New Cardiovascular Concerns with Erythritol
Research from the Cleveland Clinic, supported by the National Institutes of Health (NIH), has linked higher blood levels of erythritol to a greater risk of major adverse cardiovascular events such as heart attack, stroke, or death. This connection was discovered during a study designed to find previously unknown factors contributing to heart disease, where erythritol was identified as a strong predictor of future cardiovascular issues.
The Mechanism of Action: Platelet Activation
Laboratory and animal studies revealed that erythritol can enhance blood platelet activity, increasing their sensitivity to clotting signals and promoting blood clot formation. In mice, elevated erythritol levels were shown to accelerate the development of blood clots and blockages in arteries. This mechanism is particularly concerning for individuals with existing conditions like diabetes, obesity, or cardiovascular disease, who are already at a higher risk for these types of events.
High Consumption Levels
A study involving healthy volunteers who consumed a beverage containing 30 grams of erythritol—an amount found in a pint of keto ice cream—showed a dramatic and prolonged increase in blood erythritol levels. Levels spiked a thousand-fold and remained high for several days, reaching concentrations capable of inducing the harmful platelet changes observed in laboratory experiments. This suggests that consuming a single product with a high dose of erythritol could potentially elevate blood levels to a risky threshold.
Potential Impact on Brain Health and Stroke Risk
Research has explored the potential impact of erythritol on brain health. A study presented at the 2025 American Physiology Summit suggested that erythritol might damage cells within the blood-brain barrier. The research indicated that erythritol interfered with nitric oxide production, crucial for blood vessel dilation. Exposure was also linked to increased oxidative stress in brain blood vessel cells and could potentially make the brain more vulnerable to blood clots.
The FDA's Position and the Need for Reassessment
The U.S. Food and Drug Administration (FDA) currently classifies erythritol as "Generally Recognized as Safe" (GRAS). This classification is based on older data and may not reflect current high-dose usage. While the FDA has acknowledged the 2023 study, it requires further research to establish a direct causal link. Due to GRAS status, erythritol is not always clearly listed on labels, making it hard to track intake.
Old and New Warnings Compared
| Warning Category | Older Warnings | New Warnings (2023-2025) |
|---|---|---|
| Cardiovascular Health | None associated. | Increased risk of heart attack, stroke, and death in at-risk individuals due to enhanced blood clot formation. |
| Neurological Health | None associated. | Potential damage to brain blood vessel cells, increased oxidative stress, and reduced nitric oxide production, raising stroke risk. |
| Gastrointestinal Effects | High-dose consumption can cause digestive issues like bloating, cramping, and diarrhea. | Still applicable. |
| Safety Status | Widely considered safe and well-tolerated, especially compared to other sugar alcohols. | Safety questioned, especially regarding high consumption levels in processed foods. Calls for more long-term research. |
What to Do with the New Information
Considering the new warnings about erythritol, individuals, especially those with existing cardiovascular risk factors, should be mindful of their consumption. Practical steps include:
- Checking Ingredients: Look for erythritol or "sugar alcohols" on food labels.
- Limiting Processed Foods: Erythritol is common in sugar-free and low-carb products like keto ice cream, protein bars, and sugar-free candy.
- Exploring Alternatives: Consider reducing overall sweetener use. Options like stevia and monk fruit extract may be safer alternatives based on current research, but moderation is always advised.
- Consulting a Healthcare Provider: Individuals with concerns, particularly those with cardiovascular risk factors, should discuss diet with a doctor or nutritionist.
More details on the 2023 findings are available on the {Link: NIH website https://www.nih.gov/news-events/nih-research-matters/erythritol-cardiovascular-events}.
Conclusion
New scientific findings are raising concerns about erythritol. While previously considered safe with benefits for diabetics and dental health at moderate doses, recent studies highlight potential new cardiovascular and neurological risks, especially with high consumption levels in modern processed foods. More research is needed to confirm causality, but the evidence suggests caution is warranted. Consumers, particularly those with pre-existing conditions, should consider moderating erythritol intake and prioritizing whole, unprocessed foods.
