The Truth About Stevia and Fatty Liver Disease (Read This Before Buying)

Stevia is considered by many a miracle sweetener and a perfect sugar substitute, especially for those with a fatty liver. But because nothing is straightforward when it comes to your liver’s health, you need the full picture before making the switch.

Today, I will share the studies made on Stevia and its effects, as well as share my personal story and experience with Stevia as a sweetener.

The quick answer is that pure Stevia is considered generally safe in strict moderation and will not spike your blood sugar. But the types of Stevia blends you buy can change things, since recent research shows some popular mixes might do more harm than good.

So read on to be able to make an educated decision on this popular sugar alternative.

Contradictory findings of Stevia research

Plenty of research has been conducted on this sweetener, and all the original findings were more than encouraging.

Stevia was found to reduce fat levels and even fibrosis markers in fatty liver, therefore being considered safe and useful in the fight to reverse fatty liver. Using the natural Stevia extract showed improvements in the condition of those suffering from nonalcoholic fatty liver.

These findings followed a notable study conducted in April 2020. You can read everything about it here. The main idea, though, is this:

• Rebaudioside A (which is the Stevia extract) significantly improved liver function, reducing liver enzymes, hepatic steatosis, and hepatic fibrosis, compared to sugar consumption.

Other studies conducted by various other health experts and organizations had similar findings.

BUT there is one study in particular that had completely opposite findings to the aforementioned results. It is true, this one was made on mice, but that’s how most studies are done, at least in their initial stages.

You can read the entire study here, but the bottom line is that Stevia administration in mice increased their ALT and AST levels (which are two of the most important markers of liver function), as well as liver cholesterol levels and triglycerides in male mice.

This is pretty surprising, as all the other studies have had opposite results.

Almost everything I could find – from the first study I linked to above to reputable sources like WebMD or additional studies like this one – was praise for the benefits of the Stevia leaf extract and even potential health benefits.

The Broader Medical Consensus

In 2023, the World Health Organization (WHO) released a conditional recommendation advising against the use of non-sugar sweeteners, including Stevia, for long-term weight control.

They cited potential long-term risks like type 2 diabetes and cardiovascular issues, but I see it more like a warning saying that they don’t offer use a free pass to unlimited sweets. But you should read their recommendation fully and draw your ow conclusions.

To be fully honest and transparent, I managed to reverse my fatty liver before hearing about Stevia, so I haven’t personally tried it during my dieting days.

But after reversing my condition and learning about it, Stevia has become my go-to sweetener, alongside other sugar alternatives for fatty liver that I have mentioned.

It’s good to know both sides of the story, though, before making a decision. But in general, the experts agree that stevia extract and sweeteners using stevia are safe for humans, including those with a fatty liver disease.

So… Is Stevia good for fatty liver?

Stevia is a natural sweetener that is extracted from the Brazil- and Paraguay-native plant Stevia rebaudiana.

Unlike sugar and most other sweeteners, it has zero calories and, most importantly, it has no carbohydrates and therefore no effect on the sugar levels in our blood.

Excess carbohydrates (like the ones found in your regular sugar) are transformed by our liver in fat and stored for later use. But the modern society is consuming so many carbs, that our body just stores them continuously and never gets the chance to use them.

As a result, having an alternative to Stevia is extremely useful. This way, we can still satisfy our sweet tooth, but without all the CONs of using traditional sugar or other carbohydrate-rich ingredients.

In other words, pure Stevia can be considered a helpful tool and can support you as you win your fight against fatty liver faster.

While it is not a cure, nor a required ingredient to get well (I repeat – I reversed mine without using any Stevia), it’s good to know that you have this option, especially when replacing sugar is one of the toughest things we have to do when dieting.

It’s just like with chocolate: some types are considered OK in moderate quantities, but most chocolate on the market is bad for your health.

What are the side effects of consuming Stevia?

Stevia is considered generally safe, with very few people reporting minor side effects.

Stevioside has been safely used in research in doses of up to 1500 mg daily for 2 years and the most common side effects reported were bloating or nausea.

I also found out that there were some reports of dizziness, muscle pain, and numbness, but in all honesty, on our Fatty Liver Support Group on Facebook (with over 40,000 members), the worst side effect I saw mentioned is the slightly metallic aftertaste that Stevia leaves behind.

Some people, myself included, are not bothered at all by this and can’t even feel it, but others do.

The Erythritol (Potential) Problem

The most urgent update you need to know about buying sweeteners today is related to an ingredient that is usually paired with pure stevia extract, an ingredient that has been under a lot of criticism in recent years.

In the past, I recommended blends mixed with erythritol, based on the data that was available at that time. I ate those relatively often and even had a bag of erythritol at home to use as a sweetener. That is no longer the case.

I wrote in-depth about erythritol here, but the bottom line is that a major Cleveland Clinic study in 2023, and confirmed by further research since, links it to severe cardiovascular events like blood clots, heart attacks, and strokes.

This risk is especially high for people who already have metabolic risk factors, which include almost everyone with MASLD.

In other words, you should always be VERY careful with what you buy – many products labeled as “stevia sweetener” are actually mixed with this potentially unhealthy ingredient (and are rarely pure Stevia).

If you don’t want to search, here are two that are 100% pure (affiliate links below):

• This extract by Micro Ingredients (over 1,400 servings – so be VERY careful with the amount you add, as it is extremely sweet).
• 365 by Whole Foods Market

I have to repeat this: If you do get pure Stevia, read the label carefully. The Pure extract is extremely sweet (one tablespoon equals one cup of sugar), so add minimal amounts (follow the recommendations on the packaging carefully).

Are Truvia and Splenda good for fatty liver?

Truvia and Splenda are common names you will see at the grocery store, but you need to be very careful here. Since these are available in stores, they are considered safe, so I am not saying they’re not.

Know that traditional Splenda in the yellow packets is made of sucralose, an artificial sweetener known to potentially spike insulin and negatively alter your gut microbiome.

Splenda also has a specific “Stevia” product line, but read the list of ingredients, as it is usually mixed with other sweeteners.

Truvia, on the other hand, is made of Erythritol, Stevia Leaf Extract, and Natural Flavors – and that first ingredient is the one that alarm signals were raised against. So keep this in mind if you decide to choose it.

But, as I mentioned above, if you’re looking for an alternative, the best option is a 100% Pure Stevia extract.

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Wrapping up

Based on existing data that proves pure Stevia is safe for the liver, along with early studies linking it to improved metabolic results, I think we can safely assume it is an alternative you can add to your diet.

Now, I would personally advise against simply switching sugar with Stevia and continuing your old eating habits.

If you bake a cake with Stevia and still use all sorts of fat, white flour, chemicals, and flavorings, that would still be extremely unhealthy and not recommended. Just like it goes with eating pasta if you have MASLD, for example.

Use Stevia – just like any healthy sweetener – in moderation, only when you can’t really do without it. Moderation is key here until we have more studies and findings that would encourage us to consume more.

As I said, I managed to do just fine without it, and I reversed my fatty liver. But as soon as I found out about the pure extract, I started consuming it (and I’ve been having it for a few years already) without any problems.

And you should also consider the disturbing study mentioning the negative effects on mice, as well as the WHO guidelines. If you can do without it, it’s probably better.