KenDBerryMD - Should You STOP Erythritol? [Erythritol causing Heart Attacks?]

Short Summary

Main recommendation: Minimize erythritol-containing treats and drinks, especially if your diet relies on frequent erythritol-sweetened products, because a recent Nature Medicine study linked high erythritol intake to heart attack, stroke, and death. The speaker stresses the study shows only an association, not proof of cause, and that the concern is mainly for people consuming very large amounts daily. He advises that people who only occasionally use erythritol, or use it in toothpaste or mouthwash, should not be particularly worried.

Key Points

• The study reported a possible association between continuous erythritol consumption and major cardiovascular events, with roughly two to three times the risk among the highest consumers.
• The speaker notes the study is observational and non-randomized, so it cannot establish causation, and people with pre-existing risks like diabetes or obesity may be the ones using erythritol most.
• Two mechanistic experiments suggested erythritol made human platelets stickier and shortened clotting time in mouse carotid arteries, offering a plausible pathway.
• The study assumed average US intake of about 30 grams daily, while the FDA cites roughly 13 grams, and 45 grams was used as the 90th percentile of intake.
• Dr. Berry states blood erythritol can rise up to a thousand times above normal physiological levels after ingestion and can stay elevated for two to three days.

Details Worth Noting

• Concrete instructions: Review your daily intake of erythritol-sweetened products such as keto pancakes, syrups, desserts, sugar-free beverages, coffee, tea, and protein drinks, and reduce them. Wean down sweet-tasting foods and drinks gradually, aiming to stop them over time rather than replacing sugar with large amounts of erythritol. Occasional use of erythritol-sweetened treats or beverages is considered low concern, and toothpaste or mouthwash use is described as inconsequential.
• Dr. Berry notes erythritol occurs naturally in some mushrooms, watermelon, grapes, pears, and fermented foods such as wine, cheese, sake, and soy sauce, which he says is why it holds GRAS status.
• According to Dr. Berry, erythritol was first made by chemist Stenhouse in 1848, isolated in 1852, found in blackstrap molasses in the 1950s, and mass-produced starting in Japan in the 1990s.
• Dr. Berry says about 10 percent of ingested erythritol reaches the large intestine, which can cause cramping, nausea, watery stools, or flatulence in some people.
• The speaker says earlier studies reported beneficial effects of erythritol on endothelial function and cardiovascular risk markers, suggesting that dose may determine the effect.

Bottom Line

The concern centers on large, habitual erythritol loads from sweetened products rather than occasional use, and the evidence so far is an association plus a possible clotting mechanism, not proven harm.