Erythritol and Blood Clots: What the Latest Research Reveals

By Maya Richardson

July 25, 2025

Erythritol—a popular sweetener for decades—is the center of scientific debate. New research suggests a potential link between erythritol and the risk of blood clots, which can lead to serious cardiovascular events.

The wave of concerns about the health effects of erythritol poses a major challenge for the medical community and consumers. Understanding the effects and safety of this sweetener has become an urgent priority given the increasing incidence of cardiovascular diseases worldwide.

erythritol-blood-clots

New research links erythritol to blood clot risks, sparking safety and health concerns.

Background: What Is Erythritol?

Erythritol is no longer a strange name in the modern nutritional world. Appearing increasingly in "sugar-free" products, this sweetener is used by millions of people every day without even realizing it. The overwhelming popularity of erythritol raises the question: How does the body process it, and what is behind this sweet convenience?

Characteristics and common uses

Erythritol is a polyol – a sugar alcohol – found naturally in fermented fruits and produced commercially from glucose fermented by yeast. It provides a sweetness equivalent to 60–70% of cane sugar but contains almost no calories. Therefore, erythritol is preferred in keto, low-carb, and diabetic diets.

Absorption and metabolism in the body

After consumption, erythritol is rapidly absorbed in the small intestine and is largely excreted through the kidneys without being metabolized. This process has little effect on blood sugar, insulin, or the gut microbiota. However, this mechanism also makes erythritol a factor worth further study.

You can find more detailed information in the background article on erythritol here: "Effects of erythritol on human health".

The 2023 Study: Erythritol and Cardiovascular Risk

In 2023, a study published in Nature Medicine sparked concern among the medical community and consumers of the sweetener erythritol. Data collected from more than 4,000 adults in the United States and Europe revealed a potential link between blood levels of erythritol and the risk of thrombosis, a key factor in stroke and heart attack.

Increased platelet activity and blood clot formation

Scientists found that erythritol can increase the stickiness and activation of platelets, a key component of blood clots. When combined with preexisting cardiovascular risk factors, erythritol in the blood may promote adverse blood clotting.

Limitations and context of the study

This was a multicenter observational study, and a causal relationship cannot be established. However, the findings raise questions about the safety of seemingly harmless sweeteners, especially for people with underlying cardiovascular disease.

Understanding Blood Clots

Blood clots are not only a physiological phenomenon that protects the body from excessive bleeding, but also a silent threat to life if they occur in the wrong place or get out of control. When a blood clot forms inside a blood vessel and blocks the flow of blood, the consequences can be very serious: from stroke, myocardial infarction, to pulmonary embolism – all can happen in a split second.

Mechanism of formation and potential dangers

Blood clots form in three stages: vascular endothelial damage, platelet activation, and fibrin fixation. Many factors, including chronic inflammation, high cholesterol, and increased platelet activity, trigger this process. Once the clot moves to vital organs such as the brain or heart, the consequences can be irreversible.

Top Risk Factors

Older people, people with diabetes, people who are obese, or have a history of heart disease are at higher risk of developing blood clots. Sedentary lifestyles, smoking, and metabolic imbalances also contribute to the process happening more quickly and violently.

Is Erythritol a Direct Cause?

Following the publication of the 2023 study, the question of whether erythritol is a direct cause of thrombosis quickly became a topic of debate in the scientific community. When observational data showed that high erythritol levels correlated with a higher risk of serious cardiovascular events, experts began to trace the deeper connection between this sweetener and the coagulation system.

The link between erythritol and platelet activity

Lab experiments have shown that erythritol can promote platelet aggregation, a key step in the clotting process. In animal models and human blood samples, high erythritol levels increased the thrombosis rate, suggesting a true biological response.

Characteristics of the study group

Most study participants were elderly patients with multiple preexisting cardiovascular risk factors. Data suggest that erythritol does not exist in the physiological environment in isolation but interacts in a complex manner with the immune, metabolic, and hematological systems, facilitating clot formation.

What Health Authorities Are Saying

The scientific scrutiny of erythritol has forced global health organizations to reconsider their stance on the seemingly safe sweetener. While new studies raise questions about cardiovascular risks, public health officials are starting to make cautious statements based on the available evidence.

FDA and EFSA views

The US Food and Drug Administration (FDA) has maintained GRAS (Generally Recognized As Safe) status for erythritol, but has been closely monitoring emerging research. The European Food Safety Authority (EFSA) has also said there is insufficient evidence to change its safety standards, but recommends continued monitoring of long-term metabolic effects.

WHO and the way forward

The World Health Organization (WHO) is updating its guidelines on artificial sweeteners, with erythritol a key focus of its review. This reflects a clear shift in modern nutrition and metabolic non-communicable disease control strategies.

Who Should Be Cautious?

Not everyone reacts the same to erythritol. New data suggest a link between this sweetener and the risk of blood clots, so identifying the right group of people who should be cautious has become a preventive health priority. People with underlying cardiovascular or metabolic conditions are at higher risk when consuming erythritol regularly.

People with heart disease and blood clotting disorders

Patients who have had a heart attack, stroke, deep vein thrombosis, or a history of blood clotting disorders should be carefully counseled before using erythritol. In these conditions, the blood clotting system is already easily activated, and erythritol may be a catalyst that accelerates the formation of blood clots.

People with diabetes use it every day

Patients with diabetes tend to use erythritol instead of sugar to control blood sugar. However, consuming large doses each day – through packaged foods, sugar-free drinks, or supplements – can accumulate cardiovascular risks without adequate medical supervision.

How Much Erythritol Is Too Much?

The amount of erythritol consumed each day is not just a number—it is a factor that determines the metabolism, accumulation, and impact on each individual's cardiovascular system. A 2023 study noted that the concentration of erythritol in the blood reaches dangerous levels when absorbing about 30g in a meal—equivalent to the amount contained in two cans of "sugar-free" soft drinks. This raises urgent questions about the actual safety limit.

Consumption threshold from research data

Scientists found that just a few hours after consuming 30g of erythritol, the concentration of this substance in the blood can increase 1,000 times compared to the baseline level. This spike lasts more than 48 hours, creating favorable conditions for the formation of blood clots in people at high cardiovascular risk.

How to Control Daily Intake

Consumers should read product labels carefully, especially for "low-sugar" foods, sugar-free candy, protein powders, and packaged sweeteners. Keeping a food diary or using a nutrition tracking app can help proactively and accurately control the amount of erythritol consumed daily.

Alternatives to Erythritol

The rise of concerns about erythritol has forced many people to reconsider their sweet choices in their daily diets. Finding safe alternatives that do not affect blood sugar is a practical goal in controlling metabolic diseases and protecting the heart. Natural and clinically proven solutions are attracting strong attention.

Stevia - sweetener from the stevia plant

Stevia contains diterpene glycosides with a sweetening activity hundreds of times higher than cane sugar. It is not converted to glucose in the body and does not cause insulin fluctuations. Clinical studies show stevia can support long-term stable blood pressure and blood sugar control.

Monk fruit - natural monk fruit

Monk fruit extract contains mogroside, a zero-calorie sweetener with antioxidant properties. This sweetener is suitable for diabetics, vegetarians, and children.

Allulose – a bio-saccharide isomer

Allulose is a rare sugar with almost zero energy value. Preliminary data show that it does not increase triglycerides, does not activate insulin, and has little effect on the intestinal microbiota. Thus, it is a potential choice for those pursuing functional nutrition and metabolic safety.

Conclusion

Erythritol is a popular sweetener with many outstanding nutritional and calorie-control advantages. However, recent studies have opened a new perspective on its potential impact on the cardiovascular system, especially related to the risk of blood clots.

Understanding the mechanism of action, limits of use, and groups of people who need to be cautious is essential to protect long-term health. Consumers should closely monitor the amount of erythritol absorbed and consider choosing safer alternative sweeteners.

For a more comprehensive view of erythritol's safety, refer to the in-depth article "Is Erythritol Safe?" to make informed decisions for yourself and your family.

FAQs on Erythritol and Blood Clots

Frequently Asked Questions (FAQs)

  • Does Erythritol Cause Blood Clots? – 2023 research suggests that erythritol may increase platelet activity, promoting thrombosis, especially in people with existing cardiovascular disease, but a clear causal relationship has not been established.
  • Should the average person be concerned about erythritol? – Healthy people who consume erythritol in reasonable doses usually do not experience serious problems. However, consumption should be monitored to limit accumulation and potential long-term cardiovascular risks.
  • Are the FDA and EFSA changing their recommendations on erythritol? – Currently, the FDA and EFSA maintain erythritol as generally recognized as safe under the GRAS standard, and continue to monitor new studies to update appropriate recommendations shortly.
  • Who should limit or avoid erythritol? – People with a history of heart disease, blood clotting disorders, diabetes, and those who use erythritol daily should be cautious and consult a specialist to ensure long-term health safety.
  • Which erythritol alternatives are considered safe? – Stevia, monk fruit, and allulose are natural, zero-calorie sweeteners with clinical evidence to support blood sugar control and a low impact on the cardiovascular system. They are suitable for people who need a safer choice.
Article by

Maya Richardson

Maya overflows with a passion for writing and researching health. Her deep love of words and her endless curiosity helps Maya to empower those around her with invaluable information about a healthier lifestyle.

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