Erythritol Linked to Blood Clots and Heart Attacks, New Research Shows

There are a lot of artificial sweeteners available for people who want to have less sugar in their diet, but one, in particular, has been getting a lot of attention lately — and not for a good reason. It’s called erythritol, and it’s been most recently linked to blood clots. 

New research published in the American Heart Association journal Arteriosclerosis, Thrombosis, and Vascular Biology analyzed data from two small groups of people — 10 who had a beverage with 30 grams of the artificial sweetener erythritol and 10 who had a drink with 30 grams of sugar after fasting overnight. Their blood was drawn before having the drink and 30 minutes later. The researchers discovered that people who had the erythritol drink had more than double the risk of developing blood clots than those in the sugar group. (Blood clots can form in blood vessels, which can then break off and travel up to the heart or brain, causing a heart attack or stroke.)

This isn’t the first time the safety of erythritol has been questioned. A 2023 study published in Nature Medicine linked the sweetener to a higher risk of stroke, heart attack, and death.  

It’s important to point out that the research isn’t conclusive, given that these studies are small. But the findings are definitely raising eyebrows. Here’s what you need to know about erythritol, plus what it’s commonly found in. 

What is erythritol?

Erythritol is a form of carbohydrate called a sugar alcohol, explains Keri Gans, R.D., author of The Small Change Diet. “It is a common replacement for table sugar,” she says. 

Erythritol, which is approximately 70% as sweet as sugar, per the National Institutes of Health, “is naturally found in small amounts in some fruits and fermented foods,” says Scott Keatley, R.D., co-founder of Keatley Medical Nutrition Therapy. “Unlike regular sugar, erythritol provides a sweet taste without contributing significantly to calories or impacting blood sugar levels,” he adds. 

Erythritol is classified by the U.S. Food and Drug Administration (FDA) as generally recognized as safe or GRAS, meaning it’s considered safe when it’s used as intended. 

What is erythritol in?

Erythritol is in a wide range of goods as a sugar substitute. “It is especially popular in low-calorie, sugar-free, keto, and diabetic-friendly products,” Keatley says. “Its main appeal lies in its ability to mimic the sweetness of sugar without the associated calories, making it a popular ingredient for those managing weight or blood sugar levels.”

It’s usually found in sugar-free varieties of ice cream, candy, cookies, cakes, gum, and fruit spreads, Gans says. “It is also commonly used in stevia and monk-fruit sugar alternatives,” she adds. 

These are some of the most common products you’ll find erythritol, per Keatley:

• Bai flavored waters
• Lily’s Sweets, including sugar-free chocolate bars and baking chips
• Swerve Sweets low-carb and keto-friendly baking mixes
• DC24 daily care chewing gum
• Truvia sweetener 
• Swerve sweetener
• Halo Top ice cream
• Quest nutrition bars

How can you know if your food contains erythritol?

This involves some reading. “The FDA does not require a package’s Nutrition Facts Label to identify the specific type of sugar alcohol it contains,” Gans says. “However, it is required that the type of sugar alcohol be on the list of ingredients. “

Erythritol should be listed under its name, Keatley says. “It is not typically listed under any other name, making it relatively easy to spot,” he adds. 

While the latest findings on erythritol aren’t great, experts recommend putting them into perspective. “Everything — even food — has risks and rewards,” Keatley says. “A low/no-calorie sweetener is a game-changer for people who are with or at risk for diabetes, obesity, and PCOS.”

But, he says, “we see with this and other research like it that our body does react to these substances and we need to consume them in small amounts and with less frequency.” Most studies on erythritol look at 30 grams of the sweetener — which is a lot at once, Keatley points out. “But if someone were to have a couple of beverages, a baked good, and some ice cream sweetened with erythritol in the same day, the accumulation may be over 30 grams,” he says. 

Keatley agrees that it’s best to limit how much of the sweetener you have. “I do not think you need to avoid erythritol completely, but you should limit daily consumption,” she says. 

If you rely on artificial sweeteners for sweet foods, Keatley recommends that you “eat around.” 

“Having a little aspartame, sucralose, saccharin, stevia, and allulose means that you’re not using the same pathways and are reducing your risk of side effects,” he says.