New research has discovered a potential link between the artificial sweetener erythritol and a heightened risk of blood clots. After participants consumed erythritol, there was a noticeable rise in platelet activity, suggesting an increased likelihood of clot formation. While these findings align with previous studies, more research is required to fully understand the potential health risks associated with erythritol.
Health experts are advising people to avoid erythritol for now, recommending natural sweeteners like 100% stevia or pure maple syrup as safer alternatives. The study, conducted by Cleveland Clinic researchers, highlights that consuming 30 grams of erythritol, a popular artificial sweetener, could rapidly increase the risk of blood clots.
The results were published on August 8 in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.
Erythritol is a common ingredient in low-calorie, sugar-free, and diet products, especially those marketed for keto diets. It is often blended with stevia and monk fruit sweeteners to enhance the texture and bulk of these products. In the study, researchers assessed the impact of erythritol and regular sugar on blood platelets, which are critical in the formation of blood clots. Their findings suggest that erythritol significantly increases platelet activity, raising concerns about its potential role in promoting blood clots. In contrast, sugar did not exhibit any such effect on platelets.
Blood clots that form in vessels may travel to critical organs, such as the heart, potentially causing a heart attack, or to the brain, leading to a stroke. Clots could also travel to the lungs, resulting in a pulmonary embolism. The latest findings echo a 2023 study by the same research team, which linked erythritol to a higher risk of heart attacks and strokes, indicating it may be time to reassess erythritol’s safety as a food additive.
Popular sweeteners like Truvia and some Splenda products contain erythritol as a primary ingredient. When approached for comment, both Splenda and Truvia declined to address these new findings. However, the Calorie Control Council (CCC), which represents the low- and reduced-calorie food and beverage industry, described the findings as “misleading” and pointed out that global authorities have consistently confirmed the safety of erythritol over the past 30 years.
The study involved 20 healthy volunteers, with an average age of 30, and included both men and women. After fasting overnight, 10 participants consumed water mixed with 30 grams of glucose (sugar), while the other 10 had water mixed with 30 grams of erythritol. Blood samples were collected before and 30 minutes after consumption.
In the group that consumed erythritol, blood erythritol levels spiked dramatically—over 1,000 times higher than their initial levels. The participants also showed a significant increase in platelet aggregation (clumping) and markers released by platelets. No changes in platelet activity were observed in the glucose group, underscoring erythritol’s unique impact on platelet function.
Though this study was small and examined the short-term effects of a single dose, it raises concerns that consuming erythritol in typical daily amounts may increase the risk of blood clot formation. These results follow another recent study that found xylitol, another artificial sweetener, might also elevate the risk of blood clots in healthy adults.
These findings highlight the need for more research into the long-term cardiovascular safety of sugar alcohols, such as erythritol and xylitol, particularly for individuals at higher risk of blood clots.
While marketed as a healthy alternative to traditional sugar, erythritol is a calorie-free sweetener that naturally occurs in small amounts in fruits and vegetables. However, the erythritol used in food products is often produced commercially through fermentation and is used in much larger quantities than what naturally occurs in food.
In addition to being a primary ingredient in many sweetener products, erythritol can be found in various processed foods and beverages, including:
The amount of erythritol used in the study (30 grams) mirrors the average daily intake from food and beverages, based on data from national health surveys. However, given the rising popularity of artificial sweeteners, actual daily intake of erythritol may have increased in recent years.
Once consumed, erythritol passes through the intestines into the bloodstream and is excreted unchanged through urine. Although the body naturally produces small amounts of erythritol, additional consumption through the diet can lead to a significant buildup in the blood, as seen in the study.
Despite growing concerns over its safety, the FDA still classifies erythritol as “generally recognized as safe” (GRAS) for the general population, meaning it is safe to consume in typical daily amounts found in food and drinks.
Although erythritol has been recommended as a sugar substitute for people with chronic conditions like diabetes and obesity, experts are now urging caution. The GRAS designation is based on historical use and existing research, but it may not account for long-term risks, according to Dr. Thomas M. Holland, a physician-scientist at RUSH University, who was not involved in the study. He advises consumers to stay informed and cautious about artificial sweeteners.
Registered dietitian Kiran Campbell also recommended avoiding erythritol until more is known, especially for individuals with heart disease or those taking blood-thinning medications. Campbell highlighted the World Health Organization’s 2023 guidelines, which advise against using zero-calorie sweeteners for weight loss or chronic disease prevention.
Experts suggest that natural, minimally processed sweeteners may be safer alternatives to erythritol, even when used sparingly. Some of these options include:
While it is ideal to consume a diet low in added sugars, occasional use of natural sweeteners is likely safer than relying on artificial alternatives, based on current evidence. However, even natural sugars should be used in moderation to avoid long-term health issues like metabolic disorders.
The recent study from Cleveland Clinic indicates that consuming erythritol, a widely used artificial sweetener, may significantly increase the risk of blood clots. Although it is still considered safe by regulatory bodies, experts recommend caution and suggest choosing natural sweeteners in small amounts as a safer alternative.