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?
I am updating this article once again in late July 2025, after finding new information about this already-controversial sweetener. This new finding, combined with what we already knew, changes the situation and convinces me to stop consuming erythritol, just to be on the safe side.
Read on to find out why and make an educated decision for your particular situation.
The controversy & potential risks regarding erythritol
Back in March 2023, an article on CNN made waves, as it brought to attention the findings of a study by the Cleveland Clinic Lerner Research Institute: according to the research, erythritol has been linked to blood clotting, stroke, heart attack and death.
Because the study was made on people already suffering from various conditions and already at risk for heart-related problems, I didn’t consider it a solid enough reason to stop consuming it, as I wasn’t in that category.
But things have changed now, as a more recent study, from the University of Colorado, found that erythritol, at typical levels found in “sugar-free” drinks, may harm the cells lining blood vessels in the brain. These changes could contribute to an increased risk of stroke, supporting concerns raised by recent human studies.
Because, yes, this study hasn’t been made on humans, but in lab dishes. Also, it only looked at short-term effects, not long-term usage potential effects.
And, no matter how you put it, this is scary. As a result, I am no longer consuming erythritol starting today and I am no longer recommending it as a healthy sugar alternative.
Yes, additional research is required, but until that is ready and a clear conclusion is drawn, I don’t want to risk anything – not when there are already plenty of great sugar alternatives out there, without these potential risks. Of course, you are free to do as you feel, after talking to your doctor.
If you want to read the original article published on this website, read on – but keep in mind the findings above! I tried to edit it a bit to update my voice and opinion based on the latest findings.
PS: As you can see, I am doing my best to always stay up to date and informed about the latest findings related to fatty liver disease. If you want to support me, please consider joining my Patreon.
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 sweet, it is almost calorie-free, and helps you deal with sugar cravings and potential sugar level 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.
What is Erythritol?
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.
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, and that stands at the moment of updating the article, despite the findings of the recent studies.
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?
Erythritol is considered to be safe for the human body and safe for fatty liver as well.
As a result, most people choose to 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. This is interesting, as it contradicts the recent findings of the studies I mentioned in the article’s opening.
The results might still be a bit off and require more research, as the ones claiming benefits have only been made on animals or very small numbers of patients.
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, but play it safe. There are other options out there, so it’s not worth risking it, imho. Let me know what you think by commenting below.
Additional references: Wikipedia, Healthline, WebMD.
I was diagnosed with a fatty liver in 2014 and reversed it by mid-2015 through diet & lifestyle changes. Since then, I’ve been studying this condition continuously, keeping up to date with the latest scientific findings and practical approaches.
My articles are based on medical studies and my direct, personal experience reversing this condition. Now, I am the published author of the top-rated book, “From Fatty Liver to Healthy Liver”.
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…