Erythritol is one of the most common sugar substitutes out there, and when you’re dealing with fatty liver disease and trying to cut down carbs to speed up your recovery, it feels like a match made in heaven. But is it really that good and, most importantly, safe for the liver?
While I used erythritol regularly (and still do), when CNN highlighted a potential link between high erythritol levels and heart attack and stroke risk in March 2023, I had to pause and look closer.
Today, we will see why erythritol remains a safe option for most people looking for a great sugar alternative, and when you should avoid it.
Because even the aforementioned study was made on people already suffering from various conditions and already at risk for heart-related problems.
Why Sugar Alternatives Like Erythritol Matter for Fatty Liver
Non-alcoholic fatty liver disease (NAFLD – now MASLD) thrives on excess carbs and sugars. By lowering (or ideally eliminating) your added sugar intake, you ease the liver’s workload in processing simple sugars and reduce fat buildup.
Erythritol is perfect because it’s sweet, it’s considered healthy and generally safe, it is almost calorie-free, and helps you deal with sugar cravings and potential sugar levels spikes in your blood.
To get a clearer picture of how much sugar you should consume daily, I recommend checking my previous article on how much sugar you should have.
Why Is Erythritol Better Than Sugar?
Erythritol is a sugar alcohol – but despite its name, it has nothing to do with actual alcohol, meaning that you can’t get drunk from it, nor will you get any of the alcohol’s side effects.
Which is again good, as you should stop drinking alcohol if you have NAFLD.
When you consume erythritol, about 90 percent of it is absorbed in your small intestine and passes into the bloodstream without being broken down.
This means that your liver barely touches it. Minimal hepatic metabolism means erythritol doesn’t contribute to new fat creation in the liver, making it a great choice.
Also, your sugar levels won’t spike, and erythritol will be processed by your kidneys, which will filter it out and excrete it unchanged in urine within 24 hours.
About 10 percent of it reaches the colon, where it can draw water and ferment, potentially causing gas or loose stools – but only if you overdo it.
However, there are some people who are naturally more sensitive to it, so if it causes discomfort, it might be best to avoid it and find other alternatives like Stevia.
Note: I recommend Anthony’s Confectioner’s Erythritol (affiliate link) if you decide to use this sugar alternative in your diet. I like it a lot, looks like sugar, but it’s not. Ha!
Erythritol has been around for a long time since it is a natural sugar – it was officially discovered back in 1848 – although it started to be produced as a sugar substitute in the 1990s.
In 1997, the U.S. Food and Drug Administration officially confirmed that it is safe to consume.
All in all, it has around 70% of the sweetness of the sugar, with no effect on the blood sugar levels though and with just 0.24 calories per gram (compared to 4 calories per gram from sugar).
So… Yay or Nay?
Despite the recent study that I’ve talked about in the intro, erythritol is considered to be safe for the human body and safe for fatty liver as well.
As a result, most people can safely consume it as a sugar substitute as long as they don’t get more than 0.45 grams of erythritol per pound of body weight per day.
This means that a person with a weight of 150 pounds (around 69 kilograms) shouldn’t consume more than 5 tablespoons of erythritol per day. A level teaspoon contains about 4 g of erythritol – keep this in mind for measuring in the future.
Even more, some studies (linked to below in the References tab) also claimed that it has actual health benefits: it acts as an antioxidant in the blood, protecting the blood vessels and potentially reducing the risk of heart disease.
While these studies were made on animals or very small amounts of patients, their results are still encouraging and sound amazing: something sweet AND healthy? Perfect!
Bottom line: Until we have large, long-term trials in healthy and at-risk individuals, treat that heart-risk signal as a heads-up rather than a verdict and, unless it seems to cause side-effects, consume it in moderation unless your doctor instructs you otherwise.
References: Wikipedia, Healthline, WebMD.
I was diagnosed with a fatty liver back in 2014 and managed to reverse it by mid-2015. Since then, I’ve been studying it, continuously updating my knowledge with the latest scientific findings and practical approaches to give others the help they need to reverse their condition.
My approach to managing fatty liver is holistic, balancing scientifically-backed information with real-life, practical advice based on personal, direct experience.
I am also the admin of the Fatty Liver Support Group on Facebook and the Fatty Liver Subreddit.
I was advised of the possible harmful effects of Erythritol and Xylitol. NIH will tell you it may cause heart attacks. The simple fact that CNN announced it, I say it’s false. And if NIH has changed their viewpoint since I was last on there a couple weeks ago, I will have the same comment. I have a good feeling about either of them. So I will continue using both.
Exactly my thoughts when I saw the study was published by CNN. Instant discredit…