Erythritol

Also called E968, meso-erythritol.

Best grade C across 10 graded outcomes Other Last checked Oct 21, 2026

The short answer

From 30 sources

Erythritol is a sugar alcohol that sweetens many sugar-free foods. It barely moves blood glucose or insulin, and one 3-year school trial found fewer cavities than with xylitol or sorbitol candy (grade C). Since 2023, cohorts have linked high blood erythritol to heart events and a 30 g drink made platelets more reactive; cause is unproven.

Every graded outcome on this page

10 rows · line = participants

Grade CDentin cavities in schoolchildren: erythritol vs xylitol and sorbitol candyTooth decayn 485
Grade CGut symptoms after one large dose in a drinkGut tolerancen 64
Grade DHeart attack, stroke or death with higher blood erythritolHeart and plateletsn 2,149
Grade DGut symptoms when erythritol is drunk with fructoseGut tolerancen 37
Grade DPlaque and cavity-causing bacteria with erythritol pastillesTooth decayn 30
Grade DBlood vessel function in type 2 diabetesHeart and plateletsn 24
Grade DGlucose, insulin and appetite brain networks after 75 gBlood sugarn 20
Grade DPlatelet reactivity after a 30 g drink (vs glucose)Heart and plateletsn 20
Grade DGlucose, insulin, lipids and inflammation after a 50 g doseBlood sugarn 18
Grade DSatiety hormones, stomach emptying and fullnessAppetiten 18
7 more graded outcomes, in the evidence chapter

Key facts

What it is: A four-carbon sugar alcohol (C₄H₁₀O₄) used as a sweetener (E 968 in the EU); the FDA lists it among sweeteners that may carry the claim that they do not promote tooth decay^3,1,2
How the body handles it: Absorbed readily and dose-dependently, then excreted unchanged in urine; after 25 g, almost all was recovered in urine and gut bacteria did not ferment it^1,14
Blood sugar: 50 g and 75 g doses had no effect on glucose or insulin in healthy volunteers^17,18
EU safe intake: EFSA set an acceptable daily intake of 0.5 g per kg of body weight in 2023, based on diarrhoea, and kept the laxative warning required on labels; some high consumers exceed it¹
Cavities: In a 3-year trial of 485 Estonian schoolchildren, erythritol candy (about 7.5 g a day) led to fewer dentin cavities than xylitol or sorbitol candy (C)⁷
Heart-risk signal: People in the top quarter of blood erythritol had 1.80 to 2.21 times the adjusted risk of heart attack, stroke or death over 3 years in two cardiac-patient cohorts; later cohorts in US women, Finnish men and older US adults found weaker or similar links. All are associations with blood levels, not intake^4,25,26,27
Platelet experiment: A 30 g erythritol drink raised blood erythritol more than 1,000-fold and increased platelet reactivity in all 10 volunteers; 30 g of glucose did not⁵
Genetic studies disagree: One Mendelian randomization study found no causal link with coronary disease; two 2025 analyses found small positive associations^20,21,24
Gut tolerance: 20 g and 35 g in a drink caused no symptoms in young adults; 50 g increased nausea and rumbling, and erythritol caused fewer watery stools than xylitol at every dose¹²

What it is

Erythritol is a four-carbon sugar alcohol used as a bulk sweetener; most of it is absorbed and passes out unchanged in urine.

How it works

Established

Erythritol is a four-carbon polyol that, unlike most sugar alcohols, is absorbed readily from the small intestine and excreted unchanged in urine, with a small fraction converted to erythronate. Because little reaches the colon and faecal bacteria do not ferment it, it caused fewer gut symptoms than xylitol at the same dose. It does not raise blood glucose or insulin. Large doses release the gut hormones CCK, GLP-1 and PYY and slow stomach emptying, by a route that does not involve the gut sweet-taste receptor. The body also makes some erythritol from glucose through the pentose-phosphate pathway, which complicates studies of blood levels.^{1,14,16,17,22,12}

Forms side by side: sweetener, drinks, candies and dental powder

4 forms named in our sources. The rest show what our data holds, and say plainly where it holds nothing yet.

Erythritol forms compared

4 forms

Erythritol forms compared: 4 forms by 3 attributes. Empty cells are labelled No data yet, or Not graded in the evidence row.
4 forms	Granulated or powdered sweetener	In a drink	Candies and pastilles	Air-polishing powder (applied by a dental professional)
Absorption in people	Readily absorbed and excreted unchanged in urine; not fermented by gut bacteria.^1,14	A 30 g drink raised blood erythritol more than 1,000-fold, and levels stayed raised for more than 2 days.^5,4	Act in the mouth; no head-to-head human data on absorption.⁷	Used to clean tooth and root surfaces; not a dietary use.¹⁹
GI tolerance	20 g to 35 g in a drink caused no gut symptoms in young adults; 50 g increased nausea and rumbling.¹²	Taken with 50 g of fructose, 33 g of erythritol doubled breath hydrogen and caused more watery stools than fructose alone.¹³	About 7.5 g a day in school candies was used for 3 years.⁷	In a 2022 meta-analysis of 8 trials it was less painful and better tolerated than hand or ultrasonic cleaning.¹⁹
Studied for	Blood sugar and gut hormone studies (D); gut tolerance	Platelet reactivity (worsened, D); blood vessel function in type 2 diabetes (D)	Tooth decay in children (C); plaque bacteria in adults (no change, D)	Gum care during periodontal therapy: results comparable to hand or ultrasonic instruments

Granulated or powdered sweetener
Absorption in people
Readily absorbed and excreted unchanged in urine; not fermented by gut bacteria.^1,14
GI tolerance
20 g to 35 g in a drink caused no gut symptoms in young adults; 50 g increased nausea and rumbling.¹²
Studied for
Blood sugar and gut hormone studies (D); gut tolerance
Erythritol in a drink
Absorption in people
A 30 g drink raised blood erythritol more than 1,000-fold, and levels stayed raised for more than 2 days.^5,4
GI tolerance
Taken with 50 g of fructose, 33 g of erythritol doubled breath hydrogen and caused more watery stools than fructose alone.¹³
Studied for
Platelet reactivity (worsened, D); blood vessel function in type 2 diabetes (D)
Candies and pastilles
Absorption in people
Act in the mouth; no head-to-head human data on absorption.⁷
GI tolerance
About 7.5 g a day in school candies was used for 3 years.⁷
Studied for
Tooth decay in children (C); plaque bacteria in adults (no change, D)
Erythritol air-polishing powder (applied by a dental professional)
Absorption in people
Used to clean tooth and root surfaces; not a dietary use.¹⁹
GI tolerance
In a 2022 meta-analysis of 8 trials it was less painful and better tolerated than hand or ultrasonic cleaning.¹⁹
Studied for
Gum care during periodontal therapy: results comparable to hand or ultrasonic instruments

What the human research says

Human trials only, one row per outcome. The form line shows what each trial actually tested. Grades follow our evidence-grading policy.

Trial map

10 graded outcomes, largest study first

10 graded outcomes: 3 improved, 1 mixed, 3 no effect, 3 worsened. The largest, a 2023 observational study of 2,149 people on heart attack, stroke or death with higher blood erythritol, found a worsening. 2 other outcomes found a worsening: gut symptoms when erythritol is drunk with fructose (37 people) and platelet reactivity after a 30 g drink (vs glucose) (20).

By sizeTable

1Heart attack, stroke or death with higher blood erythritol

Worsened · Grade D · Observational, 2,149 people, 2023

Stable US patients having elective cardiac evaluation (validation cohort; a European cohort of 833 and a discovery cohort of 1,157 also studied)

Dose, result and source

Every graded outcome on this page, largest study first
Outcome	Found	People	Study	Who was studied
Heart attack, stroke or death with higher blood erythritol	Worsened	2,149	Grade D · Observational, 2023	Stable US patients having elective cardiac evaluation (validation cohort; a European cohort of 833 and a discovery cohort of 1,157 also studied)
Dentin cavities in schoolchildren: erythritol vs xylitol and sorbitol candy	Improved	485	Grade C · RCT, 2014	First- and second-grade children in southeastern Estonia
Gut symptoms after one large dose in a drink	Mixed	64	Grade C · RCT, 2007	Healthy students aged 18 to 24 at the University of Salford (UK)
Gut symptoms when erythritol is drunk with fructose	Worsened	37	Grade D · Crossover RCT, 2011	Healthy, non-diabetic adults
Plaque and cavity-causing bacteria with erythritol pastilles	No effect	30	Grade D · RCT, 2001	30 subjects assigned to erythritol or xylitol pastilles (15 per group)
Blood vessel function in type 2 diabetes	Improved	24	Grade D · Open-label trial, 2014	Adults with type 2 diabetes (single-arm pilot)
Platelet reactivity after a 30 g drink (vs glucose)	Worsened	20	Grade D · Open-label trial, 2024	Healthy volunteers, 10 per group
Glucose, insulin and appetite brain networks after 75 g	No effect	20	Grade D · Crossover RCT, 2022	Healthy volunteers
Glucose, insulin, lipids and inflammation after a 50 g dose	No effect	18	Grade D · Crossover RCT, 2023	Healthy volunteers
Satiety hormones, stomach emptying and fullness	Improved	18	Grade D · Crossover RCT, 2022	Normal-weight adults (18 participants, 5 men), mean age 24

Every graded row

10 rows

Form tested

Showing 10 of 10 outcomes. Human trials only.

Grade CDentin cavities in schoolchildren: erythritol vs xylitol and sorbitol candyTooth decayFewer dentin cavities than xylitol or sorbitolRCT
n 485 · 2014

Improved At 24 and 36 months, children on erythritol had fewer dentin cavities and cavity surfaces than those on xylitol or sorbitol, lesions took longer to develop and progress, and caries scores rose less.

Design: RCT, n = 485, 2014
Population: First- and second-grade children in southeastern Estonia
Form: Erythritol, xylitol or sorbitol (control) candies
Dose: About 7.5 g/day of polyol, four candies three times per school day
Duration: 3 years
Source: Reference 7 · PubMed 24852946 (opens PubMed)

Grade CGut symptoms after one large dose in a drinkGut toleranceNo symptoms up to 35 gRCT
n 64 · 2007

Mixed 20 g and 35 g of erythritol did not increase gut symptoms. 50 g increased nausea and borborygmi (gut rumbling) compared with sucrose. Erythritol caused significantly fewer watery stools than xylitol at every level tested.

Design: RCT, n = 64, 2007
Population: Healthy students aged 18 to 24 at the University of Salford (UK)
Form: Erythritol or xylitol in water vs 45 g sucrose
Dose: Single doses of 20, 35 and 50 g
Duration: One test day per dose, 7-day washouts
Source: Reference 12 · PubMed 16988647 (opens PubMed)

Grade DHeart attack, stroke or death with higher blood erythritolHeart and plateletsHR 1.80 and 2.21 (top vs bottom quarter)Observational
n 2,149 · 2023

Worsened Top vs bottom quarter of blood erythritol: adjusted hazard ratio 1.80 (95% CI 1.18 to 2.77) in the US cohort and 2.21 (1.20 to 4.07) in the European cohort. In 8 volunteers, an erythritol drink kept blood levels raised for more than 2 days, above levels that increased platelet reactivity in the lab.

Design: Observational, n = 2,149, 2023
Population: Stable US patients having elective cardiac evaluation (validation cohort; a European cohort of 833 and a discovery cohort of 1,157 also studied)
Form: Fasting plasma erythritol (blood level, not measured intake)
Dose: Not applicable (blood level); 8 volunteers also drank an erythritol drink
Duration: 3-year follow-up
Source: Reference 4 · PubMed 36849732 (opens PubMed)

Grade DGut symptoms when erythritol is drunk with fructoseGut tolerance2× breath hydrogen with fructoseCrossover RCT
n 37 · 2011

Worsened Breath hydrogen was twice as high with fructose plus erythritol as with fructose alone, watery stools were more frequent and gut tolerance was worse, suggesting erythritol made fructose harder to absorb.

Design: Crossover RCT, n = 37, 2011
Population: Healthy, non-diabetic adults
Form: 50 g fructose with 33.3 g erythritol vs 50 g fructose alone or with 50 g glucose
Dose: 33.3 g erythritol in one drink
Duration: Single test days, symptoms recorded for 24 hours
Source: Reference 13 · PubMed 22118754 (opens PubMed)

Grade DPlaque and cavity-causing bacteria with erythritol pastillesTooth decayNo change in plaque or mutansRCT
n 30 · 2001

No effect Plaque mass and mutans streptococci fell significantly with xylitol but not with erythritol; neither changed plaque protein or S. sobrinus.

Design: RCT, n = 30, 2001
Population: 30 subjects assigned to erythritol or xylitol pastilles (15 per group)
Form: Erythritol vs xylitol saliva-stimulating pastilles
Dose: 5.2 g/day in five chewing episodes
Duration: 2 months
Source: Reference 11 · PubMed 11275673 (opens PubMed)

Grade DBlood vessel function in type 2 diabetesHeart and plateletsCentral pulse pressure 47 to 41 mm HgOpen-label trial
n 24 · 2014

Improved A single dose improved fingertip endothelial function (0.52 to 0.87 au, P = 0.005). After 4 weeks, central pulse pressure fell from 47 to 41 mm Hg (P = 0.02) and pulse wave velocity tended to fall (P = 0.06).

Design: Open-label trial, n = 24, 2014
Population: Adults with type 2 diabetes (single-arm pilot)
Form: Erythritol in an orange-flavoured drink
Dose: 36 g/day, plus a single 24 g dose at the first and last visits
Duration: 4 weeks
Source: Reference 15 · PubMed 24366423 (opens PubMed)

Grade DGlucose, insulin and appetite brain networks after 75 gBlood sugarNo glucose or insulin effectCrossover RCT
n 20 · 2022

No effect Erythritol had no effect on glucose or insulin and raised CCK and PYY. Unlike xylitol, it did not change hypothalamic blood flow on brain imaging.

Design: Crossover RCT, n = 20, 2022
Population: Healthy volunteers
Form: 75 g erythritol, 50 g xylitol, 75 g glucose or water given into the stomach
Dose: 75 g single dose
Duration: Single test sessions
Source: Reference 18 · PubMed 34404339 (opens PubMed)

Grade DPlatelet reactivity after a 30 g drink (vs glucose)Heart and plateletsPlatelet aggregation up in all 10Open-label trial
n 20 · 2024

Worsened Blood erythritol rose more than 1,000-fold (median 6,480 vs 3.75 µmol/L) and stimulated platelet aggregation increased in every subject, with more release of serotonin and CXCL4 from platelets. Glucose caused no such increase.

Design: Open-label trial, n = 20, 2024
Population: Healthy volunteers, 10 per group
Form: Erythritol drink vs glucose drink
Dose: 30 g single dose
Duration: Single intervention
Source: Reference 5 · PubMed 39114916 (opens PubMed)

Grade DGlucose, insulin, lipids and inflammation after a 50 g doseBlood sugarNo glucose or insulin riseCrossover RCT
n 18 · 2023

No effect Erythritol had no effect on glucose or insulin compared with water and no effect on blood lipids, uric acid or high-sensitivity CRP; an exploratory analysis found lower ghrelin.

Design: Crossover RCT, n = 18, 2023
Population: Healthy volunteers
Form: 50 g erythritol, 25 g D-allulose or tap water given into the stomach
Dose: 50 g single dose
Duration: Single test sessions
Source: Reference 17 · PubMed 36678329 (opens PubMed)

Grade DSatiety hormones, stomach emptying and fullnessAppetiteCCK, GLP-1, PYY up; slower emptyingCrossover RCT
n 18 · 2022

Improved Erythritol released CCK, GLP-1 and PYY compared with water, slowed stomach emptying, increased fullness and lowered expected food intake. Blocking the gut sweet-taste receptor did not change the hormone response.

Design: Crossover RCT, n = 18, 2022
Population: Normal-weight adults (18 participants, 5 men), mean age 24
Form: 50 g erythritol, 25 g D-allulose or tap water into the stomach, with or without the sweet-taste blocker lactisole
Dose: 50 g single dose
Duration: Six test sessions
Source: Reference 16 · PubMed 35135006 (opens PubMed)

What the numbers add up to

Each point is worked out from the data and the sources numbered on this page, with the arithmetic shown under it. It adds no new data and is not medical advice.

The platelet study dose is close to EFSA's daily limit

For a 70 kg adult, EFSA's acceptable daily intake works out to 35 g, so the 30 g drink in the platelet study was about 86% of a full day's limit in one serving.^1,5

A child's share of the limit

For a 30 kg child, the 7.5 g a day used in the Estonian candy trial is 0.25 g per kg, half of EFSA's acceptable daily intake, before any other erythritol in food or drinks.^7,1

Gentler on the gut than xylitol, dose for dose

At every dose from 20 g to 50 g, erythritol caused fewer watery stools than the same amount of xylitol in the same people.¹²

Studied doses

Doses used in research, shown against the official limits. They describe the studies, not a recommendation for you.

Studied doses in research, not advice. These are amounts used in research, not personal advice. Your clinician or pharmacist can say what fits you.

Doses studied in human trials

Doses studied in human trials ranged from 5.2 g a day in pastilles and about 7.5 g a day in school candies (3 years) to 36 g a day in a drink for 4 weeks. Single test doses of 20 g to 75 g were used in tolerance, blood sugar, gut hormone and platelet studies. These are research amounts, not product directions.^{11,7,15,12,16,18,5}

When trials measured an effect

3 outcomes

How long trials ran before effects were measured
Outcome	Measured at	Basis
Blood erythritol after a drink	Raised more than 1,000-fold soon after 30 g; stayed raised for more than 2 days	Volunteer intervention studies^5,4
Fewer dentin cavities	Seen at 24 and 36 months	3-year Estonian school trial⁷
Gut symptoms from a large dose	The same day (single 50 g dose)	Tolerance trial in 64 young adults¹²

Interactions and safety

Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.

What Erythritol meets

1 cited row

Medicines 0

No medicine rows in our sources.

Erythritol0 medicines · 1 supplement

Supplements and foods 1

Measured in a human study

Interactions

1 agent

Published interactions, grouped by kind
Agent	What the source says	Evidence
Other supplements1
Fructose (large amounts in the same drink)e.g. 50 g fructose with 33 g erythritol	In a crossover trial, adding erythritol to a high-fructose drink doubled breath hydrogen and increased watery stools and gut intolerance compared with fructose alone, suggesting worse fructose absorption.¹³	RCT

Check with what you take

Kept on this device only

Add what you take. We list every interaction our evidence profiles cite between Erythritol and your picks, and between your picks.

Add a supplement or medicine

Most cited:

Add a supplement or medicine you take to check it against Erythritol.

Starting from one medicine? The interaction checker rates how serious each pair is, on a curated list of 19 entries for 11 medicines. This cabinet has no severity rating: it lists every interaction row our supplement pages cite.

Who should be careful

5 groups

People with heart disease or high clotting risk: Higher blood erythritol was linked to more heart attacks and strokes in people already at cardiac risk, and a 30 g drink raised platelet reactivity in healthy volunteers. This does not prove harm, but it is a reason to discuss large regular amounts with your clinician.^4,5
Large amounts at once: 50 g in a drink increased nausea and gut rumbling, and EFSA set an acceptable daily intake of 0.5 g per kg of body weight because of diarrhoea risk.^12,1
Pregnancy and breastfeeding: No reliable human data: LactMed has no erythritol entry and several human studies EFSA reviewed excluded pregnant women. EFSA found no effects on reproduction or development in rodent studies and set one acceptable daily intake (0.5 g per kg of body weight) for the whole population; the unresolved heart and platelet signal is a reason to keep amounts modest.¹
Children and teens: EFSA found that high consumers among children and adolescents may exceed the acceptable daily intake, which is set per kg of body weight, so the same drink or sweet is a larger share of the limit for a smaller body.¹
Fructose intolerance: Erythritol taken with a large fructose load made gut symptoms worse in healthy adults.¹³

The erythritol heart-risk findings in context

6 notes

Two kinds of evidence point the same way, and two kinds point elsewhere.

Cohorts: In US and European patients having cardiac evaluation, those with the most erythritol in fasting blood had about twice the 3-year risk of heart attack, stroke or death (2023). Later cohorts point the same way but more weakly: in the Nurses' Health Study the top quarter had 1.55 times the coronary risk, falling to 1.21 (not significant) once diabetes was accounted for; in Finnish male smokers followed about 19 years, the death rate was 1.50 times higher per log unit of serum erythritol (1.15 times, top vs bottom quarter); and in 4,006 older US adults higher levels went with heart failure and cardiovascular death. Blood levels were measured, not intake, so these are associations, not proof that the sweetener causes harm.^4,25,26,27
Platelet experiments: In 10 healthy volunteers, 30 g of erythritol increased stimulated platelet aggregation in every subject, while 30 g of glucose did not. These are lab measures of clotting potential, not clinical events.⁵
The body makes it: Erythritol is made from glucose through the pentose-phosphate pathway; in university freshmen, those who gained central fat had 15 times higher blood erythritol. In a 2-year weight-loss trial (observational analysis of 664 adults), falls in plasma erythritol tracked improvements in estimated 10-year cardiovascular risk, which fits blood erythritol partly reflecting metabolic health rather than sweetener intake.^22,28
Genetic studies: A 2024 Mendelian randomization study found no supportive evidence that erythritol raises coronary disease risk; two 2025 analyses found small positive associations with coronary disease and stroke.^20,21,24
Lab work: In a 2025 cell study, human brain blood-vessel cells exposed for 3 hours to an erythritol concentration said to match a 30 g drink made more oxidative stress and less nitric oxide, and released less clot-dissolving t-PA. This is a dish experiment, not evidence from people.³⁰
Where that leaves it: A 2025 review describes the platelet effects in pilot trials as possibly temporary and calls for more research. As of 2026, no trial has measured heart attacks or strokes in people randomized to eat erythritol, so the cohort and platelet findings show a signal worth taking seriously, not a proven cause.⁶

How to read the label

What to check on the Supplement Facts panel.

How to read the label

4 checks

Find erythritol in the ingredient list

Erythritol is often combined with other sweeteners (one tested blend contained erythritol, xylitol and stevia); the ingredient list shows which are present.²³

Grams per serving

The platelet experiment used 30 g in one drink. EFSA's acceptable daily intake is 0.5 g per kg of body weight a day, about 35 g for a 70 kg adult.^5,1

The laxative warning

EU labels for foods with polyols carry a laxative-effect warning under Regulation (EU) No 1169/2011; EFSA declined to exempt erythritol from it in 2023.¹

The tooth-decay claim

US labels may say erythritol does not promote tooth decay, but the rule bars claiming any degree of risk reduction.²

Have the bottle? Photograph its Supplement Facts panel and see each line, erythritol included, beside the doses and forms the trials used in Label X-Ray.

Frequently asked questions

Short answers to common questions; the numbers link to the sources below.

Common questions

8 answers

Does erythritol raise blood sugar or insulin?

No, in the studies we found. Doses of 50 g and 75 g given to healthy volunteers had no effect on glucose or insulin, because erythritol is absorbed and passed out unchanged in urine.^17,18,1

Does erythritol have calories?

Very few. It is absorbed but not used for energy and leaves the body unchanged in urine; reviews describe it as non-caloric.^14,9

Is erythritol bad for your heart?

It is not settled. In cardiac patients, the highest blood erythritol went with about twice the risk of heart attack or stroke, later cohorts found weaker links, and a 30 g drink made platelets more reactive. But blood levels also rise with poor metabolic health, genetic studies disagree, and no trial has tested heart events.^{4,25,26,5,28,20,21,24}

Is erythritol safe to use every day long term?

No trial has followed heart or other health outcomes in people randomized to eat erythritol for years. The longest trial gave children about 7.5 g a day in candies for 3 years. EFSA's acceptable daily intake is 0.5 g per kg of body weight, and cohort studies linking high blood erythritol to heart events leave long-term safety open.^7,1,4,25

How much erythritol is too much?

EFSA set an acceptable daily intake of 0.5 g per kg of body weight, about 35 g a day for a 70 kg adult, because larger amounts can cause diarrhoea. In a tolerance trial, 50 g at once caused nausea and gut rumbling.^1,12

Does erythritol cause diarrhoea or bloating?

Less than most sugar alcohols. Up to 35 g in a drink caused no symptoms in young adults, and erythritol caused fewer watery stools than xylitol at every dose. Taken with a lot of fructose, it made gut symptoms worse.^12,13

Is erythritol safe for people with diabetes?

It does not raise glucose or insulin. A 4-week uncontrolled pilot in 24 people with type 2 diabetes found better blood vessel measures, but the heart-risk signal came from people with cardiac risk, so people with diabetes may want to discuss large regular amounts with their clinician.^17,15,4

Is erythritol better than xylitol for teeth?

One 3-year Estonian trial of 485 children found fewer dentin cavities with erythritol candy than with xylitol or sorbitol candy, and the same programme found less plaque and fewer mutans bacteria. A small adult study found xylitol, not erythritol, lowered plaque bacteria, and a 2020 review and a 2024 meta-analysis (2 erythritol trials) found too few erythritol studies to judge. Grade C.^7,8,11,10,29

Sources

30 sources: trial abstracts, NIH fact sheets and reference databases. Numbers in the text link here.

Sources cited on this page

30 sources

1Re-evaluation of erythritol (E 968) as a food additive.Guideline EFSA Journal (EFSA Panel on Food Additives and Flavourings), 2023 · PMID 38125972
221 CFR 101.80 Health claims: dietary noncariogenic carbohydrate sweeteners and dental cariesGuideline Electronic Code of Federal Regulations, 2026 · ecfr.gov
3PubChem compound summary: Erythritol (CID 222285)Database National Library of Medicine, 2026 · pubchem.ncbi.nlm.nih.gov
4The artificial sweetener erythritol and cardiovascular event risk.Observational Nat Med, 2023 · PMID 36849732
5Ingestion of the Non-Nutritive Sweetener Erythritol, but Not Glucose, Enhances Platelet Reactivity and Thrombosis Potential in Healthy Volunteers-Brief Report.Open-label trial Arterioscler Thromb Vasc Biol, 2024 · PMID 39114916
6Sweeteners: erythritol, xylitol and cardiovascular risk-friend or foe?Review Cardiovasc Res, 2025 · PMID 40444390
7Effect of erythritol and xylitol on dental caries prevention in children.RCT Caries Res, 2014 · PMID 24852946
8Effect of three-year consumption of erythritol, xylitol and sorbitol candies on various plaque and salivary caries-related variables.RCT J Dent, 2013 · PMID 24095985
9Erythritol Functional Roles in Oral-Systemic Health.Review Adv Dent Res, 2018 · PMID 29355425
10Effects of xylitol and erythritol consumption on mutans streptococci and the oral microbiota: a systematic review.Systematic review Acta Odontol Scand, 2020 · PMID 32633595
11Comparison of erythritol and xylitol saliva stimulants in the control of dental plaque and mutans streptococci.RCT Caries Res, 2001 · PMID 11275673
12Gastrointestinal tolerance of erythritol and xylitol ingested in a liquid.RCT Eur J Clin Nutr, 2007 · PMID 16988647
13Combination of erythritol and fructose increases gastrointestinal symptoms in healthy adults.Crossover RCT Nutr Res, 2011 · PMID 22118754
14Metabolism of erythritol in humans: comparison with glucose and lactitol.PK study Br J Nutr, 1993 · PMID 8457525
15Effects of erythritol on endothelial function in patients with type 2 diabetes mellitus: a pilot study.Open-label trial Acta Diabetol, 2014 · PMID 24366423
16The Role of D-allulose and Erythritol on the Activity of the Gut Sweet Taste Receptor and Gastrointestinal Satiation Hormone Release in Humans: A Randomized, Controlled Trial.Crossover RCT J Nutr, 2022 · PMID 35135006
17Metabolic Effects and Safety Aspects of Acute D-allulose and Erythritol Administration in Healthy Subjects.Crossover RCT Nutrients, 2023 · PMID 36678329
18Erythritol and xylitol differentially impact brain networks involved in appetite regulation in healthy volunteers.Crossover RCT Nutr Neurosci, 2022 · PMID 34404339
19Efficacy of erythritol powder air-polishing in active and supportive periodontal therapy: A systematic review and meta-analysis.Meta-analysis Int J Dent Hyg, 2022 · PMID 34318577
20Erythritol as a Potential Causal Contributor to Cardiometabolic Disease: A Mendelian Randomization Study.Observational Diabetes, 2024 · PMID 37939167
21Role of erythritol in coronary heart disease, ischemic stroke, and venous thromboembolism: A Mendelian randomization analysis.Observational Medicine (Baltimore), 2025 · PMID 41137360
22Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults.Observational Proc Natl Acad Sci U S A, 2017 · PMID 28484010
23A polyol-stevia blended sugar replacer exhibits low glycemic response among human subjects.RCT Clin Nutr ESPEN, 2019 · PMID 31451273
24Associations between artificial sweeteners and cardiovascular disease, stroke, and diabetes: A Mendelian randomization study.Observational Am J Prev Cardiol, 2025 · PMID 41141604
25Plasma levels of polyols erythritol, mannitol, and sorbitol and incident coronary heart disease among women.Observational Eur J Prev Cardiol, 2025 · PMID 39230875
26Serum Erythritol and Risk of Overall and Cause-Specific Mortality in a Cohort of Men.Observational Nutrients, 2024 · PMID 39339699
27Erythritol, Erythronate, and Cardiovascular Outcomes in Older Adults in the ARIC Study.Observational JACC Adv, 2025 · PMID 39983608
28Declines in plasma erythritol and improvements in cardiovascular disease risk and atherogenic lipid profiles: a 2-year randomized weight-loss dietary intervention trial.Observational Am J Clin Nutr, 2026 · PMID 42759771
29Sugar substitutes on caries prevention in permanent teeth among children and adolescents: a systematic review and meta-analysis.Meta-analysis J Dent, 2024 · PMID 38762077
30The non-nutritive sweetener erythritol adversely affects brain microvascular endothelial cell function.Lab study J Appl Physiol (1985), 2025 · PMID 40459966

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2 entries

Dated changes to this page
Date	Change	Who and why
Oct 21, 2026summary, key facts, evidence notes, who should avoid, heart-risk section, FAQ, questions, related	Brought the heart-risk section up to date: added three later cohorts (Nurses' Health Study women 2025, Finnish men 2024, ARIC older adults 2025), a 2026 analysis of a 2-year weight-loss trial in which falling blood erythritol tracked lower estimated heart risk, and a 2025 cell study, all labelled as observational or laboratory evidence rather than proof of cause. Added a pregnancy and breastfeeding note (no human data; LactMed has no entry; EFSA found no reproductive effects in rodents). Added a 2024 caries meta-analysis to the tooth-decay notes (only 2 erythritol trials, not pooled). Trimmed the FAQ from 11 to 8 (added long-term safety; moved air polishing and blood levels to page questions). Interactions re-checked: LactMed and LiverTox have no erythritol entry and no new interactions were found. No 2023–2026 randomized trial of erythritol on blood sugar, gut tolerance or teeth qualified for a new row.	Writer: Kymata Health EditorialTrigger: A–Z audit against docs/supplements/AUDIT-STANDARD.md
Oct 19, 2026all	New page. Every PMID checked with NCBI E-utilities (esummary title, year and journal) and its abstract read with efetch, including the EFSA 2023 re-evaluation; eCFR 21 CFR 101.80 and PubChem read on the date shown. The Witkowski cohort and Mendelian randomization studies are graded as observational; dental air-polishing is listed as a form, not a dietary outcome.	Writer: Kymata Health EditorialTrigger: new page

Supplement & Nutrient Encyclopedia. Educational information only; it is not medical advice and does not replace a clinician. Dietary supplements are not intended to diagnose, treat, cure or prevent any disease. Statements about supplements have not been evaluated by the FDA.

Erythritol

Medicines 0

Supplements and foods 1

Fructose (large amounts in the same drink)