Podcast episode 119 (in German)
Erythritol and xylitol – a thousandfold, measured in ten people
October 27, 2026
30 grams of erythritol raise the blood level from 3.75 to 6,480 micromoles per liter, more than a thousandfold, and afterwards platelets clump more strongly. This episode examines what lies behind the headlines about erythritol and xylitol — and why a blood value is not yet a food diary.
What it is about
Erythritol and xylitol are sugar alcohols: sweet, almost without energy, and found in sugar-free bars, chewing gum and toothpaste. Two large observational studies in heart patients found more cardiovascular events at high blood levels; two small experiments in healthy people showed that platelets react more strongly after a portion. The episode takes both seriously and then asks the question missing from the reports: the body produces both substances itself from glucose, and more of them when blood sugar is high. The same measured value can therefore be a cause or an indicator of a diseased metabolism. The conclusion is not an all-clear but an open question — and a calculation anyone can do themselves: how much of it is actually eaten per day.
Key points
- After 30 grams of erythritol, platelets clumped more strongly in all 10 healthy volunteers, with every stimulus and at every level; after glucose this did not happen.
- In the 2023 study of over 4,000 heart patients, the top quarter of erythritol levels in the two validation cohorts had an event about twice as often over 3 years.
- For xylitol, the risk in the top versus the bottom third was 1.57, confidence interval 1.12 to 2.21 — discovered in 1,157 people, confirmed in 2,149.
- In the Nurses’ Health Study with 762 women with coronary heart disease, the value for erythritol shrank from 1.55 to 1.21 as soon as diabetes was taken into account; the confidence interval of 0.86 to 1.7 includes 1.
- The body produces both substances itself; for xylitol a review estimates 5 to 15 grams a day, but the fasting level stays low because it is immediately processed further.
- In 2023 the European authority for the first time set a maximum amount of 0.5 grams per kilogram of body weight, around 35 grams at 70 kilos — derived from the diarrhea threshold, not from the heart.
- A Korean survey of 110 products arrived at an average of just under 14 milligrams per kilogram a day, for adults about 1 gram instead of the 30 from the experiment.
Where the data stop
What the experiments measured was how sticky platelets become when they are stimulated in the laboratory — no heart attack, no long-term administration, 10 people each on one afternoon. The cohorts consisted of people undergoing cardiological evaluation, and none of the studies recorded what they ate, only the level in the blood. Because the body’s own metabolism produces more of it when blood sugar is high, the value may be a consequence of a disease rather than its cause. Genetic variant analyses were supposed to settle this and contradict each other: a 2024 study found no indication that erythritol drives coronary heart disease, a second one found the opposite.
The other side is thin too. The Finnish study, in which 52 people ate an average of 67 grams of xylitol a day for 2 years, examined teeth, not platelets, and is known only from a review. For the dental benefit, the Cochrane review of 10 studies found a single supported comparison, for toothpaste. And erythritol was compared against nothing everywhere — in everyday life, the alternative is sugar.
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Published on October 27, 2026.
The topic in the database
- The sugar alcohols behind “sugar-free”. After 30 grams of erythritol the blood level rises more than a thousandfold – measured in ten people per …Erythritol and xylitol
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Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-09-22.