GRAS Status in 2011, Baolingbao Biology, China (GRN No. 382)

4. GRAS Status in 2012, O'Laughlin Biotechnology, China (GRN No. 401)

5. GRAS Status in 2019, Cargill, New Mexico, USA (GRN No. 789)

Safety Reviews

• In 2000, a safety review of erythritol was issued by an international expert committee administered jointly by the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO). The Joint is also referred to as JECFA or Joint FAO/WHO Expert Committee on Food Additive. See the full report here.

• In 2003, the European Union (EU) Scientific Committee on Food (SCF) issued the "Opinion of the Scientific Committee on Food on Erythritol." It concluded that erythritol is safe for use in foods, but not in beverages.

• In 2010, the EU Food Safety Authority issued a Scientific Opinion evaluating the limits of erythritol use by children.

• In 2015, the EU issued a Scientific Opinion on the safety of erythritol and extended its use in beverages containing up to 1.6 % erythritol.

__________________________

2023 Study: What are the long-term effects of erythritol?

I typically don’t comment on specific articles about sweeteners and their health effects, as it’s important to consider all the evidence. You can’t just look at a single study. Also, I'm a chemical engineer, not a physician. But because I can't keep up with emails from my readers worried about erythritol, I'll provide an overview of the study and my thoughts here.

The study on erythritol and cardiovascular event risk was published on February 27, 2023, in the Nature Medicine Journal. The results show a correlation between erythritol and increased risk of cardiovascular diseases (CVD) in people with a high risk for CVD.

You can read it HERE or HERE.

As mentioned earlier, the safety of erythritol is well-established. It has been thoroughly studied, recognized as safe by the FDA since 2001, and is approved for use in over 50 countries. It's one of America's most popular sugar alternatives.

THE ESSENTIAL DETAILS OF THE STUDY

• The study focused on people already at higher risk for CVD — specifically heart attack and stroke — such as patients with metabolic diseases, including obesity and type 2 diabetes. So its findings primarily apply to these groups, not the general population.

• Researchers performed four different studies, summarized below:

1) They first analyzed 1,157 blood samples of patients collected between 2004 and 2011 and found erythritol might play a role in the risk for CVD.

2) Then, they tested another batch of blood samples from 2,149 patients in the U.S. from the same time period, and found similar associations.

3) An additional 833 samples, gathered by colleagues in Europe from 2016 to 2018, were tested.

4) Because researchers found that higher levels of erythritol in blood were associated with a greater risk of CVD within three years, they conducted a fourth set of studies to find out more. Since these earlier studies didn’t measure how much erythritol participants actually consumed, it was unclear whether the elevated levels were due to diet or internal production.

4.1 For the intervention study, a small sample size of 8 healthy participants was given a single large dose of erythritol (30g). The dose is equivalent to having a beverage with about 8 teaspoons of erythritol at once or consuming a pint of keto ice creams in one sitting, such as this one. They chose 30g for two reasons. During erythritol’s approval process, the Food and Drug Administration estimated this to be the upper level of intake PER DAY. Also, this amount of daily intake for erythritol was reported in the 2013–2014 National Health and Nutrition Examination Survey data.

4.2 For in vitro studies, blood from 55 healthy adults was tested.

4.3 For animal studies, mice were injected with erythritol.

• The findings show an association between erythritol and an increased risk of CVD.

CORRELATION DOES NOT IMPLY CAUSATION

The study shows an association, not a cause-and-effect relationship. A link between erythritol & cardiovascular disease does NOT mean that consuming erythritol will lead to more heart attacks and strokes.

Because the findings only show a correlation, there’s a need for further safety studies examining the long-term effects of erythritol on heart attack and stroke risk — especially in patients at higher risk for CVD.

WHAT THE TIMELINE TELLS US

It's important to point out that when researchers analyzed blood samples from 2004 to 2011, erythritol wasn’t yet widely consumed in the U.S. — especially during the early part of that period. Major sugar alcohols like xylitol, sorbitol, and maltitol dominated sugar‑free gums, mints, candies, chocolates, and diabetic‑friendly foods during that time. Adoption of erythritol was gradual:

• 2004: Cargill, the first and only producer of erythritol in North America at the time, opened the erythritol plant in Blair, Nebraska, producing 20,000 tons/year.

• 2008: Truvia®—the first major U.S. sweetener made with erythritol—launched, jointly developed by Cargill and Coca‑Cola.

• 2013–2014: National dietary surveys (NHANES) began showing some U.S. consumers were reaching daily intakes of about 30 g of erythritol.

Since the study didn’t track what the patients actually consumed, the reported elevated blood levels may not reflect what they ate—especially between 2004 and 2008.

In fact, erythritol is naturally produced by the body through a process called the pentose phosphate pathway (PPP). In healthy people, this production is minimal and doesn't build up in the blood. But in those with metabolic issues like obesity or type 2 diabetes, erythritol levels are often elevated—suggesting it may be a marker of poor metabolic health, not necessarily something caused by diet.

In short: Correlation doesn’t prove causation, and just because erythritol shows up in the blood doesn’t mean it’s causing harm—it could simply be a byproduct of underlying health conditions.

CONFOUNDING VARIABLES

The researchers acknowledge that there are variables that cannot be controlled and might have led to erroneous conclusions. For example, people who are obese or have type 2 diabetes tend to be more likely to have an unhealthy lifestyle & diet in the first place, which would have led to a higher risk for CVD.

CONCLUSION OF THE STUDY

The findings suggest that, until further studies, people at higher risk for CVD may want to limit erythritol intake. This was a multi-part study, published in a reputable medical journal, and it brings valuable insight into potential mechanisms. Still, the results should be interpreted within the context of the population studied and the limitations acknowledged by the authors — especially the fact that it didn’t track what patients ate and it was observational, meaning it simply shows a link, not cause and effect.

2024 FOLLOW-UP STUDY ERYTHRITOL

Building upon the 2023 research, the same research team at the Cleveland Clinic conducted additional small studies on erythritol and xylitol. These trials involved 10 to 20 healthy participants—still far too few to draw meaningful conclusions.

In one study, they compared the effects of consuming 30 grams of erythritol versus glucose. Only the erythritol group showed increased blood levels and signs of heightened platelet activity, suggesting a potential risk for clot formation. The xylitol study also raised similar concerns, but again, both studies had significant limitations due to their small sample sizes.

ERYTHRITOL REMAINS SAFE

​In 2023, the FDA reviewed the first paper to evaluate the potential cardiovascular effects related to consuming erythritol and determined that the observational studies cited did not establish a causal link between consuming erythritol and the observed effects. The FDA stated it will continue to monitor and review new information on erythritol as it becomes available.

So, until further studies come out, erythritol remains safe in moderate intake by the general population, especially those not at increased risk for CVD.

Wondering what a moderate intake is?

It’s an amount we can reasonably expect someone to consume. To have an idea, look at the serving size listed on the food nutrition label. For example, a serving of keto ice cream, such as this one or this one, is ⅔ cup (about ⅓ pint) and contains 6 to 11 grams of erythritol.

MY RECOMMENDATION

1) The key, regardless of the sweetener, is not to go overboard. Diversify the sweeteners you eat, as there’s no shortage of zero-calorie options. Here’s what you can try:

• Bulk sweeteners

Allulose-based sweeteners

Fiber-based sweeteners

Maltodextrin-based sweeteners

• Bulk-free sweeteners

Pure extracts of stevia

Pure extracts of monk fruit

Liquid zero-calorie sweeteners

​Not sure if you need a bulk-free or bulk option? Go HERE.

2) If you want to learn about specific sweeteners, check out my SUGAR SWAP TOOL™ to get details about products being sold in stores. Plus, you get quick tips on how to use each sweetener.

3) Read labels if you want to monitor erythritol in your diet:

• Start by checking the list of ingredients – If erythritol is present, check if it contains other sugar alcohols, such as xylitol, mannitol, sorbitol, isomalt, or maltitol. Currently, erythritol is way more popular than all the other sugar alcohols, so a much more common ingredient.
  

• Move on to the nutrition facts label – Under “Total Carbohydrates”, look for "Sugar Alcohols." If no other sugar alcohol is present, the amount listed is the total amount of erythritol PER SERVING. Note that by law, food manufacturers are not required to list the amount of sugar alcohols. However, they must include it if they make claims like sugar-free and no-added-sugar, which are common in zero-calorie, low-carb, and keto foods.
  

Which Brand of Erythritol is Best?

* PURE ERYTHRITOL *

(Without Any Other Sweeteners)

Certified Organic Erythritol

Granulated Erythritol

Powdered Erythritol

All products listed above contain 99.5% erythritol and are made in China from corn. Their chemical structure is exactly the same. They will taste the same and be metabolized via the same pathway in the body. So, there isn't really "the best" erythritol, but you can choose between:

• Organic or non-organic

• Crystal size (granulated, powdered)

• Price (4 to 20 dollars per pound).

* ERYTHRITOL BLENDS *

Erythritol is less sweet than table sugar; therefore, to compensate for that, it is usually combined with high-intensity sweeteners (HIS) such as stevia, monk fruit, or sucralose. Erythritol is the predominant ingredient in almost 100s of sweeteners sold in stores — check out my Erythritol Buying Guide.

In those blends, note that we are consuming mostly erythritol with just a hint of stevia, monk fruit, or sucralose. The weight ratio between erythritol and HIS is, in some cases, 200 to 2000 (erythritol) to about 1 (HIS). It means that although 99% of the weight comes from erythritol, 70 to 99% of the sweetness comes from the HIS. Erythritol performs essential roles such as making the product spoonable or pourable. It also improves the taste of other sweeteners, by masking off-flavors (any non-sweet taste and aftertaste).

Erythritol is also blended with low-digestible carbohydrates, such as soluble fibers (inulin, fructooligosaccharides), rare sugars (xylose), and other polyols (xylitol, maltitol).

I also found erythritol combined with refined sugar. Those blends are not calorie-free. They maintain the texture, baking, and browning properties of table sugar with 50% to 75% fewer calories.

• To see all erythritol blends, go to my ERYTHRITOL BUYING GUIDE

• For stevia blends, visit my STEVIA BUYING GUIDE

• For monk fruit blends, check out my MONK FRUIT BUYING GUIDE

• For blends with refined sugar, refer to my SUGAR BLENDS BUYING GUIDE

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TAKEAWAY

Pros of Erythritol

✔️ A zero-calorie sweetener — most of what we ingest is not metabolized.

✔️ A natural sweetener as it's "derived from a natural source" and "found in nature".

✔️ Sugar-like appearance — white, crystalline, and looks just like table sugar.

✔️ Non-hygroscopic — doesn’t absorb moisture, so it stores well in a sugar bowl.

✔️ Heat and pH stable — holds up in cooking and baking across a wide pH range.

✔️ Flavor enhancer — makes the taste of other sweeteners more sugar-like.

✔️ Tooth-friendly — doesn't promote tooth decay.

✔️ Antioxidant — acts as a free radical scavenger, protecting us against diseases.

✔️ Least likely polyol to cause adverse digestive issues

✔️ Zero glycemic index — isn't metabolized into glucose; no impact on blood sugar.

✔️ Zero "net carbs" — offers 4g of non-digestible carbohydrates per serving (4g).

Cons of Pure Erythritol

👎 Not a 1:1 sugar replacement: It is almost 30 percent less sweet than table sugar, so expect to add 1.3 times more than table sugar to get the same sweetness. Blends tend to be 1:1 sugar replacements.

👎 Digestive issues: Be prepared for possible digestive discomfort if you over-consume, ingest quickly in concentrated form, or eat by itself on an empty stomach.

👎 Cooling sensation: The cooling effect erythritol causes when dissolved in the mouth is an undesirable distraction, but it may be a positive effect when paired with mint flavor or beverages. This effect is a concern if we consume it by itself or sprinkle it over our food.

👎 No browning: Erythritol does not undergo browning during baking and cooking. We can bake with erythritol as we would with sugar—mix it with dry ingredients or cream. It won't brown, but results in crispy baked goods.

👎 Cost: Erythritol costs 6 to 20 times more than table sugar when you factor in that sugar is sweeter, so you use less. Table sugar averages $1 per pound, while erythritol ranges from $4 to $12 per pound. Powdered erythritol tends to cost more, but you can save by grinding granulated erythritol at home.

👎 Solubility: Erythritol's crystals do not dissolve quite as well as table sugar. Powdered erythritol dissolves more easily than granulated erythritol.

👎 Recrystallization in cold temperatures: Foods and beverages sweetened with erythritol may form crunchy crystals when refrigerated or frozen. To minimize recrystallization, use powdered erythritol instead of granulated erythritol in your recipe, or simply consume it immediately for optimal freshness.

👎 Storage: Erythritol tends to form lumps even when stored properly in an airtight container or resealable bag. That does not mean it is unsuitable for eating. By storing erythritol in your freezer or refrigerator, you avoid clumping.

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Learn More About Erythritol

• Food and Drug Administration Interactive Nutrition Facts Label: Sugar Alcohols. 
  

• NIH, National Library of Medicine, National Center for Biotechnology Information: PubChem - Open Chemistry Database.
  

• Manufacturer of erythritol via fermentation from corn, based in Nebraska: Cargill: Zerose® Erythritol. For more: Zerose® erythritol.
  

• Manufacturer of erythritol via fermentation from apples and pears, based in the Netherlands: Fooditive. 

 

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