Is Erythritol Really a Safe Sugar Substitute?

If you're one of those unable to tolerate sugar alcohols, this finding might not surprise you. The FDA-approved in 2001, erythritol—a sugar alcohol sweetener— and deemed it generally recognized as safe (GRAS) . Since then and especially in recent years, its popularity has grown, and it is marketed as being zero‑calorie, having minimal effects on blood sugar, and having dental-friendly properties .

But recent research from the University of Colorado Boulder is raising serious questions about erythritol’s vascular safety—especially its potential impact on brain blood vessels and stroke risk .

Key Findings from the Study

In laboratory tests, scientists treated human cerebral microvascular endothelial cells—the cells that line brain blood vessels—with levels of erythritol similar to what's found in a single sugar-free beverage serving (around 30 g) . They observed several concerning effects:

• Increased oxidative stress (free radicals)—damaging cellular integrity.
• Reduced nitric oxide production, which normally relaxes and widens blood vessels.
• Raised endothelin‑1 levels, a molecule that triggers vessel constriction.
• Blunted release of tissue plasminogen activator (t‑PA), the body’s natural clot-dissolving enzyme.

Together, these shifts can make brain vasculature more prone to clotting and impaired blood flow—key contributors to ischemic stroke risk .

What the Experts Say

“Big picture, if your vessels are more constricted and your ability to break down blood clots is lowered, your risk of stroke goes up,”
said Auburn Berry, the study’s first author and graduate student at CU Boulder.

Senior author Christopher DeSouza, professor of integrative physiology, commented:

“Our study adds to the evidence suggesting that non‑nutritive sweeteners that have generally been purported to be safe, may not come without negative health consequences.” 

Context: What Earlier Studies Found

This isn’t the first time erythritol has been flagged. Previous observational studies—including one by the Cleveland Clinic involving around 4,000 participants—found that elevated erythritol levels in the bloodstream correlated with significantly higher risk of heart attack and stroke over the following three years 0turn0news24. Another study linked erythritol to enhanced platelet reactivity, which increases clotting potential.

But crucially, those earlier studies were epidemiological—observing associations, not mechanisms.

Study Limitations & What’s Next

• Lab-based: The new findings come from in vitro experiments with isolated cells—not human subjects or animal models—so results may not fully translate to real-world physiology turn0search1.
• Single dose exposure: Cells received erythritol for only a few hours. Effects from repeated or chronic consumption were not tested.
• Need for clinical research: Experts stress that animal studies and human trials are needed to confirm these mechanisms and evaluate actual risk .

Practical Takeaways

• Label awareness matters: Erythritol may be listed simply as a “sugar alcohol” on packaging—look for ingredient names like erythritol on product labels .
• Moderation is wise, especially for individuals with cardiovascular risk factors such as diabetes, hypertension, or high cholesterol.
• Consider natural alternatives—that may carry fewer vascular uncertainties—such as raw honey, monk fruit, date syrup, or small amounts of maple syrup news23turn0news22.

Summary Table

Final Thoughts

Though erythritol has long been marketed as a safe sugar substitute—especially for people with diabetes or aiming to reduce calories—emerging evidence from the University of Colorado study suggests it may not be entirely benign. By altering critical functions in brain blood vessel cells, erythritol could theoretically raise ischemic stroke risk, especially when consumed frequently or in large amounts.

As Auburn Berry put it: “Our research demonstrates not only that, but how erythritol has the potential to increase stroke risk.” But until animal or human trials confirm these mechanisms, PG-specific guidelines remain out of reach.

In the meantime: stay informed, read labels, consume mindfully—and consider natural sweeteners if you're using erythritol regularly.