What is the best sweetener for people with fructose intolerance?

October 24, 2025 •

5 min read

An estimated one in three people with dietary fructose intolerance struggles to find suitable sweeteners. Navigating labels to find a sweetener that doesn't trigger digestive symptoms like bloating and gas can be challenging, but there are several options available that can make a difference. Choosing the best sweetener for people with fructose intolerance often depends on individual tolerance and the specific type of sugar involved.

Quick Summary

This article explores various sweeteners suitable for a low-fructose diet, examining options like glucose, stevia, and rice syrup. It provides an in-depth comparison of their benefits, potential drawbacks, and suitability for those with fructose malabsorption. The guide helps navigate safe and tolerable choices for managing symptoms effectively.

Key Points

Glucose is a safe choice: Containing no fructose, dextrose is a highly tolerable sweetener for those with fructose malabsorption.
Stevia and Monk Fruit are calorie-free and well-tolerated: As natural, zero-calorie sweeteners, pure stevia and monk fruit are excellent choices, though it's important to check for potentially problematic fillers.
Rice syrup is a fructose-free liquid option: Made from glucose and maltose, fructose-free rice syrup provides a honey-like taste and texture suitable for many recipes.
Sugar alcohols require caution: Sweeteners like xylitol and especially erythritol can cause digestive issues, even in those with fructose intolerance, due to their effect on gut absorption.
Avoid high-fructose sweeteners: Agave, honey, and high fructose corn syrup are high in fructose and should be avoided to prevent triggering symptoms.
Test individual tolerance for certain options: Small amounts of pure maple syrup might be tolerated, but it depends on individual sensitivity due to its sucrose content.

Understanding Fructose Intolerance and Sweeteners

Fructose intolerance, or fructose malabsorption, is a digestive condition where the small intestine struggles to absorb fructose effectively. The unabsorbed sugar then travels to the large intestine, where it is fermented by gut bacteria, leading to uncomfortable gastrointestinal symptoms. For those with this condition, avoiding high-fructose foods and choosing the right sweetener is crucial for symptom management.

While high-fructose sweeteners like agave syrup and honey are obvious culprits, others like table sugar (sucrose) also contain fructose. Sucrose is made of 50% glucose and 50% fructose. Some individuals can tolerate small amounts of sucrose because the presence of glucose can aid in fructose absorption, but many still experience issues, especially with larger quantities. This makes exploring alternative sweeteners a necessary step for a comfortable diet.

Tolerable Sweetener Options

There are several options that are generally well-tolerated and can replace high-fructose sweeteners in your diet. These options vary in taste, caloric content, and suitability for different uses.

Glucose (Dextrose): Glucose, or dextrose, is a simple sugar that is often a reliable choice. Since it contains no fructose, it is easily absorbed and does not cause gastrointestinal distress. It is a reliable option for cooking and baking, though it is important to use it sparingly, as high consumption is not recommended for overall health.

Rice Syrup: This natural sweetener is made from rice and primarily consists of glucose and maltose, another glucose-based sugar. Fructose-free varieties are available and are considered safe for those with fructose malabsorption. Rice syrup offers a light, honey-like caramel taste and works well as a liquid sweetener.

Stevia: Stevia is a natural, plant-based, zero-calorie sweetener derived from the Stevia rebaudiana plant. It gets its sweetness from compounds called steviol glycosides, which are not metabolized by the body in the same way as sugar. Pure stevia is generally considered very safe for fructose intolerance and does not cause digestive issues. When buying stevia products, be cautious of blended varieties that might contain fillers like erythritol or maltodextrin, which can sometimes cause problems.

Monk Fruit: Monk fruit, or Luo han guo, is a natural sweetener that is also calorie-free. Its sweetness comes from mogrosides, which, like steviol glycosides in stevia, are not absorbed by the body. It is considered safe for those with fructose intolerance, and like stevia, it's important to check product labels for added fillers.

Pure Maple Syrup: In small, controlled amounts, pure maple syrup can be tolerated by some individuals with fructose malabsorption. It is primarily composed of sucrose, which provides a balanced glucose-fructose ratio. However, the key is moderation, and individual tolerance should always be tested carefully.

Sweeteners to Approach with Caution

Some sweeteners should be approached with caution, as they can cause symptoms in some individuals, particularly those with higher sensitivities.

Xylitol: A sugar alcohol that is generally better tolerated than sorbitol but can still cause digestive issues, especially in high concentrations. Xylitol, often marketed as birch sugar, can have a laxative effect for some.
Erythritol: While often marketed as a low-FODMAP sweetener, studies have shown that the coingestion of erythritol and fructose can increase carbohydrate malabsorption and worsen gastrointestinal symptoms. It is absorbed in the small intestine but can still cause problems if consumed in large quantities, especially in beverages.
Sucralose (Splenda®): As an artificial sweetener, sucralose is not a sugar alcohol and is poorly absorbed by the gut. However, some animal and human studies suggest it may have adverse effects on the gut microbiota, which could be a concern for some individuals with gut sensitivities.

Sweeteners to Avoid

Agave Nectar: Extremely high in fructose, sometimes up to 90%.
Honey: The fructose content varies widely by variety, but it is generally very high in fructose.
High Fructose Corn Syrup (HFCS): As the name implies, this sweetener is rich in fructose.
Sorbitol: This sugar alcohol is known to cause significant digestive problems for those with fructose intolerance and is often found in diet foods.

Comparison of Sweetener Options


Sweetener	Type	Fructose Content	Tolerability	Notes
Glucose (Dextrose)	Simple Sugar	0%	High	Safely absorbed; can be used in baking.
Stevia	Natural, Zero-Calorie	0%	High	Derived from a plant; check for erythritol fillers.
Monk Fruit	Natural, Zero-Calorie	0%	High	Derived from monk fruit; check for fillers.
Rice Syrup	Natural Sugar	<0.2%	High	Primarily glucose and maltose; mild caramel flavor.
Pure Maple Syrup	Natural Sugar	Sucrose (approx. 50% fructose)	Moderate (limit 1-2 Tbsp)	Tolerance is highly individual; consume in small amounts.
Xylitol	Sugar Alcohol	0%	Cautious (individual tolerance)	Better tolerated than sorbitol but can have laxative effects.
Erythritol	Sugar Alcohol	0%	Cautious (can increase malabsorption)	May worsen carbohydrate malabsorption when consumed with fructose.

Making Your Choice: A Personal Approach

Ultimately, the best sweetener for people with fructose intolerance is a personal decision based on individual tolerance. It is highly recommended to follow a structured elimination and reintroduction diet, such as the low-FODMAP diet, under the guidance of a healthcare professional or registered dietitian. This process will help you identify your personal threshold for various sweeteners and determine what works best for you without triggering symptoms.

For most individuals, starting with a sweetener that contains no fructose, like pure glucose, stevia, or monk fruit, is the safest bet. Once you have stabilized your symptoms, you can carefully test other options in small amounts. Always read food labels carefully, as many products contain hidden fructose sources or blends of sweeteners that could cause issues. Choosing a simple, whole-food-based diet wherever possible remains the most effective long-term strategy for managing fructose intolerance.

Conclusion

While living with fructose intolerance requires careful dietary management, it doesn't mean you have to sacrifice all sweet flavors. Options like glucose, rice syrup, stevia, and monk fruit offer safe and delicious alternatives that can be used with confidence. Meanwhile, sweeteners like xylitol, erythritol, and sucralose should be approached with caution, and high-fructose products such as agave and honey should be avoided altogether. By taking a thoughtful and personalized approach, you can successfully navigate your sweetener choices and enjoy a variety of foods symptom-free. You can learn more about managing your diet with food intolerances at the University of Virginia's GI Nutrition website.

Frequently Asked Questions

Regular table sugar, or sucrose, is composed of 50% glucose and 50% fructose. While the presence of glucose helps some absorb the fructose, many with fructose intolerance may still experience symptoms, especially with larger quantities. It is best to consume it in very small, controlled amounts, if at all.

Yes, pure stevia, which is a plant-based, zero-calorie sweetener derived from steviol glycosides, is considered very safe for people with fructose intolerance. However, it is important to check for blended products that may contain other sweeteners or fillers that could cause issues.

Erythritol is a sugar alcohol that should be approached with caution. While it's often marketed as low-FODMAP, studies have shown that consuming it alongside fructose can actually increase carbohydrate malabsorption and worsen digestive symptoms for some individuals.

Glucose, or dextrose, is often considered the safest sweetener because it is a simple sugar containing no fructose and is easily absorbed by the small intestine. Stevia and monk fruit are also highly recommended zero-calorie options.

Sugar alcohols, or polyols, are generally not well-absorbed by the digestive tract. Some, like sorbitol, should be strictly avoided, while others, like xylitol and erythritol, may be better tolerated in small amounts but can still cause digestive issues for many.

Both honey and agave are very high in fructose. Agave nectar can contain up to 90% fructose, while honey's fructose content varies but is generally quite high, making them common triggers for digestive symptoms.

The best way is to work with a healthcare professional or a registered dietitian on a structured elimination and reintroduction diet, such as a low-FODMAP diet. This helps identify your individual thresholds for different types of sugars and sweeteners.