Sugar Alcohols: Everything You Need to Know

I’ve been on a bit of an alternative sweetener kick these past few weeks, for good reason: people want and need to know about this stuff. While a purist shudders at the prospect of any non- or hypo-caloric sugar substitute gracing his or her tongue, I’m a realist. People are going to partake and it’s important to understand what’s entering your body and what, if any, effects it will have. Whether it’s diet soda, artificial sweeteners, stevia, or the mysterious sugar alcohols, people want the sweet without worrying about a big physiological effect – an insulin surge, a blood glucose dip, even a migraine. So I’ve been covering the various types and have tried to be comprehensive about it. As a whole, it all seems fairly safe. Alternative sweeteners might mess with some folks’ adherence to a low-sugar diet, and they might induce or fortify cravings, but the research doesn’t suggest that they’re going to give you cancer or diabetes. The potentially negative effects are all fairly subjective, so it’s safe to play around with them and determine their role in your life based on how they affect your appetite, state-of-mind, and any other subjective health markers.

One remains, however. I have yet to cover sugar alcohols. I was surprised, actually, having gone through my archives and finding nothing. Sugar alcohols are pretty prominent in the low-carb world – all those sugar-free desserts and chocolates and protein bars geared toward Atkins types tend to use sugar alcohols – so I had better get to it, huh?

What Are Sugar Alcohols?

A sugar alcohol, also known as a polyol, is an interesting type of carbohydrate. Its structure is kind of a hybrid between a sugar molecule and an alcohol molecule (hence the name “sugar alcohol”) and, for the most part, our bodies do a poor job of digesting and breaking down sugar alcohol in the small bowel. It’s also sweet to the tongue and resistant to fermentation by oral bacteria, meaning sugar-free gum manufacturers employ it judiciously to sweeten their products without causing cavities. Our colonic bacteria, however, can and do ferment the stuff. For that reason, it’s a kind of prebiotic that, as Kurt Harris points out, can stimulate diarrhea and exacerbate existing irritable bowel syndrome-related symptoms. Common side effects of sugar alcohol consumption (or over-consumption) include bloating, gas, and abdominal pain. Sugar alcohols are not quite non-caloric, but all contribute fewer calories than sucrose, and their effects on insulin and blood sugar (if any) are pretty minimal.

Sugar alcohols pop up in nature, in fruits like apples and pears, but any commercial product that contains them must list the specific alcohols in the ingredients. If they aren’t counted toward the official carb count, they must be listed separately in the nutritional information. Let’s look at some of the popular ones you’ll be encountering:

Xylitol – Glycemic Index of 13

Xylitol is one of the more popular sugar alcohols. It tastes remarkably like sucrose, has about half the calories, and is 1.6 times as sweet, with little effect on blood glucose and none on insulin levels. You can find xylitol in certain berries, corn husks, mushroom fibers, and oats; most commercial xylitol comes from hardwood and corn. Xylitol has a cooling effect on the mouth and is actively protective against dental caries (as opposed to merely being neutral or non-contributive, like the other sugar alcohols), making it the favorite choice of sugar-free chewing gum makers.

There appear to be some interesting health benefits to xylitol, too, beyond the well-established preventive actions against dental plaque and cavities. Xylitol shows promise as a bone remineralization agent, positively affecting both tooth enamel and bone mineral density (albeit, thus far, in rats). I count at least ten studies showing xylitol’s promise in the treatment or prevention of osteoporosis.

Just don’t feed it to your dog. Also, it may exacerbate intestinal distress or cause diarrhea, so exercise caution (and linger near a toilet if you’re unsure of its effect on you).

Sorbitol – Glycemic Index of 9

Sorbitol is found primarily in stone fruits, and manufacturers use it in diet sodas, sugar-free ice creams and desserts, as well as mints, cough syrups, and gum. It’s about half as sweet as sucrose, with 2.6 calories per gram (compared to sucrose’s 4 calories per gram, of course). Being a polyol, it has the potential to cause great gastrointestinal distress, especially in patients with IBS. This is compounded by its relative lack of sweetness when compared to other polyols, like xylitol; people are more likely to consume greater amounts of sorbitol to attain the desired level of sweetness and companies are more likely to use more of it.

There don’t appear to be any proactive beneficial effects with sorbitol. It doesn’t affect insulin or blood glucose, which could be good for diabetics, but there’s nothing like xylitol’s promise.

Erythritol – Glycemic Index of 0

Erythritol is almost non-caloric (0.2 calories per gram) and about 60-70% as sweet as sugar. It’s the only sugar alcohol that doesn’t appear to cause gastrointestinal distress (because the body absorbs it rather than let it pass to the colon for fermentation), it doesn’t affect blood sugar or insulin, and it cannot be fermented by dental bacteria (and it exhibits some of xylitol’s inhibitory effect on carie-causing oral bacteria, though not all of it).

For the most part, erythritol seems pretty safe, and it’s rumored to taste very similar to sugar. Overconsumption – taking in more than your body can absorb – can result in bloating and gastrointestinal distress, but it takes a lot.

Maltitol – Glycemic Index of 36

Maltitol is very similar to actual sugar in terms of mouth feel, taste, and even cooking performance (except for browning, which it cannot do). It’s 90% as sweet with half the calories, so manufacturers love using copious amounts of maltitol in sugar-free desserts and other products. That’s all well and good while you’re eating the stuff, but what about half an hour later once all that sugar alcohol has finally reached your colon and the bacteria has started feasting and fermenting? Bloating, diarrhea, abdominal pain.

It’s right there in the name, isn’t it? Mal.

There are others, but those are the big ones. Overall, the literature shows that sugar alcohols are fairly neutral as far as blood glucose and insulin effects go. Some people may see spikes, as I’ve seen reports on blogs and in comment boards to that effect, but most people won’t. They can hit your gut pretty hard and cause problems there, especially if you’ve got a preexisting condition, but healthy people with healthy digestion (which isn’t as widespread as most people think, of course) should be okay with some here and there. Xylitol in particular seems promising, and I’ll keep my eye out for more information on that as it emerges.

If you’re doing fine without sweeteners (non-caloric, hypo-caloric, artificial, natural, whatever), keep it up. Don’t go looking for an excuse to introduce sugar substitutes. But if your desire for something, anything sweet is derailing your attempts at a healthy diet, sugar alcohols may be worth experimenting with. Give it a shot if you’re gonna and let me know how it goes.

What have your experiences been with sugar alcohols? They get a bad rap from being used in so many processed “low-carb” treats, but have they helped or hindered your path to health? Let me know in the comment section!

TAGS:  is it primal?

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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185 thoughts on “Sugar Alcohols: Everything You Need to Know”

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    1. recommended by my oncological dentist. gets the most out of what’s left of my saliva glands and it’s good for my teeth as well… she tells me.

    2. I use Xylitol as a nose-spray. I buy it in loose, bulk form, under the branding, Xylo-Sweet. I add it to a little water in a nose-spray type bottle and it is all that I need to keep my allergies and upper-respiratory infections at bay. Xylitol is often an ingredient (primary) that is used in naturopathic nose sprays, for allergies. My home-made concoction is about 75% less expensive than buying a Xylitol-based nose-spray product.

      I am also experimenting with Xylitol for collagen repair and growth. So far, I have only been able to determine that my skin “likes it” for its moisturizing and smoothing effects, but, it is still too soon to tell if it will repair age-related facial sagging.

      As a sugar substitute, Xylitol products are my favorite, taste-wise, but, I suspect that I do better with stevia-leaf products which have no effect on my digestion (IBD issues).

      Neither Xylitol nor stevia cause any significant glucose spikes, unless I use more than about 2 tablespoons.

      1. Just a comment on my reference to stevia — I know that on this thread we are comparing Xylitol to other products which specifically contain sugar-alcohols, which, stevia, I believe does not. Stevia products are produced directly from stevia-plants with no industrial processing.

        I make a tea from the loose, bulk stevia-plant herb and use that as a liquid sweetener.

        1. Extremely incorrect. The only way it is possible to get “unprocessed” stevia is to directly buy or grow the leaves. It is literly illegal to sell whole, unprocesed stevia in a product or in a bottle – “Stevia is LEGALLY REQUIRED to be INDUSTRIALLY PROCESSED to separate “Reb A” from “Reb B”, and one of those two parts of substances of the plant is not legal to sell as food or sweetener.

    3. Xylitol aka Zerose (Cargill) & XIVIA (DuPont): Is a poison to canine. Created in the late 1800’s, approved by the FDA in 1963. Lots of what appears to be reputable documentation, information citing it’s benefits and safety. Please remember Aspartame, NutriSweet and Saccharin(< was produced first in 1879!) Like all predecessors this FrankenSugar is being brilliantly re-touted with all the right stuff n bloggin-forces to boot w/studies, endorsements, 1/2truths, etc.

      They're chemically manufactured products that involve fermentation, high heat (for sterilization & creates unnatural harmful residuals), chemicals used in part of a process (hydrogenation).

      FYI in late June 2015, the FDA instructed ALL FOOD PRODUCERS to remove "TRANS FATS" from foods with 3 years ….finally! The Franken Sugars are strategically trenched in globally and will be here for awhile, although you have power to stay with the natural choice ~ Read: "Why George Won't Chew on Xylitol" ; P ThX

      "XIVIA™ C Crystalline form with the look and taste of sugar
      XIVIA™ CM50
      XIVIA™ CM90
      XIVIA™ CM170
      Primarily chewing gum
      Xylitab® 100
      Xylitab® 200
      Xylitab® 300 Directly compressible for simple tablet manufacturing – only available from Danisco Tablets
      XIVIA™ CX
      Microbiologically tested Pharmaceuticals, including parenteral nutrition and injectable treatments
      XIVIA™ CFP No endotoxins Pharmaceuticals, including parenteral nutrition and injectable treatments" source: DuPont-Danisco

  1. I can say that sugar alcohols (all of the mentioned) DO raise blood sugar at least in patients with type 1 diabetes.

    1. I would caution people about the use of sorbitol. Many of the complications of diabetes occurs because of an accumulation of sorbitol intracellularly and in the interstitial fluids. glucose is your best bet for a sweetener. it is not inflammatory, and every tissue in the body can use it as an energy substrate. evolutionarily speaking it is the original source for energy in animal life, just be careful with the insulin spikes of course – a healthy dose of fat with your sugar should slow down gastric emptying which should help mitigate the insulin response.

      1. “Many of the complications of diabetes occurs because of an accumulation of sorbitol intracellularly and in the interstitial fluids. ”
        Please provide a reference for this.

      2. “Glucose is your best bet as a sweetener”: This seems to be poor advice, if only because — although glucose is a simple sugar — it is 25% less sweet than sucrose, but provides as many calories per gram. “Glucose is not inflammatory”: This is best considered untrue. Glucose is hardly a neutral substance and is well-established to participate in nonenzymatic oxidative reactions in the body. The hemoglobin A1C test that diabetics get is a measure of the amount of oxidative modification that occurs in blood cells from glucose. SImilar reactions are believed to underlie many of the complications of diabetes. Many medical investigators regard glucose as pro-inflammatory.

      3. I am a type 1 diabetic (diagnosed age 6, now 31). My body responds to sugar alcohols exactly as predicted by their glycemic index. I have no reaction to erythritol and use it abundantly with no ill effects. I have no reaction to aspartame (diet drinks). Malitol (in most ‘no sugar’ treats’ spikes me as expected and I bolus assuming 75% of it will be converted to glucose). I avoid maltodextrin (very common in NSA treats) because it is WORSE than sugar (glycemic index almost as high as glucose). We T1Ds need to be educated consumers who check the scientific literature, not just notice that our BGs go haywire after eating some ‘no sugar added’ product and declare that all alternative sweeteners are high GI.

    2. Absolutely! I have to track ANY carbs, regardless of source, for proper diabetes mgmt. The “sugar free” sugary snacks are just as bad and potentially worse than the natural use of cane sugar in a food.

    3. I have a question about sugar alcohols. My husbad has a brain tumor and was told that tumors love sugar. So we cut out sugar and cut down the carbs as I understand the liver will still make sugar. Some people tell me that sugar alcohol is just sugar. Should we stay away from it? Or does it make good replacement?

      1. All dietary carbohydrates eventually turn into glucose in your body. Tumor cells don’t like glucose any more than the rest of the cells in your body do.

        1. Not true. One of the most commonly misregulated proteins in cancer cells is Glut-1, a glucose transporter protein. This protein regulates uptake of glucose into the cells (and its upregulation is partly how tumor cells survive). Thus, many tumor cells are tuned to be more sensitive to glucose. High glucose has a more profound effect on tumor cell survival than healthy cell survival.

      2. I hope your husband is doing well. You’re very smart to cut down on sugar and carbohydrate. Ketosis has shown to be very beneficial to individuals with brain tumors. Yes, the liver makes glucose, even without dietary carbohydrate intake. Glucose is required by your body – just not at toxic levels of the usual American diet.

        It is a good replacement for use once in awhile. It can make some have cravings and does effect blood sugar in a small portion of individuals. You can do some individual and inexpensive blood glucose testing with the various artificial sweeteners.

      3. I would stay away from anything sweet until the tumor is gone. I have read so much about cancer and glucose. I don’t know if the tumor is cancerous ( I hope not). But I have also heard of tumors especially in the brain going away on their own w/ extremely low sugar and carb diet. Sugar feeds cancer. Take away their food source and they die. Please do your own research.

    4. I agree, sugar alcohols may raise blood sugar slower, but they can actually raise blood sugar higher in a type-1 diabetic. They also seem to feed unhealthy gut bacteria.

    5. I am not diabetic at all and have very stable low blood sugar and tend to burn a lot of ketones on a moderate-carb paleo diet. I experimented with eating a malitol sweetened chocolate lately and tested my blood sugar afterwards and found it quite elevated indeed. It also gave me really bad bloating and gas….

      No need to repeat that experiment.

    6. I’m no diabetic, but hypoglycemic. And yes, maltitol made my blood sugar go rooler coaster.

  2. My personal experience with the above sweeteners are pretty on target as to what you described.

    Erythritol is great and I’ve been using it for years.

    There’s actually an amazing, full-fat cheescake that I’ve found at Whole Foods that’s made by a bakery out of California – Crave, I think.

    The crust is almond meal, cinnamon, erythritol, and butter and the filling is full fat cream cheese, full fat sour cream, and some Sorbitol. AMAZING not-so-cheating cheat.

    1. Wowww!!! That sounds awesome! I wish I could find it here in sc! My Dr has me on restriction from just about everything 🙁 no sweets no starches! I’m Italian and miss my spaghetti and Italian bread! I could most definetly go for some cheese cake 🙂

  3. I use Spry gum and toothpaste which are both sweetened with Xylitol and I personally think they are both great products. These products are made by Xlear, Inc. which also makes a good Xylitol sweetner to replace sugar called XyloSweet.

    1. Yes I use the Spry gum , mouthwash xylosweet. They are great IMO. I also use xylitol from Emeral inc and it is made from birch trees.
      I don’t experience diarrhea from xylitol anymore.

    2. I like the spry gum, I just wish it were a little firmer in texture and more like orbit (which has xylitol but I don’t know how much).

      1. Try googling “Zellies gum” – full Xylitol gum, firmer than Spry, great taste. I’m lovin the chocolate mint flavor!

  4. Any time I eat more than a tiny bit of sugar free jelly beans or candy I am in the bathroom in pain. I drink a lot of diet soda (sadly) and that never bugs me and neither does splenda (other than triggering cravings I suppose). Something about the sugar free candy destroys me. The sugar alchohol in protein bars dont hurt me too much.

  5. Okay, I don’t have something relevant to the article to say (mainly because I haven’t read it yet), however I am a Primal-ite…but on a local news channel here in the San Fran bay area (KRON 4 News) they just had an anchor come on with a news blurb that some research team (didn’t catch who because wasn’t paying attention until the rest of the story) has discovered that people who eat lots of fiber from whole grains are healthier and less likely to have cardiovascular problems such as heart disease. The went on to say that fiber from whole grains are superior to those from fruits and vegetables. Then concluded that those that eats lots of fiber from whole grains are overall healthier than those that don’t. I just was dumb-founded when i heard this and decided I should share this “gem” with the primal community, because even while great strides are being made to “cure” CW, it (CW) finds new ways to subvert change.

    1. I read about this briefly, and it was just a correlation study. People who eat a lot of fiber are less likely to eat as much highly processed foods as people who eat little fiber (assuming standard american diet). Therefore, it appears like fiber protects against those diseases.

      If they compared people who eat a lot of fiber to people who don’t eat a lot of fiber because they follow a primal/paleo eating plan, I’m guessing it would be a different story entirely.

    2. My experience: My initial response to grain fiber is, of all things, getting constipated. I am not going by frequency of bathroom visits here but by how my insides feel. (I might have IBS, I haven’t bothered asking my doc though as it can be difficult to diagnose.) Vegetable fiber’s better, but stuff doesn’t stay in my intestines long, which sort of makes it useless to eat it as far as I’m concerned.

      I read a study abstract a while back indicating findings that if you have a high fiber-to-fat ratio in your diet, you absorb less calcium. What sort of diet are the experts recommending for women now? High-fiber, low-fat. Is it any coincidence that we’re seeing more osteoporosis now? Doubt it. And that’s just calcium.

      1. Check out and “Fiber menace” (book). Very enlightening, and funny as heck, too :^)!

  6. Erythritol is great. Erythritol + stevia is my favorite general use sweetener and I haven’t had any problems with that combination.

    1. I love Erythritol. My wellness doctor in Houston had me start using it a year and a half ago. My blood glucose has come way down, as have my triglyerides. I find that if I mix it with Xylitol (about half & half) that it cuts the coolness a lot. I use it with almond flour and make pound cake and cookies with this mixture just fine and no gastric problems.

      I have to have my sweet fix often and this is great. I drink tea and coffee black, but have one “Latte” a day using full fat coconut milk and stevia. Good stuff!

  7. I keep reading about the questions about the safety of sugar substitutes and realize that I’m probably better off without them but I just can’t quite make that leap. I can do black coffee but I can’t do unsweetened. Just going to have to live with this one.

    1. I switched over to Stevia for my morning coffees. The taste is different from sugar, but you get used to it fast. I love it.

      1. Eating Primal has really curbed my appetite for sugar and although I use some of the sugar alcohols occasionally (and stevia), I try to avoid “sugar” in general. This coming from a former M&M binger. When I stop constantly bombarding my system with “sweet,” everything else tastes better!

      2. I switched too and it took me about a week and a half to get used to the taste…not I can’t tell the difference!

  8. Mark – thanks a ton for doing these posts. I wish I had the time to research these things, hence my love for MDA.

    When it comes to desserts, I do like my stevia, but we all went over that last week. I have NO NEED for sugar alcohols when I make desserts or drinks as I find that stevia is fantastic.

    The one place I do get them from is sugar-free chewing gum. I don’t chew it every day, but I do chew it. Trident Fresh Mint…its so tasty! I haven’t noticed any problems with re-introducing them into my diet after my recovery from IBS. During my IBS days, they were no good. Now, its not so bad, and I actually notice nothing from the 1-2 g I might get from chewing gum. Not for everybody, but at least I know I’m not slowly giving myself cancer (with that particular indulgence…).


    1. Gum doesn’t affect my IBS issues either, but fruit does, oddly.

      Wish I could enjoy Stevia, but it makes my coffee taste dirty… and not in a good way.

    2. I use to chew A LOT of Trident gum, then one day I was looking at the package and in bold it says it contains Phenyl something or other. I’m not sure what it is but its in coke zero as well. If I can’t pronounce it (and its in bold), I assume I shouldn’t eat it.

      1. That’s phenylalanine, which is an essential (human bodies can’t produce it) amino acid. It’s listed in bold because a small percentage of people have phenylketonuria (PKU) and can’t process phenylalanine, which causes it to build up in the body with toxic effects. You’d know if you had PKU and if that’s the only reason you’re avoiding Coke Zero and Trident, than use them without fear of phenylalanine. Nearly all sources of protein naturally contain some phenylalanine.

        1. As long as you have Tyrosine – another amino acid – in your diet , which is needed to produce adrenaline and dopamine , your body converts some of this , under normal conditions , to Phenylalanine. I dont know what it does if you have PKU but if you are worried about it speak to your Doctor – there might be a blood test that confirms your doubts.

  9. Several months ago (before going Primal) I was experiencing severe bloating and gastrointestinal distress. At first I thought it was “too many veggies” but upon further research I realized it was in fact – the pack or more of sugar-free gum I was chewing daily.

  10. Sugar-free gum helped my smile but definitely didn’t do me ANY favors ‘down there’. It was worth it to stop chewing the stuff all together. My recommendations?? Stick to brushing!!

  11. I wonder if this explains why I’ve have problems with my gastrointestinal tract lately…. Well among other things, but I think I’ve been drinking more diet soda, and chewing gum.

    1. Oh my, I cannot believe anyone concerned with health would still drink any kind of soda. Xylitol is good for you but I understand some have issues with it due to other health concerns. If you read at all you know that any diet soda, just one a day, increases you risk of heart attack by 61%. Too risky for me. I am so thankful for sites like this one to help answer questions about important issues in our diet. I am new to this site, and way of thinking, but feel that it is so very important in the big scheme of thngs… just keep reading. It is amazing what you can learn on the “net”. Be sure to look at the articles about Coke and the dangerous chemicals in it that are missing when it is sold overseas! Interesting that our Govt would allow these when other countries will not… very nasty stuff.

      1. One diet soda increases risk of heart attack by 61% sounds like complete BS to me. How does diet soda cause inflammation? Please tell me the “links”.

        Was everyone on the study eating the same, have the same exercise levels and stress levels? LOL.

      2. What about Zevia? Does it increase the risk of heart attack?

  12. I use Xylitol and stevia as my sweetners of choice. Xylitol replaces the white sugar in recipes nearly 1 to 1 perfectly. Liquid stevia is my new favorite, and I find it quite sweet. A few drops will do ya.

  13. I try very hard to limit us to stevia, though Hubby still uses Splenda in his coffee. The drive to remove other artificial sweeteners has been ongoing the last few years. We are so much better off.

  14. While I usually use stevia when I need a little sweetness, I have also found xylitol and erythritol to be very tolerable. They taste good and don’t give me the insulin rush that real sugar does. Moderation is the key with them. Recently, I discovered an ice cream company called Clemmy’s which is making full fat ice cream with xylitol. As a splurge, I eat 1/4 to 1/2 cup of it topped with nuts and unsweetened coconut.

    1. oh. my. god. You can order Clemmy’s online, too. I just looked. O_O *weeps* I am so sick of most of the low-sugar ice creams being lowfat as well. Breyer’s is all right, but they still have some weird ingredients in their low-carb version.

    2. Anyone who calls 1/4-1/2c of ice cream a “splurge” is my hero…. I haven’t had ice cream in months, but when I do, 1-2c. is “normal”…

    3. Wow thanks for mentioning this I am going to try it. I did no know about Clemmy’s

    4. I have tried Clemmy’s Ice cream now an it is DELICIOUS! Thanks for posting about it. It is a my neighborhoode Sprouts and I had never heard of it.

      Of course this will be an rare to occassional cheat since I try to minimize dairy.

      Thanks again

      1. I can not see why anyone knowing anything about carbs would knowingly eat this. I found it online, and checked it out. It is as high in carbs as regular ice cream. It also uses maltitol which has been shown to raise blood sugar levels in diabetics! And xylitol is usually the 4th to 8th ingredient on the list of ingredients. is not low carb!! Do a study on the sweetener used, and I feel you will not want to buy it…I know I won’t….just sayin!!

        1. …Yes, it has 100% harmfil ingredients, including artificisl sweeteners, pasturized and factory-farmed “milk”, factory-farmed egg yolks, THE LITERAL WPRD “PROCESSED”, and also every single other listed ingredient.

  15. Something that is just ever so tangential to this would be my concern w/ stuff in toothpaste such as sodium lauryl sulfate and triclosan that we are putting in our MOUTH. I mean the artifical sweetener is one thing but what about these nasty chemicals? I understand that triclosan (EWWW!) is only in Colgate Total but SLS is fairly ubiquitous and in pretty much everything that suds.. Grok didn’t have toothpaste.. what did he use?! Am I just becoming uber barbarian or what?! haha

      1. it’s not just the artificial sweeteners and other fun chemicals in conventional toothpastes that are a problem – its also the *glycerin* the problem is that the glycerin coats the teeth and it takes up to 25-30 rinses to get it off! coated teeth cannot be re-mineralized even if your saliva/mouth ph is correct from a good diet – dump commercial toothpastes of all kind and get some xylitol, hym. salt, baking soda and a little bentonite clay – mix (2 parts, 1 part, 1/2, 1/2 in that order) and add cloves, cinnamon, ginger – whatever – and you have a great cleaning and healthy tooth powder – and much cheaper to boot!

        grok probably picked his teeth and maybe around the ocean – swished his mouth with seawater – yes?

    1. I use Tom’s of Maine out of pure habit. I could probably get by with just baking soda, but my daughter would go into full-on rebellion.

      Weston Price reported excellent dental health in populations that had, as he put it, “green slime” on their teeth. Teeth are living things–feed ’em right and they tend to stay healthy. The hygiene thing makes your social life easier, but that’s about it; otherwise it tends to mask underlying health problems til they’re severe.

    2. The Sodium Lauryl Sulfate is from coconut, it is found in my Xylibrite toothpaste made by natures sunshine so I am sure it is okay, but the triclosan is not in it. It is an antifungal agent polychloro phenoxy phenol. The safety of this is currently under review by the FDA so you know it is not good.

    3. I had an Egyptian friend who made his own toothbrushes from twigs. He lived in Illinois at the time and I think he may have used Birch for this but not sure. He would cut the end of the twig on the diagonal and then make tiny crosscuts on that end surface, forming a sort of brush. He would just rub the end on his teeth and they were perfectly white and healthy. I found a wiki article that discusses the “Teeth Cleaning Twig” as well.

  16. Mark,
    Have you had any complaints about Truvia sweetner? I was using that for a couple of months and started having pain in my breasts. I have a history with some vascular problem in my one breast found thru having a thermography. Being on a yeast and sugar free diet and supplementation it cleared up in 3 years. Maybe I am susceptible for problems in that area but I sure was getting scared at the time and I know God whispered, “It’s the Truvia”. It would have never dawned on me that it was the problem. I am thinking it all cleared up within a week or 2 of stopping the use of it. Just curious if someone else out there had any issues with it.

    1. Truvia is not made from stevia itself but a chemical derivative. In online low-carb forums, people have reported a number of adverse side effects that went away after they stopped consuming Truvia.

      1. I am so thankful for MDA and the comments you wonderful folks put on it. Just when I think I’m doing something that ‘seems’ healthy, you let me know I’m straying into dangerous territory. I’m so trasing the Truvia today!

  17. I used to use Xylitol fairly regularly for tea and coffee before I learned to appreciate their unsweetend states. I never had any ill effects, but a family member who tried it had intestinal distress.

    I hadn’t heard of erythritol until a few weeks ago when I came across it in a low carb recipe. I wasn’t sure what to make of it, so I appreciate your review. It sounds great for using in occasional baking and treats! 🙂

  18. Damn! This post should have come in time for Valentine’s Day! Well-meaning boyfriend brought me home a dark chocolate bar that was labeled with “low-carb,” “gluten free,” etc. The first ingredient was maltitol. I nibbled on a square and didn’t have that nasty sickly-sweet feeling in my mouth after a few minutes that I usually get from table sugar, and didn’t get any GI issues. But a couple of big mystery zits have appeared in key places, usually a sign that I’ve ingested dairy, grains, or excess sugar.

  19. I’ve heard children that chew gum or eat candy sweetened with Xylitol have fewer ear infections.

  20. Has anybody ever heard of Lakanto? It’s an awesome sweetner! It tastes like brown sugar.Does anybody know the real way to calculate the carb count when you eat something that has a sugar alcohol? I’ve been told a few different ways and I’m a little confused.

    1. I’d say test your blood sugar after you eat the stuff. If it elevates there’s a carb count; if not, don’t worry about it.

  21. Thanks Mark! Our little community switched over to mostly xylitol for what sweets we produce for ourselves – your coconut treat recipe with xylitol is particularly good and we have ’em around alot –

    it bakes very well and although it won’t make you caramel as it does not caramelize so well – it’s flavor is very clean –

    make sure you get at least GMO free corn xylitol( NOW products) or go for the real birch stuff (emerald forest) – it’s very good –

    as for the bloating, bowel issues – we notices a very little of it in the first few days but had seen advice that this goes away – it does (for all of us it did) and the result is a very nice sweetener – good taste – functions well – yea!

  22. … and – another area, as mark mentioned, is that not only does xylitol not contribute to cavities, but several euorpean studies have shown it to actually arrest and prevent them as well – it seem the mechanism is that xylitol depresses the growth of staphylococcus mutens, the main cavity bacteria – and thereby actually actively fights dental caries.

    Over on DaiaSolgaia have an (anecdotal) account of how – when we discovered small cavities in our then-2 year old’s front teeth (from allowing her too much in-between meal fruit we think…) we have stopped totally the caries with diet adjustment (more primal!)supplementing cod liver oil and butter (as per Weston Price) and we only allow her xylitol-sweetened goodies – on top of that – a small dab of xylitol after she brushes her teeth discourages the caries bacteria. The result is – at 3 years old – the caries are no bigger and have even visibly re-mineralized – as dentin will do if given the right conditions. Enamel will not – so she is stuck with the small spots from the original damage but there is no progression-

    xylitol is cool…

    1. I bet it’s the diet more than the xylitol that did it, too. Bacteria tend to get a better foothold when you give them something easy to attack, whether that’s hard tissues or soft ones.

      1. i would agree – but we were not about to go halfway and risk NOT stopping the caries if we, in fact, could be successful –

        not quite ready to use my kid’s teeth as a study experiment – if ya know what i mean…

        1. I find I am just much better off not eating sweets….even ersatz ones with stevia or any of these. They just start me on a slippery slope of wanting more.

          I have found that having a small amount of starch with some fat included in my meal seems to satisfy me and keep my blood sugar from getting wonky …recently I have been having half a sweet potato with a small dollop of Coconut Oil as my dessert. Satisfies my sweet tooth

  23. Maltitol sucks. I only use it when I want some candy from one of the big name brands that offers a sugar-free version. I actually don’t eat candy all that often, maybe about four to six times a year at this point, and I suspect I’m overestimating. Usually at this point it’s when I really miss Jelly Bellies. And I always regret eating them afterward. OMG.

    Sorbitol’s OK I guess, but they use it in Dreamfields and if I have more than one serving I regret that later too. Not as badly as maltitol, I admit.

    I’m not that impressed by erythritol by itself. I almost can’t taste it. But it’s really good paired with stevia.

    The liquid multivitamin I use (yes, I use one) is sweetened with xylitol. It’s not vile, at least. And I have no dogs here.

  24. The only sugar alcohol I use is xylitol and that is in the Spry chewing gum. Love the peppermint flavor.

    Is it possible that it could help with a sore throat? Twice I have had the beginning of a sore throat, chewed a couple of pieces of Spry and by the next morning the sore throat was gone. Of course it might have been the extra D and the olive leaf extract I took too.

  25. I avoid Maltitol like the plague. But it’s really my own fault. About ten years ago now, we were all doing Atkins, and we found some fudgesicles that were low carb when we were out shopping a couple hours away from home. We were so excited, and so the three of us thought it would be a good idea to eat the *entire* box, instead of letting any melt… I think that was two, or maybe three a piece, I’m not sure. Like so many things, it seemed like a good idea at the time.

    I have never been in so much pain in my life, and just thinking about it makes me queasy LOL The two hour car ride home was, I can say honestly, the worst car ride in my life. I haven’t eaten a fudgesicle or anything with Maltitol in it since.

    Erythritol is good for baking almond flour based stuff. It gives it a good texture.

  26. I chew Glee gum with xylitol and it does give me gas and maybe a touch of constipation but I don’t chew it all the time.

  27. After being diagnosed with a corn intolerance recently, I found that almost all the sugar alcohols I had been eating for years (especially erythritol) were made from corn. And many from GMO corn. Now I react to them with a bad headache, including products like Z-Sweet and Swerve, which appear to be healthy and say that they’re non-allergenic. The only sugar alcohol I can tolerate now is birch bark xylitol from Swanson Vitamins and SmartSweet. Also, many stevia products are combined with dextrose, erythritol or corn-based xylitol so I only buy “stevia extract,” which is just 100% stevia.

    By the way, from what I’ve read Truvia is owned by Coca-Cola and developed by Cargill and is made by combining chemically modified stevia with erythritol that’s made from GMO corn. Some say that there are residues of methanol and ethanol in it. I assume that PureVia, which is owned by PepsiCo, is about the same. I will never touch either of these products, or anything like them, again.

  28. sugar alcohols make me feel sick! whew. 5 minutes into chewing a piece of orbitz or stride gum I can feel my stomach cramping. and back in the days when I used to eat “gummy” candy (great for hiding said alcohols) I knew two pieces in whether or not the bag was full of sugar alcohols.

    yikes. the stuff is dangerous.

  29. Ugh…I learned my lesson with malitol…I accidently picked up sugar free dark chocolate as a quick treat before school instead of my normal 85%….and mid-way through glass my tummy started grumbling…..

    …uh oh…

    AWFUL! I felt like I was going to give birth to the chocolate devil baby, the cramps were the worst!! Luckily I made it home before anything too exciting happened but I learned my lesson. NEVER AGAIN.

  30. Another vote for Xylitol. I buy it by the 3lb bag online…way cheaper than local. I baked a lot of things with it (and agave nectar) at Christmas to show visiting family just how easy it is to switch to a more paleo way of eating. There was like 3/4 cup of xylitol in the lemon ice cream and I was secretly afraid it might send someone running to the bathroom but NO ONE had a problem with it.
    Gum wise-I wasn’t pleased with Spry. Spit it out out of boredom within 5 minutes of chewing. Now I buy Trident, which is partially sweetened with xylitol.

  31. I have been a Sugar Free addict for years and STILL trying to quit. Still looking for the “Gum Patch”.

    A couple things always always happen when I eat ANY Sugar Free substitute except Stevia:

    1- MAJOR intestinal distress.

    2-A bloated stomach from here to eternity.

    I remove all things SF for a week and TADA! Things go back to normal.

    If it’s man made then it’s probably going to do some damage. My .02.


  32. Luckily for me I can not really stand the taste of things with sugar alcohol anyways. Every now and then I have a stick of sugar free gum if someone offers, but that’s about it.

  33. Sugar Free since 1996 here and dealing with IBS, candida, maybe SIBO…anyway here’s my experience
    1. dig stevia completely

    2. reserve birch tree xylitol for special occastions when I make flourless choclate cake. Will not freeze a lemon sorbet however!

    3. Have had bowel issues with both erythritol and maltitol and avoid them and sorbitol at every turn since I don’t trust it for good reason.

  34. Oh yea.. Lets get LOHAN into this discussion. Its a sweet Chinese herb that’s got my attention for the dark brown sugar taste but since its an HERB there’s no nutrition data on it.

    Mark how can I find out the effect of LOHAN?? I bought a bottle of finely powdered stuff and it tastes great in combo with Xylitol and Stevia because it broadens the flavor notes. However hus far I’ve only toe- dipped since I only find broad claims that it is safe but I want more info.

  35. I guess I’m really lucky: never had a problem with Xylitol or Maltitol. Love both of them!

  36. I don’t consider myself a “purist” by any means.. and although I don’t always succeed in staying away from sugar, I never knowingly ingest any of these alternative sweeteners.. there’s more to health than just blood sugar, insulin, etc..

    as mentioned in the post, xylitol for example, is manufactured mostly from either hardwood or corn (from wikipedia: Xylitol is produced by hydrogenation of xylose, which converts the sugar (an aldehyde) into a primary alcohol.).. doesn’t sound very natural to me..

    if I choose to make a treat, I use a little bit of honey or maple syrup.. I’m in no way saying those are healthy or beneficial, and I try to minimize their use.. but at least they’re recognizable whole / real foods..

  37. I wonder if adding xylitol in a smoothie containing fruit could mitigate the effects fructose may have on your dental health. I read that it helps regulate pH in the mouth, which could be beneficial since fructose is acidic? Or is it alkaline, cause I thought that only occurred in the body.

    That’s if fructose does have any effect on teeth within the mouth, or just all damage is resulted in the blood sugar spike it creates.

  38. I can only tolerate sugar alcohols in small amounts, as in a couple of pieces of gum. More than that creates intestinal issues.

    But has anyone had a problem with mouth sores from sugarless gum? If I chew sugarless gum daily, which I would when I exercise because it keeps my mouth from getting dry, then I will develop canker sores in my mouth. Regular gum doesn’t do that, so I switched to that.

  39. I only chew Xylitol sweetened gum. As far as cooking.. depending on sweetness required I use a combinattion of stevia and Xylitol or just Xylitol with very good results. If the item I am making only needs to be mildly sweet I can use more stevia since when I use it in high doses it has an aftertaste. With Xylitol you can’t tell the difference from table sugar.

  40. I was always suspect of the “sugar free” sweetened things, they made me feel like crap (literally) every time I ate them. Chewing gum makes me feel bloated and gassy…. I know some of that is the air I am swallowing, but I suspect it is also the sweeteners.

    I am really physically sensitive to artificial flavorings (savory or sugary) so I usually avoid them and go natural (honey, sugar, spice, salt) in small amounts.

  41. I used to Protein bars with sugar alcohols but had to stop because they gave “intestinal issues” and did not help me lose weight at all.

  42. I had my first experience with xylitol when I was offered some sugar-free chocolate made with xylitol at work one day. Oh my God, what a horror. I spent the entire afternoon in the bathroom, and was not sure I’d be able to get out and get home at quitting time! And since I don’t want to kill my dogs I won’t have xylitol in the house either. And malitol is even worse. I don’t eat any commercial sugar-free chocolates as I have not found any yet that don’t contain malitol.

    But I do sometimes make my own at home, melting unsweetened chocolate and coconut oil, and adding chopped nuts, etc., and I use erythritol these days. I love the taste, it has no intestinal effects, and doesn’t affect my blood sugar either.

    I’m afraid I still need “sweet” every now and then. I’ve tried to give it up but the longer I do without the more likely I am to fall face-down into a sugar binge. Having my own sweets every so often definitely keeps the sugar demon at bay. I love erythritol!

  43. I really didn’t think that any of these products were to be used in amounts large enough for baking. But I’m surprised that even small amounts such as gum will produce such bowel distress for some people.

  44. I slowly switch my family over to Xylosweet when I went Primal. It was a gradual thing, so as not to cause any abdominal distress for anyone. I now use it 100% for my almond flour baking and drinks, with no problems. My diabetic hubby,who hatea all things artifical, loves it. But we are super careful not to give it to our dog, as it is even more deadly for them than chocolate!

  45. Xylitol is a great gum! Make sure the gum uses xylitol as its only sweetener though, like Spry products!

  46. If you cut out all sweets for a week or 10 days, you lose the taste for it. Try just not doing any of it!

  47. I found that xylitol (I use Ideali brand) is excellent for making any baked goodies, tastes good in drinks, etc. I’m pretty moderate with it, and tend to use slightly less than the sugar called for in recipes, as it seems slightly sweeter to me. I’ve noticed no gastro effects specifically from it that I’m aware of, but it’s frankly hard to tell since I must take Metformin for my diabetic management, and it wreaks havoc on me. I have no dogs, only cats, but I am very careful when I use it not to spill any of it, or the treats that I make with it. My hubby reports that since he’s been enjoying the treats I make with it, he has less plaque on his teeth.

    I also buy a box of Rocky Mountain Chocolate Factory sugar-free chocolates now and then for a special treat. They use maltitol. I only eat 2 or 3 pieces per day, and have had no ill effects from it. It’s the best chocolate I’ve ever had. Apparently maltitol actually makes better chocolate than sugar.

    I tried stevia in a flavored water drink once. I believe it was Truvia or PureVia. It gave me a migraine almost instantly. I’m reluctant to try it again, but I wonder if one of the pure forms would be okay. Sadly, I’m prone to migraines, so I have to be careful.

    I’m not completely Primal yet (baby steps) but so far, I find that I mostly don’t use sweetener that much. My sense of taste is greatly improved with no sugar in my diet. These sweeteners don’t seem to have any effect on that. Unfortunately, being a cook and serious baked goods junkie, I’m having a hard time giving up the sweet in my life.

  48. My dentist has been recommending Xylitol for a couple years now. He swears by it and has seen results in various patients. He says the important thing is to have the equivalent DOSE OF SIX pieces of Xylitol gum a day to get the proper effect/benefits.

    I currently (tho sparingly because I don’t do much sweet stuff) use Xylitol from Birch Tree and mints that I got from Swanson’s. I also eat and give my 2 year old daughter Sparx Candy(tiny hard almost pure xylitol candies) as a much better alternative to other treats out there.

    Thanks Mark for all the great info! and again!

  49. I can’t believe people are buying into this artificial sweetener stuff.

    Read ‘Cure Tooth Decay’ and you” understand.

    Tooth decay is not caused by bacteria but by an imbalance of ca/phos ratio which all these artificial sweeteners cause.
    Your ph in blood and saliva changes and needs to be corrected with —> minerals.
    Everytime your ratio is out of wack you have tooth and bone decay.

    If you want to flame me go right ahead…but read Ramiel Nagel’s Book first.

    Trying to halt tooth decay with lab produced sugars…what else are these pharmaceutical companies gonna come up with. /sigh

    1. Sugar alcohols and stevia aren’t artificial sweeteners. Saccharin, aspartame, acesulfame potassium, and sucralose (Splenda) are.

  50. Xylitol doesn’t cause the irritability that sugar does. One regular cookie and I feel like everything is being done to purposely bother me. A cup of xylitol/almond flour based cake, however, has no effect. Of course, I also don’t get mood swings from sugar-heavy fruits either.

    And I know it’s not coming from expecting the result because I’ve suddenly realized I’m being irrationally cross and only remembered I had grain/sugars later.

  51. Good web site online! predilection the seventh heaven you might have on scheme here. Please run on the turning into occurring moreover I consign equal skookum tumtum to go to terribly frequently.

  52. I read recently that sugar alcohols including erythritol trick your mind/body – that it doesn’t know the diff and your “sweet” cravings escalate. Thoughts?

  53. I’ve been using xylitol for baking, and luckily for me, I never experience any side effects. I must say, when I first switched to a primal diet I was craving sugar like crazy and I would actually consume more and more food just because there was always SOMETHING missing. Thankfully xylitol curbs all my sugar cravings and I don’t feel guilty about eating it.

    1. Me too, I plan to use xylitol to sweeten my sweeten potato souffle and to sweeten my cranberries this holiday season. It is great and I use xylitol moderately usely once every 2 weeks.

  54. I have used Stevia, xylitol, erythritol and oligofructose as natural non GI raising sweeteners for almost 2 years now. I find Stevia to have a weird bitter aftertaste, almost like it’s synthetic, but the good side is that it doesn’t seem to affect my bowels. Xylitol tastes nice, but too much of it causes severe gastro distress! I now use a mixture of xylitol and stevia for certain things and I’m ok. The other two natural derivative sweeteners (erythritol and oligofructose from veg and fruit) are great in crystal or powdered form (like icing sugar). I put the powder in whipping cream for a guilt free dessert topping. What’s more, I have NO gastro effects from either of these and in fact, they are prebiotics and feed the good bacteria in your gut! I have not noticed that this has been a detriment to my weight loss efforts. In fact, I’d say it’s kept me on the straight and narrow during “dark times”. You know what I mean. I will not however touch malitol or any other fake lab chemical mixture because the natural alternative exists, and by my experience, works!

  55. I am a grandmother of twin 14 month old boys they are not identical thank god. One of them has a very rare disease called CSID congenital sucrase-iaomaltase deficiency. His body does not make any enzymes to process sucrose, fructose, maltose, and any starches. If he has anything with this he has the most severe diarrhea you could ever imagine, I was changings his diaper once when we still had not found out what wrong with him, it came out like someone turned on the water faucet. They say this is congenital and he will not grow out of it. According to the website many people they believe they have been misdiagnosed, with other bowel disorders such as IBS or short bowel. I was diagnosed with IBS when I was young and have always watched what I ate no salads or I would bloat up turn really white and felt like my insides were coming out I had better be close to a restroom or I was going to make a mess. It was just liquid and I felt weak and faint. Come to find out i think I was misdiagnosed, because after finding out this what he has I decided to eat only things he would be able to and with out exercise just watching and making sure nothing I ate had any sugar, fructose, corn syrup, starches, or maltose in it I lost 87#, no longer have diabetes, high blood pressure or stomach issues. He does not know it yet but he probably saved my life. If you have any of these problems I would get on this website and then have my doctor do the upper and lower GI with the biopsy and seen them to be tested for CSID.

  56. Until today I had no idea I should worry about sugar alcohol. Then about 3 weeks ago I started drinking a zer calorie drink regularly. Suddenly my “IBS” went crazy. I cast about for a reason…stress? Food? Change is cloud cover (haha)? Found sugaralcohol. Specifically erythritol – supposedly the kindest and best. I thought I was being turned inside out by some horrid growling alien beast! No more sugaralcohol for me.

  57. One time I ate ONE cookie from the Whole Foods bakery that was sweetened with maltilol. I consider myself to have an iron gut and nothing ever bothers my digestion. Except that cookie. I had 3 days of bloating, gas, and abdominal pain.

    Never, ever, again will I consume maltilol.

  58. I found this post because I was trying to find info about erythritol… I have some sweetener stuff at home that is stevia + erythritol, and I wanted to be sure it is okay to consume. I really wanted to forego any sweet stuff since re-committing myself to primal (let myself go over the past few weeks), but I was having a very bad “sweet craving” so had a cup of tea sweetened with it. I now have a rotten headache, BUT I have no idea if it was the sweetener, or the fact that I’ve ditched sugar today completely and my body is giving me withdrawal symptoms!

    I’m thinking of making some stewed apple sweetened with blueberries tomorrow to get my sweet fix. I eventually want to avoid sweet stuff altogether, but I’m not sure I’m ready yet!

  59. Just wanted to confirm that sugar alcohols should be avoided by people with IBS or IBD. I had a negative reaction to Clemmy’s that I usually only get when I eat wheat. Since it’s gluten free, I guess it had to be the sugar alcohols that irritated my stomach so badly… Good to know for future reference.

  60. Was eating about 5 xylitol mints a day and the occasional piece of gum. Had very bad digestive problems, loose stool, loud stomach groaning and uncontrollable gas. Horrible stuff. I had no idea what the cause was for over a year. I don’t trust that stuff at all. I have no issues with any other type of food. beware. problem is gone as soon as I stopped all xylitol consumption.

  61. My first experience with sugar alcohols was with sugar-free chocolate candy. I thought I had flu. The second time I examined the contents on the candy and found 22% sugar alcohol. Then it happened again with lite ice cream (6%). That did it for me. From then on I checked the ingredients and now when I see sugar alcohols listed, no matter how much, I put it down. It’s not worth the intestinal reaction I have to it. I’d rather do without !!!!

  62. I find after having protein bars with sugar alcohol im in paid for two days… I happen to give them up when I tried a new bar yesterday and forgot to check for sugar alcohol and I suffered last night and now today…
    I have now decided to get as much info on sugar alcohol as possible!

  63. I bought Glee Gum with xylitol online and after using it consistently and daily for a month or more, I found it DID DID DID regrow tooth enamel on broken teeth

  64. Thanks for all the sharing. My expience is that I have/had oral Candida..and went on a very low carb eating plan ( ) , Had great success. BUT, since I have a challenge with moderation, I would chew 5 to 10 pieces of xylitol gum…or have the same number of mints with xylitol…and after three more bouts of a mouth that felt like rough sandpaper had been rubbed on all the mucous membranes, I figured it was my excess xylitol. If I have more than a little, my mouth startes to “zing” and I know it is time to stop.There is no challenge if I use moderation…one of my life lessons. To date, I have not seen any information about this.
    The good thing is that I get a body message about any problem foods. My mouth “zings” with any bread, chips, legumes, grains, or other high carb food. But the xylitol is a conundrum. Any insights are most welcome.

  65. Like a number of you here, I had a very bad reaction to sugar alcohols. I already have digestive issues without them and have been searching for whatever info I can on them. Do any of you know if consuming sugar alcohols that occur naturally in foods (fruits, veggies, oats…) has the same negative effect on the body as consuming added sugar alcohols? I will be speaking with a doctor about this and my diet soon, but was wondering if any of you felt a difference.

  66. This article asserts that the negative effects of sugar alcohols “are all fairly subjective, so it’s safe to play around with them and determine their role in your life based on how they affect your appetite, state-of-mind, and any other subjective health markers.” However this is not true. The thing to remember is that sugar alcohols are not absorbed by the body, which can cause a lot of digestive and elimination problems.

    The typical recommended sugar alcohol serving size is around 50 grams or 1.7 ounces. If this is exceeded, the sugar alcohol works like a laxative and causes cramping, farting, pooping and sometimes extreme diahrrea. A laxative effect is NOT SUBECTIVE. The people who are most at risk are children, people who are under average height or weights, and people who are prone to gastro-intestinal problems.

    Sugar alcohols are all highly processed fake foods. Not quite sugar and not quite alcohol. Eat them sparingly.

  67. I used xylitol for a while and finally decided I needed to set it aside because I found that it was so much like sugar that it kicked off old overuse tendencies. Over the last few months I have pretty much gotten used to nothing. And nothing is okay.

  68. Cannot tolerate any of these. My stomach explodes. I can’t believe that nobody else reacts.

  69. I cannot tolerate any sugar alcohol. If I ingest a little – I get terribly bloated. If I ingest more than a little (say a drink that uses it), I get diarrhea. I am finding this stuff in everything and I am dismayed. I eat gluten-free, some meat and tofu when needed for protein with little red meat, and dairy (yogurt mainly, also lactose problems). All of these sugar alcohols wreak havoc in my intestines. If I accidentally eat some, I can tell, and then I go read a label. Just discovered it in my whey protein ….. grrrrrrrrrrr …. Perhaps I am the only person in the world who cannot tolerate this stuff. Or perhaps I am the only person who has figured it out. My guess is that these will not be considered healthy options in 5-10 years. But that is a guess….. – ginnis


  71. I realize that we’re all different, however, I think my situation is important to note. I’ve been reading today that if these polyols are used in high dosages it may cause diarrhea. Well, I was using 1/3 the recommended dosage (1/3 scoop of protein powder per day for 5 days). I quit using it because I realized it was probably xylitol causing my problems.
    Now the diarrhea is gone and I no longer consume polyols of any kind!

  72. Hi All,

    Have read the above thread with interest but not sure i have had the question that bought me to this thread answered and wondered if anybody could shed some light on it for me. In the 21 transformation book, Mark lists Xylitol as something to be avoided in the beginning of the actions chapter. I came to this thread trying to see why he suggested it to be avoided but it doesn’t seem to me like he is saying it should be avoided in this thread. I could be miss reading this and may have the explanation right in front of me or one of you could shed some further light. I have had a sweet tooth most of my life and am now trying to adhere to the Paleo/Primal way, i have cut out so many things but i still enjoy a cup or two of Decaff tea with a small spoon of Xylitol in it. And when we cook instead of sugar or other sweetener recommended in the recipe we substitute for Xylitol. I was a bit wobbled by the thought of having to drop the Xylitol too (Big Baby, I know… lol) but hoped to find out why Mark was suggesting it before making an informed choice on whether to stick with it or bite the bullet and drop it. Anybody?

    1. I think in the beginning 21 days avoiding xylitol is to prevent wanting more and more and then going to the hard stuff: real sugar. Once you are well grounded in the primal lifestyle yo can experiment, but if you see you do not tolerate it well (physically, or it leads to emotional sugar cravings) then you got your answer.

  73. I ate some small samples of sweets yesterday made with “Swerve” (Erythritol + Chicory) and broke out into hives about an hour later. This morning have some not so fun joint tightness and pain in my hands plus still moderate hives even though I took two doses of Benadryl to try to knock down the allergic reaction. So apparently I am one of the people who has the rare hive reaction to Erythritol.
    For me this supposedly safe sugar alternative is completely not worth it.

  74. I have tried to find an answer to the question why ALCOHOL (i.e. wine, whiskey, beer) are “allowed” on the Primal Blueprint eating plan, can anyone answer this for me please? My understanding is that alcohol comes from the sugars?

  75. I just tried the sugar alcohol chocolate mints and man r they good! But I was wondering why I had to stay close to a toilet and now I know. I was having terrible stomach aches and then it Thanks for the insight…definitely wont be buying them again!

  76. I use xylitol and erythritol for baking at home. (For applications like sweetening drinks where I don’t need the bulk of a sugar alcohol for texture, I just use stevia.) I also buy some maltitol-sweetened ice cream and chocolates. I think they help my long-term low-carb lifestyle more pleasurable. The digestive effects tend to kick in if I have more than 2-3 servings in a day, so they’re pretty easy for me to avoid by staying within my limits.

  77. i have diabetes type 2 – sugar alcohol spikes my glucose levels significantly. my levels are normally under control but if i have something with even a little bit of sugar alcohol, i can see my readings go up to a number i haven’t seen for a long time. so i don’t know, overall, how it affects others with diabetes, but i’ve learned that for me, it’s best to stay away from it.

    1. Educate yourself. All alcohol sugars are not the same. Some make folks get cramps and diarrhea. Some have a gylcemic number. Erythritol does not. I cannot take the time for your education. The info is out there and Erythritol is great…I use it for everything…get it from an Internet source, 5 # bag is under $30. Very few people I know have had any negative issue with Erthritlol. YOU SHOULD NOT GET A SPIKE WITH IT. IT IS ZERO ON THE GLYEMIC INDEX.BUT you cannot eat breads/chips/rice/corn and other grains…that is what is most likely tipping your blood sugar.

      1. i AM educating myself. i was only diagnosed for a couple of months. and cathy – i DO use the internet. there’s a lot of information out there for a new diabetic to ingest. i wasn’t eating any breads/chips/rice/corn – lots of that stuff i cut out right away. i exercise – fit as a fiddle. just genetics are not in my favor. my BG is now very normal. but MOST sugar alcohol will still spike my levels. erythritol is not as bad – but it has a little effect on me as i can not tolerate sugar alcohol very well. not every one is the same so i still go by what i wrote before. it affects people differently. if you educated yourself as you are telling me to, you would know diabetes is not managed exactly the same for everyone. your assumptions that i was dead wrong. i have background studies in nutrition and food science. but that doesn’t mean even i go around assuming i know everything. or that people aren’t educating themselves as you put it. i repeat – there’s a lot of contradicting information out there and new information/research ALWAYS popping up. you would know that if you actually used the internet as much as you claim you do.

        1. So sorry to push your emotional buttons. That is one of the huge problems with typing a note…You could not hear the compassion and understanding in my typing. The only reason I suggested you search the Internet is because I did not have time to type the solution, when I saw your note. You are doing the best you can. Of course, you are. We all do. AND periodically we learn something really amazing. I am a 70 year old holitic registered nurse who speicalizes in nutrition and Energy Medicine. No one has the same body, or the same answers. BUT there is a huge cultural disconnect with what to eat in this country. 99% of the people I know, report that they know they should eat better than they do. Most of those who eat well, do it because they had/have a health issue that forces it. Personnaly I knew what good eating was….but took 65 years to be 100% on board. I ate well for the past 40 years…but not well enough. May your journey be paved with solutions. Sorry about offending you…not at all my intention.

  78. I`m scared about sugar alcohol. I am worried that something bad can happen if i drink milk after i eat a 2g sugar alcohol quaker bar. My dad says that since its only 2 grams, you won`t taste it. Someone please give me advice that its nothing to worry about or that its not the same as normal alcohol.

  79. Caramel Turtle Truffle from Baskin-Robbins did a number on my stomach this evening. The bloating, diarrhea and gas I had were the worst I have ever had. it had me running to the restroom every half hour or so. The ice cream was delicious while I was eating it, but now I’m paying the price. Beware of sugar alcohols. 🙁

  80. I like to buy and consume sugar free chocolate bars from Trader Joe’s, but I was concerned when I found out that one of the ingredients is maltitol, which is made from hydrogenated corn syrup. Since I believe that all corn produced in the U.S. is GMO, I have reason to believe that the corn used to make maltitol is also GMO, and that the hydrogenation of that product makes it an unhealthy food source. Any information about this?

  81. Sorry guys, Xylitol is metabolized the same way as fructose,i.e. it stimulates visceral fat (de novo lipogenesis)* Seems that since it is a form of powdered alcohol it is metabolized the same way as ethanol(remembering that fructose is fermented into an alcohol too). I can’t seem to find any negatives on Erythritol though. Up to 90% is left unmetabolized and excreted.

    * Effects of xylitol on metabolic parameters and visceral fat accumulation
    Kikuko Amo, et al.
    J Clin Biochem Nutr. Jul 2011; 49(1): 1–7.Published online Jun 17, 2011.
    doi: 10.3164/jcbn.10-111

  82. Your information on sorbitol is not accurate. It does raise blood sugars, but more slowly and less predictably than sugar because of its tortuous digestion. It provides 2.5 calories per gram (60% the calories of sugar), but is less sweet so often more is used. By the time it gets to the liver it’s fructose, and will contribute to fatty liver and liver insulin resistance. Diabetics, and possibly everybody else, should avoid it at all costs.

  83. Just wanted to say thanks for taking the time to share this information. Very useful stuff!

  84. You did not cover monk fruit aka Lo Han. It has finally become available at my local grocery store though I have not looked at it closely. I stumbled across some info about it a few years back, it it was very expensive. Is it a viable alternative? And what about Coconut crystals? I rarely drink coffee, but every other sweetener ruins the taste for me except the Coconut Secret Coconut Crystals (tree sap). What are your opinions on these. I am very new to Primal and even thinking of going Keto first to see if it will help me lose weight. I have many chronic illnesses including Lyme which me being over weight only worsens my situation. At the present time if I use a sweetener I use Xylitol and ofcourse coconut crystals in my occasional cup of coffee (with coconut butter, & raw butter).

  85. As a long term diabetic, now suffering with heart disease and periodontitis I have recently tried xylitol for the gum disease WITH DISASTROUS RESULTS. I had read that putting a teaspoonful of it in the mouth to dissolve and mix with saliva and then “pulling” with it as in swishing in an oil pulling manner, would saturate under the gum line and the bugs would eat the polysaccharide and not be able to assimilate it and die. After five minutes I spat the whole lot out into the sink. I did this as recommended four times a day for two days. My blood sugars increased steadily until after two days I had to stop as it climaxed in an incredible 27 (sorry that NZ reading but believe me its really high – 6 is normal). Interesting that so much of it was metabolised through the mouth only. In addition, my teeth became sore and sensitive and gum began bleeding again (they had stopped bleeding for a few weeks using salt water pull). Not impressive but not long enough to tell if it kills bacteria. In all likelihood it may kill some but not others. It has been demonstrated that swabs of gum disease show different levels of a variety of bugs so perhaps it works for some and not others? ALL I KNOW IS DON’T DO IT IF YOU ARE DIABETIC.

  86. I cannot believe that sugar alcohols are still used. I found out the hard way about 20 years ago that sugar free gummies ( then with sorbitol) made me sick enough to go to the emergency room. I had no idea what was happening to me. Then, there is maltitol! I have IBS and cannot tolerate any amount of this poison. Why is it necessary to sweeten candy, cakes, etc. with sugar alcohols? If I make sweets at home, I use Splenda and have no “gut” reactions. A baker once told me sugar alcohols are used because they are the sweetest (translantion cheapest) way to sweeten. I am not amused when the warnings say:Excessive consumption MAY cause a laxative effect. Really! One piece of gum causes me gastrointestinal distress. I know so many people that can’t use these products. So WHY do they still exist? I have found that any ingredient ending in “tol” will knock me off my feet. Anything that can cause a reaction like that in so many people is not a good product and (in my opinion) should be banned! It is such a serious problem that companies have changed the names of these ingredients since they know people have figured out the endings of the trouble makers. And, Zylitol!!! You think this is a good ingredient? When I was a child I ate a bar or Exlax thinking it was a candy bar. The experiences I have had as an adult with sugar alcohols were much more drastic than the Exlax and that is a horrific memory. Oh well….bottom line is I will not purchase any processed foods that have even a hint of sugar alcohols in them. No sorbitol, no maltitol, no xylitol. Poison!

  87. Any new news on artificial sweeteners? I just bought xylitol made from birch (trying to avoid corn and GMO) I love the taste, I use it sparingly. Is it still considered fairly safe? Or have any new studies come out it causes big toenail cancer or something? Thanks in advance for any info

  88. Have any of you tried monk fruit? It seems to be the new thing in natural sugar substitutes, and I’m wondering how it stacks against erythritol .

  89. I’m a user of xylitol: I use it in my morning espresso and for home baking. I love it’s subtle sweetness and have never experienced and of the side effects listed. It’s a great substitution for sugar, honey or maple syrup in recipes. I’ve baked cakes, cookies and pies with it, and my non-primal family and friends haven’t noticed a difference. I think it’s a great sugar substitute, better than any paleo-approved ones.

    1. I completely agree. I may use a little in my coffee and tea. I use xylitol when doing any “paleo” baking which is not that often. The amount I consume is minimal. But as stated above it is a great substitute for sugar. I have never experienced any issues related to xylitol.

  90. I’ve been reading recently that Sorbitol can’t be readily disposed of by Diabetics and can build up in the blood stream leading to many types of Neuropathy and Cardiovascular damage. The implications are it might explain much of the damage experienced by people with Type I or Type II.

    The rest of us however don’t get a free pass. High levels of Glucose can be transformed into Sorbitol in the body and lead to the same types of damage in people who are not diagnosed as Diabetic.

    I’m reading this second hand, but to me its very scary stuff.

    I had heard also that in the Colon various bacteria can take the various Polyols and interconvert them into each other. Ironically one that keeps getting mentioned is into Glucose causing a secondary spike after the primary from a meal and then into Sorbitol since the body is exhausted from the production and release of Insulin to process the primary.

    I have a hard time staying away from the “sweets” but this new information alarms me enough to fight the urge harder.

    Xylitol on the other hand has been implicated in promoting “more” tooth re-mineralization by conducting Calcium ions deeper into any exposed dentine.. the mechanism not entirely understood. So I’m frustrated with Xylitol.. I want to use it to help my teeth.. but if its got a pathway to Sorbitol.. I’d like to avoid it too.

    1. Its a little intriguing though that Sorbitol and Myoinositol appear to both be mentioned in in articles about Neuropathy and high blood glucose.

      Sorbitol for causing the problems, and Myoinositol for being exhausted in the presence of high blood glucose. They both interact at the glycoprotein level studding cell surfaces.

      Myoinositol is known for treating women with PCOS – Poly Cystic Ovarian Syndrome which seems to be related to high blood glucose levels.

      Myoinositol is itself a carbohydrate, but its also known as a cellular building material, more like an essential fat. If there is not enough, things like Insulin resistance show up. I gather its rather like “conduit” building material from the inside to the outside of the cell.. its used for building receptors for signals like Insulin.

      Sorbitol seems to snuff out the receptors and Myoinositol seems to be what’s needed to rebuild them.

      It takes a long time to remove Sorbitol from the body, so I’d guess it could do a lot of damage. If Myoinositol levels fall that damage could be magnified.

  91. I have type 2 diabetes and Maltitol will definitely spike me. Xylitol is “okay” but will give me a glucose bump. I do not like the toxicity factor for my pets. My choice is Erythritol because it causes no glucose effects for me, comes in a confectioner’s sugar grind as well as crystals and is not toxic to my pets. I have been doing more baking and experimenting and find, as others have, that the ultimate combination for best results is Erythritol and a bit of Stevia glycerate. This combination gives you the best results in sweetening without overdoing the Erythritol because in my family two members report that everything tastes sweet after eating erythritol- air & water- and they do not care for that. The stevia lets me use less erythritol and that improves things. The glycerate form is less bitter and keep in mind that all of these products differ among brands. I have used Now brand erythritol, Pyure (stevia/erythritol blend) and Swerve. Among those I prefer the Swerve. I also prefer Sweetleaf stevia over some other brands.

  92. I have type 2 diabetes and Maltitol will definitely spike me. Xylitol is “okay” but will give me a glucose bump. I do not like the toxicity factor for my pets. My choice is Erythritol because it causes no glucose effects for me, comes in a confectioner’s sugar grind as well as crystals and is not toxic to my pets. I have been doing more baking and experimenting and find, as others have, that the ultimate combination for best results is Erythritol and a bit of Stevia glycerate. This combination gives you the best results in sweetening without overdoing the Erythritol because in my family two members report that everything tastes sweet after eating erythritol- air & water- and they do not care for that. The stevia lets me use less erythritol and that improves things. The glycerate form is less bitter and keep in mind that all of these products differ among brands. I have used Now brand erythritol, Pyure (stevia/erythritol blend) and Swerve. Among those I prefer the Swerve. I also prefer Sweetleaf stevia over some other brands. I am however, still experimenting.

  93. Hindered I’d say. It’s either that or the excessive dairy which I don’t doubt hinders fat loss thanks to Marks research.

    I’ve been doing Low-Carb going on years now and just this past week I gained for the first time despite being cheat free. Suffice to say I’m fascinated.

    I binged on cheese, cultured cream, and lots of chewing gum. So either it’s the sugar alcohols, dairy or both.

  94. I ate an entire bag of Worther’s sugar free caramel candies. About 14g sugar alcohol in a 15g serving. I forget which sweetener Worther’s uses, but about two hours later, I got a terrible bought of diarrhea. I’ve eaten them before without incident (but never a whole bag at once). Proceed with caution.

  95. I purchased magnesium glycinate powder which had xylitol added.Every time I took it,I would have stomach pain and heartburn.I had used magnesium glycinate before with no problem.I then read that xylitol can feed bad bacteria in the gut.Worst part is no idea how much xylitol is in each serving. Plus I had no idea it was poison for dogs,not that mine can get to it…….but it is going in the garbage..

  96. Lately, there has been research reported about saccharin, nutria-sweet and sucralose vein implicated in obesity (!) because they affect gut flora dramatically, and essentially make people insulin resistant.

    Has there been any such research or even concern that sugar alcohols might do the same thing?

  97. I recently found out I’m deathly allergic to glycerin.
    I’ve been researching but still am not sure if I should avoid all polylols, or sugar alcohols…
    How can I do this? Also, I know it’s made from vegetables.
    I’m not sure what to eat. I’ve become vegan and am trying to eliminate processed foods and it has helped, but it’s still very confusing. Can you help?

  98. I have recently begun experimenting with sugar alcohols. I am one of those peopel who can’t seem to tolerate Xylitol…it ALWAYS gives me cramps. It’s a bummer too, because I can tolerate the taste. Now, I just got some powdered Erythritol (Swerve brand) and made chocolate chia pudding with it. It’s so far so good with this stuff and reminds me of Xylitol with the taste. I got powdered because I read it was easier to work with in baking and desserts than the granular because it dissolves better. I will update later.

  99. I have found xylitol, and erythritol highly beneficial in losing 70 pounds in less than 6 months. I have not experienced any bad effects; I am using the Trim Healthy Mama products, or organics, to avoid chemicals and GMO products. I delayed pursuing this alternative way of eating for a year because I was concerned about the sugar alternatives, but found enough comfort in legitimate studies.

  100. Thank you so much sorry this! I have been on a keto diet since December, but only recently discovered sugar free candies and chocolate bars. I became lazy and overindulged and I have had nothing but gas and cramps and diarrhea as a result. I feel better informed now, and I will only be eating sugar alcohols in homemade treats made in small batches. I have a problem where when I buy a whole bag of candies I tend to eat he whole thing fast. Thanks again for this very informative article.

  101. None of these can possibly be safe because ALL of them are either “extracted from” something or are manufactured, so obviously they contain pesticides, metals, etc., and also are “isolated”.

  102. Erythritol makes my kidneys hurt, bad, which makes sense since it is filtered through the kidneys, which doesn’t make it seem like it’s very healthy!

    And whatever they put in the sweetener, Sweet Luv, they don’t specify, gives me a headache. That being said, I don’t think any of these sugar alcohols are very healthy.