Erythritol is the sugar alcohol that upsets stomachs the least, which is why it shows up everywhere.
Then 2023 and 2024 brought a run of unwelcome findings about blood clots.
People with high blood levels had twice the cardiovascular events
In 2023 the Cleveland Clinic analyzed more than 4,000 people in the US and Europe and reported that those with high blood erythritol had roughly twice the risk of a heart attack or stroke within three years.
In the lab, erythritol made platelets clump more easily.
In 2024 they fed it to people directly
The same team gave healthy people 30 g of erythritol and looked at their blood. Clot formation rose sharply.
The same amount of glucose produced no change.
| What was eaten | Platelet response | Clot formation |
|---|---|---|
| 30 g erythritol | Up | Up |
| 30 g glucose | No change | No change |
30 g is what a tub of zero-sugar ice cream or a large bottle of a sugar-free drink can hold. It is not a dose inflated for the experiment.
Cause and effect is not settled yet
Your body makes erythritol on its own. That makes it hard to tell whether a high blood level comes from eating a lot of it or from a metabolism that produces more of it.
The research team said as much and asked regulators to reassess.
With cardiovascular disease or a high clot risk, the safer move is to skip the habit of eating erythritol-heavy products in quantity every day.
Finding it on the label
- •"Erythritol" or "sugar alcohol": common in sugar-free ice cream, jelly and chocolate
- •Stevia and monk fruit products often blend in erythritol for bulk
- •Drinks mostly use aspartame or sucralose, so they hold little erythritol
Sugar alcohols differ a lot from each other
| Sugar alcohol | Calories (1 g) | Stomach upset |
|---|---|---|
| Erythritol | 0.2 kcal | Low |
| Xylitol | 2.4 kcal | Moderate |
| Maltitol | 2.1 kcal | High |
| Sorbitol | 2.6 kcal | High |
This table explains why erythritol spread so widely. Almost no calories, and it goes easy on your stomach.
That same advantage makes it easy to eat a lot at once, which is exactly where the problem sits now.
Sources · Witkowski et al., Nature Medicine (2023) · Cleveland Clinic intervention study, ATVB (2024) · JECFA evaluation of sugar alcohols